Children’s concussion clinic for Cork

A clinic for treating concussion in children is set to open at the Bon Secours Hospital in Cork, at a time of rising concern about the long-term impact of such an injury.

However, paediatric neurologist, Dr Niamh Lynch, who will operate the clinic, said that, contrary to popular opinion, the majority of concussion does not occur on the sports field, but on foot of a fall and a bang to the head.

“In terms of the most common cause of concussion, there is none. The majority of children I treat haven’t been near a sports pitch. They have fallen over and banged their head,” she said.

The focus on rugby as the prime cause of concussion was misguided, she said. “The focus should be on the concussion, and getting it diagnosed, to avoid the more serious effects of second-impact syndrome. If a child falls in the school yard, and hits their head, on a Wednesday, and gets a second blow to the head playing a match the following Saturday, they could be in serious trouble. It’s very important that the concussion is diagnosed after the first blow,” Dr Lynch said.

A single concussion is not usually dangerous, but a second, within a short timeframe, is, due to the danger of ‘second-impact syndrome’. Failure to diagnose multiple concussions could lead to post-concussion syndrome, which leaves the victim with “the prolonged feeling of being in a fog”, as well as potentially affecting movement and balance. These symptoms could persist for more than a year, Dr Lynch said.

She also warned parents that safety helmets worn by children would not prevent concussion.

“They prevent fractures and lacerations, but not concussion. They don’t absorb the impact, they diffuse it,” she said.

She was also critical of the practice of allowing children to decide if they were fit to continue playing after a blow to the head.

“Very commonly, the child is asked ‘Are you ok to play on’? A child is not in a position to make that decision. Parents shouldn’t be afraid to insist that they leave the field of play,” Dr Lynch said.

The new clinic, set to open after the Easter holidays, will run on a Tuesday, so that weekend injuries can be seen quickly. “Under my normal room-referral system, patients may have to wait for an appointment. The clinic will allow more rapid access. The child will be neurologically assessed, and if I pick up anything unusual, they will be sent for an MRI on the day,” Dr Lynch said.

Symptoms of concussion can include headache, vomiting, dizziness, sleep disturbance, a heightened emotional state, confusion, and possible amnesia around the event that caused the concussion, Dr Lynch said.