The long-lasting effects of concussion on the brain have become increasingly evident in recent years, highlighted by scientific research. Much of that research relates to traumatic brain injuries (TBIs) sustained during adult contact sports. When it comes to kids, though, there can be a fair bit of inadvertent head-bumping outside the sporting field.

New research led by the University of Tampere in Finland has investigated how a TBI sustained during childhood can negatively impact adult education.

"A mild, single concussion is often considered a relatively harmless event, but our research suggests that it can have long-term effects on learning and cognitive abilities," said Julius Möttönen, a doctoral researcher at the University's Faculty of Medicine and Health Technology and the study's lead and corresponding author. "This should get more attention in both healthcare and schools."

A TBI is defined as brain damage or a disruption to brain function caused by a sudden external force. Based on clinical findings and brain scan results, it is usually categorized as mild, intermediate, or severe. According to a 2023 study, the incidence of mild pediatric TBI (pTBI) increased in Finland between 1998 and 2018.

For the current study, the researchers obtained data on all zero-to-17-year-old pTBI patients from the nationwide Finnish Care Register for Health Care who'd attended an emergency department or been hospitalized for an intracranial injury, according to ICD-10 classification codes. Those patients were categorized as either concussions or more specific intracranial injuries based on brain imaging findings, and they were compared to a reference group of children with limb injuries (broken ankles and wrists), which was "designed to mimic similar risk-taking behavior as those patients with TBI."

In Finland, education is compulsory, usually from age seven until the end of secondary education, and generally takes nine years to complete. It takes at least 25 years from birth to reach the highest tertiary education (a licentiate or doctoral degree), and most men complete up to one year of conscription at 19 before starting their tertiary education. For this reason, the researchers excluded patients under 26 at the end of follow-up as they wouldn't have had time to complete a full education. The researchers divided patients' education into three levels: upper secondary education (12 years of education), lower tertiary education (15 years of education), and higher tertiary education (more than 17 years of education). All education in Finland is free.

Of the 136,828 pediatric patient records initially retrieved from the Finnish Care Register, 24,039 contained information about higher education in patients aged over 26. From that number, the pTBI group totaled 8,487, and the reference group totaled 15,552. The mean age at the time of injury was around 13 in both groups. Of all the patients in the pTBI group, 89.5% had a concussion, and 10.5% had a specific intracranial injury, such as bleeding in the brain.