Zusammenfassung
Die Gehirnerschütterung ist eine noch häufig unterschätzte Verletzung, die mit länger andauernden Folgeproblemen vergesellschaftet sein kann. Im Vergleich zu Erwachsenen ist die Erholungsphase gerade im Kindesalter häufig verlängert. Primär erfolgt eine körperliche und geistige Belastung symptomatikabhängig. Der Reintegration in den Alltag kommt entscheidende Bedeutung zu. Im Kindesalter muss somit primär auf eine Wiedererlangung der Schulfähigkeit fokussiert werden. Dabei ist ein Neuauftreten oder Wiederauftreten von Symptomen dringend zu erfassen, da sonst ein längerer prolongierter Heilungsverlauf möglich ist. Schulische Einschränkungen sind auf ein Minimum zu reduzieren. Entsprechende Konzepte sind in Nordamerika bereits umgesetzt. Für Deutschland sind derartige Konzepte bisher nur unzureichend etabliert. Neben den für die sportliche Wiedereingliederung bestehenden Return-to-Play-Protokollen ist dringend eine schulische stufenweise Wiedereingliederung sinnvoll und zu fordern.
Dazu müssen akademische Anpassungen und Unterstützungen etabliert werden sowie symptomorientierte Organisations- und Unterrichtsmodifikationen umgesetzt werden.
Abstract
Concussion injury of the brain is still a frequently underestimated injury, which can be associated with long-lasting consequences. Compared to adults, the recovery phase is often prolonged in childhood. Primary treatment consists of symptom-dependent physical and mental activities. Re-integration into daily life is crucial. In childhood, the primary focus is therefore on returning to school. New symptoms, or an increased presence of symptoms must be detected, to avoid prolonged recovery courses. School restrictions have to be minimized. Corresponding concepts are already implemented in North America. Comparable concepts are not established in Germany. In addition to well-known standard return-to-play protocols for sport re-integration, it is urgently recommended to integrate gradual return-to-learn protocols.
Thus, academic adaptations and support must be established as well as symptom-oriented organizational and teaching modules.
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A. Gänsslen, T. Neubauer, C. Hartl, N. Moser, E. Rickels, H. Lüngen, M. Nerlich und W. Krutsch geben an, dass kein Interessenkonflikt besteht.
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Gänsslen, A., Neubauer, T., Hartl, C. et al. Schulische Reintegration nach kindlicher Gehirnerschütterung. Unfallchirurg 120, 442–448 (2017). https://doi.org/10.1007/s00113-017-0317-2
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DOI: https://doi.org/10.1007/s00113-017-0317-2