Searching for treatments for childhood’s ‘silent injuries’

Concussions sustained in high-profile contact sports have raised awareness of the major health issues surrounding adult brain injuries.

There has been significantly less public discussion about how such injuries impact the developing brain.

A fall in the playground or a knock playing sport are common causes of concussion for children and adolescents.

There are usually no outward signs of injury, and most kids recover quickly and are back to normal within a month.

However, for up to a quarter of such injuries, recovery is much slower and symptoms linger.

This ‘post-concussion syndrome’ can result in serious headaches, impaired concentration and changes to mood and sleep patterns, which can impact schooling and other aspects of life.

Paediatric neurologist Associate Professor Karen Barlow started out researching severe traumatic brain injuries.

“Much to my surprise, 90 per cent of referrals to the program were children with post-concussion syndrome,” she says.

“They eventually recover, but it can take a very long time. This sparked my passion for investigating better treatments for post-concussion syndrome.”

Associate Professor Barlow has moved to Brisbane from Canada to take up a joint clinical and research appointment.

Her time is shared between treating traumatic brain injuries at Lady Cilento Children’s Hospital, and pioneering research to improve the care and outcomes for these patients.

She looks forward to working with Queensland’s paediatric brain injury rehabilitation program and establishing links throughout Australia and overseas.

As Associate Professor Barlow explains, for young people with post-concussion syndrome, there are currently few evidence-based treatments.

“We have moved on from the old ‘rest in a dark room’ approach, and understand that a healthy diet, regular sleep and a return to exercise need to be part of the recovery process."

Associate Professor Karen Barlow

"There is a lot we can do without drugs, but some children will need medication.”

The paediatric neurologist is analysing results from a small clinical trial into the use of melatonin for post-concussion syndrome.

“Melatonin is a hormone produced in the brain with analgesic and neuroprotective properties,” she explains.

“It also has a good safety profile, which makes it a good candidate for use in young people.”

Raising awareness of the syndrome is another priority.

Her team at the University of Calgary developed a website and electronic tools to guide parents and teachers through the recovery process.

“We wanted to provide a clearer pathway for managing these children, who have no outward signs of injury, but can be really struggling and not feeling themselves.”

It is hoped a modified version will be piloted in Brisbane.

This story is featured in the Summer 2017 edition of UQMedicine Magazine. View the latest edition here. Or to listen, watch, or read more stories from UQ’s Faculty of Medicine visit our content hub, MayneStream.