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Schulische Reintegration nach kindlicher Gehirnerschütterung

Die Rolle des Unfallchirurgen

School re-integration after child brain dislocation

The trauma surgeon’s role

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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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Authors and Affiliations

  1. Klinik für Unfallchirurgie, Orthopädie und Handchirurgie, Klinikum Wolfsburg, Sauerbruchstr. 7, 38440, Wolfsburg, Deutschland

    A. Gänsslen

  2. Unfallchirurgie, Landesklinikum Horn, Spitalgasse 10, 3580, Horn, Österreich

    T. Neubauer

  3. Unfallchirurgie, Landeskrankenhaus Steyr, Sierninger Str. 170, 4400, Steyr, Österreich

    C. Hartl

  4. Verwaltungs-Berufsgenossenschaft, Bezirksverwaltung München, Postfach 20 20 42, 80020, München, Deutschland

    N. Moser

  5. Klink für Unfallchirurgie, Orthopädie und Neurotraumatologie, Allgemeines Krankenhaus Celle, Siemensplatz 4, 29223, Celle, Deutschland

    E. Rickels

  6. ZNS – Hannelore Kohl Stiftung, Rochusstr. 24, 53123, Bonn, Deutschland

    H. Lüngen

  7. Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland

    M. Nerlich & W. Krutsch

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  1. A. Gänsslen
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Correspondence to A. Gänsslen.

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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.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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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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