Why Are Kids at Greater Risk of Sports Concussion than Adults?

Dr. Robert Cantu explains why the brains of children are more vulnerable to concussion — from nerve fibers in the brain that are more easily torn apart to the size discrepancy between their large skulls and little necks.

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[Dr. Robert Cantu] Well children, especially young children, are much more vulnerable to brain injury than adults for a given acceleration force. Children's brains are largely not myelinated. That's the coating of nerve fibers. It helps transmission, but it also gives strength. So nerve fibers in children are more easily torn apart. Nerve fibers in children also are more accelerated from the standpoint of the brains in the children are lighter in weight. So it takes less acceleration to put that brain in motion than the heavier brain of an adult. The brains of children are also housed in disproportionately large skulls. The skull of a child by the age of five has reached about 90% of an adult skull diameter, but those big skulls are on very weak necks, and so that bobblehead doll effect also sets up the youth brain to have greater injury. The metabolic cascade of concussion, the excitotoxic shock issue, is more easily put in play in children than it is an adult. That's another risk factor for children. Children tend to have, as a group, older equipment, coaches that are much less experienced than adults, and of course kids don't have informed consent. So there are a lot of things going on that puts kids at greater risk than adults.
Posted on BrainLine August 30, 2013.

Produced by Noel Gunther and Erica Queen, BrainLine.

About the author: Robert Cantu, MD

Robert Cantu, MD is chief of Neurosurgery Service, chairman Department of Surgery, and director of Sports Medicine, Emerson Hospital; clinical professor, Department of Neurosurgery, and co-director, Center for the Study of Traumatic Encephalopathy, Boston University School of Medicine.

Dr. Robert Cantu