During 2011, a traumatic brain injury (TBI) was sustained by 4,641 people in Oklahoma. From this number, the age group of 0 – 14 years of age accounts for 55 percent of TBI-related emergency department visits (according to the Oklahoma Department of Health, 2011).
From 2000 through 2006, a total of 665 children ages 0-4 were discharged from Arkansas hospitals with TBIs. Between 74 and 115 hospitalizations occurred annually, an average 95 of children per year (Arkansas Department of Health). From 2000 through 2006 a total of 898 children ages 5-14 were discharged from Arkansas hospitals with TBIs. Between 110 and 160 hospitalizations occurred annually, an average of 128 of children per year.
The Centers for Disease Control and Prevention estimate that 37,000 children ages 0-14 receive brain injuries severe enough to require hospitalization each year in the United States.
“In rural communities, falls/jumps are the primary cause of mild traumatic brain injuries, including concussions, for youth ages 14 and younger,” said Maureen Cunningham, CFRE and executive director of the Brain Injury Association of Missouri. “This rate is 64 percent of the 97 mild traumatic brain injuries that required emergency care or hospitalization in 2011. Being struck by or against an object is 10 percent of mild traumatic brain injuries in rural communities, along with motor vehicle traffic crashes causing another 10 percent of mild TBI in rural communities.”
Cunningham added, that for youth ages 15 to 24, being struck by or against an object jumps to 44 percent of the mild traumatic brain injuries that require emergency care or hospitalization.
“A simple definition of a concussion is a bump, blow or jolt to the head or body that interrupts the normal operation of the brain,” Cunningham said. “Notice that the impact does not have to be to the head, it can be to the body causing the head to move rapidly with the brain bouncing around inside the skull – and causing the change in the operation of the brain.”
“Most people associate concussions with athletics or sporting events, but due to the nature of the work, farm and ranch youth are at risk,” said Karen Funkenbusch, instructor of Agricultural Systems Management, rural safety and health specialist for the University of Missouri Extension, and director of the Missouri AgrAbility Program. “Slips, trips, and falls are common hazards that can cause a concussion. Additional risk factors include equine activities, working with livestock, working with heavy tools and equipment, making repairs in tight spaces or under raised equipment, and working in an ever-changing environment with low visibility.”
“The signs and symptoms of a concussion, which is a mild traumatic brain injury, can affect one or more area of functioning such as: cognitive functioning, physical abilities, perceptions and psychological/emotional,” Cunningham said.
The signs most often associated with concussions are headache and nausea. The youth may also experience balance and vision issues, run slower or not steady, or report blurry or double vision.
“The key to identifying a potential concussion is a change in the person,” Cunningham said. “For example, the change in sleep patterns or personality, the youth appearing to walk or run unsteady, or the youth taking longer, than normal, to respond to a question or request.”
“Youth are at greater risk of sustaining a concussion and can take longer to fully return to normal activities, but prevention is the same,” Cunningham said. “There should always be caution such as wearing a helmet when riding an ATV or riding a horse for work or recreation, Cunningham added. Seatbelts have proven to be effective in preventing death and brain injuries in cars and trucks.”
A concussion is a mild traumatic brain injury. And most individuals will fully recover from a concussion. “However, once you have one concussion you are at greater risk of sustaining an additional concussion,” Cunningham said. “With each concussion, the risk increases. Symptoms are often worse and last longer with each concussion.”
Most concussions occur without a loss of consciousness.
Recognizing the signs and symptoms of a concussion is important to recognize potential concussions and reduce the risks of additional concussions or potential long-term effects of multiple concussions.
“Reducing the risk of concussions from recreation, sports and work on the farm is important,” Cunningham said. “But it is essential to know that every fall, bump, collision or injury does not result in a concussion or a more severe brain injury.”

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