Trying to incorporate minor head injuries into studies is often more difficult than making a study of severe head injuries, doctors in many different areas note. Death and very severe injuries are noted by hospital records. When a minor head injury occurs with other more serious injuries, the head injury is often left out of reports. Concussions fall into this category.
The problem of insufficient documentation is worse in rural areas. Most minor head injuries go unreported there because people don’t bother to visit an Accident and Emergency department. When a hospital is involved, there are often a number of medical professionals that attend to the injury, including neurosurgeons, general or orthopedic surgeons, neurologists, geriatricians, and primary care physicians.
A Health Interview Survey study of USA households showed an annual estimated rate of head injury of 6 per 1000 of the population, but it also included facial injuries. Actual head injuries would probably be somewhat less than this, many studies on this subject note.
There is also dispute over just what ‘minor head injury’ means. Three different studies use three different definitions of the term. Something like the Glascow Coma Scale is very useful for severe injury, but does not work very well when it comes to lesser injuries. Level of consciousness does not always directly correspond to the severity of a head injury, either.
Observers in hospitals in Long Island and Manhattan have learned that minor head injury is all too often underestimated. It deserves more attention from investigators and health planners. While it is rare to have some sort of extended disability from a minor head injury, there can still be consequences that cause loss of productivity and quality of life.
Concussions are often underestimated in terms of their seriousness. This has become apparent recently in sports. Football has become very aware to the seriousness of concussions and is taking many steps to eliminate the bad effects which can show themselves later in life.