Head injuryRecent research published in the journal PLOS Medicine suggests even mild head injuries during childhood can increase the risk of mental illness, low educational attainment and early death.

Data collected from more than a million people born in Sweden between 1973 and 1985 found that around 9% of the cohort had suffered a traumatic brain injury (TBI) before the age of 25. More than three-quarters of these cases were classified as mild injuries. Researchers followed these 100,000 or so individuals up until age 41, comparing their life outcomes with those of others who hadn’t suffered a head injury, including unaffected siblings.

After factors such as age and sex were taken into account, it was determined that those who had suffered a TBI were 76% more likely to receive a disability pension, 58% more likely to have failed to gain secondary school qualifications and almost twice as likely to have been admitted to hospital for psychiatric reasons, compared to those who hadn’t sustained a head injury. TBIs also increased the likelihood of an early death by 70%.

When looking at those who had sustained at least one TBI and their siblings who hadn’t done so – of which there were almost 70,000 – the researchers found similar but less dramatic results, suggesting that genetics could also play a role in the development of the aforementioned health and social issues.

One of the authors of the study, the University of Oxford’s Professor Seena Fazel, commented on the findings: “Our study indicates far-reaching and long-term consequences of head injury. It reinforces what we knew already -- that prevention is key. As the data only included hospital admissions for head injury, and therefore didn't take into account less severe accidents many children have that go unrecorded, these are likely conservative estimates of the scale of the problem.

“Existing work to prevent head injuries to young people in sports, for example, needs to be enhanced. However, we cannot prevent every injury. Long-term follow-up could identify negative effects so that early intervention can prevent a drift into low attainment, unemployment and mental illness.”

Lead researcher Dr Amir Sariasian added: “We found even a single mild traumatic brain injury will predict poor adult functioning. The risk will increase with severity and recurrence and older age at first injury.”

Although TBI is the leading cause of disability and mortality in children and young adults, the researchers pointed out that the chance of experiencing such an event is low and avoiding risk completely is not recommended, citing the benefits of exercise and an active lifestyle. The team did assert that more should be done to prevent young people from experiencing head injuries, and that any problems arising from them should be picked up early on.

“[Design of] playgrounds, helmets, the use of helmets, even certain rules in certain collision sports may need to be thought about,” said Professor Fazel, who also stressed the importance of road safety and the danger of drink driving, with traffic accidents being a common cause of head injuries in young adults.

The NHS advises parents to take their child to A&E if they suffer a head injury and exhibit any of the following symptoms:

  • Loss of consciousness, however brief
  • Memory loss, such as not being able to remember what happened before or after the injury
  • Persistent headaches since the injury
  • Changes in behaviour, such as irritability, being easily distracted or having no interest in the outside world (this is a particularly common sign in children under five)
  • Confusion
  • Drowsiness that occurs when they would normally be awake
  • Loss of balance or problems walking
  • Difficulties with understanding what people say
  • Difficulty speaking, such as slurred speech
  • Problems with reading or writing
  • Vomiting since the injury
  • Problems with vision, such as double vision
  • Loss of power in part of the body, such as weakness in an arm or leg
  • Clear fluid leaving the nose or ears (this could be cerebrospinal fluid, which surrounds the brain)
  • Sudden deafness in one or both ears
  • Any wound to the head or face