HAPPY SUMMER! It’s time again for our semi-annual newsletter. Thanks to all of you who have been so supportive of this practice. I have remained the busiest private practice pediatric neurosurgeon in the US due to your strong support. We appreciate the opportunity to care for your children. Please let me know if there are any recommendations you have to facilitate patient referral or care. In order to better coordinate referrals, a business card is enclosed.

I would like to take this opportunity to remind everyone summer is trauma season for children. As many of you already know, I wrote a recent chapter on severe head injuries (PATHOPHYSIOLOGY AND TREATMENT OF SEVERE HEAD INJURIES IN CHILDREN in PEDIATRIC NEUROSURGERY p. 355-379, 1999). We continue to work with the American Association of Neurological Surgeons to coordinate research efforts and bring the most current treatment to the children of Central Florida.

It is estimated that 300,000 children/year suffer a concussion. There are more than 5 different “concussion” definitions, although most of us agree that a concussion is a temporary alteration in level of consciousness, without radiographic abnormality. I would make the following recommendations:

• If a child has an altered mental status for >30 seconds, they should have a head CT.
• If the CT is normal, they should refrain from contactsports, bicycle riding, or any activity in which they may strike their head again, for at least 3 weeks.
• After that, they should be evaluated by a physician prior to returning to their routine activities. There is data to suggest that a second concussion, within 3 weeks of the first, can lead to permanent neuropsychological sequellae, e.g. memory and concentration.

Interesting trivia: What sport accounts for the most pediatric head injuries requiring admission to Central Florida hospitals?

A: golf(more than all other sports combined)! The usual injury is the child getting too close to some one swinging a golf club.