Sustaining a head injury may make young people more prone to violent behavior in the future, according to a new study.

Furthermore, young people who suffered a recent head injury (within the year) were the most likely to report violent behavior.

The study, conducted by University of Michigan researchers, is one of few that has examined the long-term effects of head injuries in the young adult population.

While the media has focused its attention as of late on youth, college and professional athletes who suffer head injuries and concussions while playing, researchers insist the study has a broader focus.

“These are not necessarily sports-playing injuries,” said lead author Sarah Stoddard, a research assistant professor at the School of Public Health and  research fellow at the U-M School of Nursing, in a press release. “They could be from a car accident or from previous violent behavior, but it does support some of the sports research that’s been going on with concussions.”

The data from the study was compiled from over eight years of research that came from following a large group of ninth-graders in Michigan into young adulthood.  In the fifth and sixth years of study, the participants were asked if they had ever suffered a head injury.

Those who said yes (23 percent) reported more violent behavior in the eighth year of the study.

Additionally, injuries reported in the seventh year were an even stronger predictor of violence in the eighth year.

“We found that the link between a head injury and later violence was stronger when a head injury was more recent, even after controlling for other factors including previous violent behavior,” Stoddard said.

Head injuries were defined in the study as having been knocked unconscious or sustaining a concussion or fractured skull.

An estimated 1.7 million people suffer from head injuries or traumatic brain injuries (TBI) each year – though this number only includes people who get medical care.  About three-quarters of the injuries are mild and therefore do not get medical attention, but doctors say any TBI disrupts brain function.

Long-term impact can include changes in cognition, language and emotion, including irritability, impulsiveness and violence.

The study was published in the journal Pediatrics.

As the summer days pass by, it gets harder to maintain a schedule with your families enjoying some much-needed down time. A break from the stress of your busy school-year schedules is necessary, but too much time without exercising the brain can be detrimental to your child’s academic health.

This is why it is important to attend to your child’s summer reading list starting now. Most middle and high schools choose one or two required readings and allow for some independence with a suggested reading list. This is a great opportunity for your child to get introduced to a new author or genre he or she may not have known before. In addition to developing a love of reading, children in these grades will likely be tested on material read or be expected to write a response to the text.

You can help your child maintain information about the stories by giving her a journal in which to take notes, reading the book with her, and having weekly discussions with her to ensure she comprehends the material. You may also want to celebrate the completion of books with a special reward, such as a little extra money to spend back-to-school shopping or a family movie night. However you do it, supporting your middle school or high school age child in their summer reading will ensure her school year gets off to a great start.

A new study indicates there may be an increased risk of automobile crashes among teenage drivers who start school earlier in the morning.

Researcher analyzed the crash rates of students who attended high schools in two Virginia school districts, Virginia Beach and Chesapeake.  In Virginia Beach, high school classes began at 7:20-7:25 a.m. –  over an hour earlier than the adjacent Chesapeake district, where classes began at 8:40 – 8:45 a.m.

The weekday crash rate for teen drivers in Virginia beach was 25 percent higher (80 crashes for every 1,000 students) than the rate for teen drivers in Chesapeake (64 crashes for every 1,000 students).

Researchers said traffic congestion was similar for both cities and unlikely to have accounted for differences in crash rates.

“We were concerned that Virginia Beach teens might be sleep restricted due to their early rise times and that this could eventuate in an increased crash rate,” said lead author Robert Vorona, MD, associate professor of internal medicine at Eastern Virginia Medical School in Norfolk, Va, in a press release.  “We are planning to perform subsequent studies to follow up on these results and to investigate other potential ramifications of early high school start times.”

According to the American Academy of Sleep Medicine, the average teen needs a little more than nine hours of sleep each night.  However, chronic sleep restriction is a common problem among teens because biological changes that occur during adolescence shift the onset of sleepiness later in the night.

Researchers believe the delay can make it a challenge for teens to get enough sleep when they have to wake up early for school.

Vorona suggested that starting high school later in the morning may promote driver alertness and potentially decrease crash rates by allowing teens to get more sleep at night.

“We believe that high schools should take a close look at having later start times to align with circadian rhythms in teens and to allow for longer sleep times,” he said.  “Too many teens in this country obtain insufficient sleep. Increasingly, the literature suggests that this may lead to problematic consequences including mood disorders, academic difficulties and behavioral issues.”

Previous studies have shown that delaying school start times by one hour could also enhance students’ cognitive performance by improving attention and increasing rate of performance, as well as reducing mistakes and impulsivity.

The study was published in the Journal of Clinical Sleep Medicine.

Some stories are harder to report on than others.  As a doctor and a father, I can assure you that any story involving the death of a child is the most difficult – especially when that death may have been preventable.

This may have been the case for Wes Leonard, the 16 year-old basketball star from Fennville High School in Michigan.  On Thursday night, Leonard scored the game-winning shot to conclude a perfect season shortly before collapsing on the school court.  He was rushed to Holland Hospital, but attempts to revive him were unsuccessful, and Leonard was pronounced dead at 10:40 pm.

By all accounts, Leonard was a healthy, disciplined student athlete who ate properly and lifted weights in his spare time.  Not only was he the top scorer on his basketball team – in fact, he had surpassed 1000 career points in a previous game – he was also the quarterback for the school football team.

But, as I often warn people, it can be impossible to know what may lie under the surface without the proper tests.  If Fennville is like most high schools in America, they likely require student athletes have a yearly physical on file, but it is my firm opinion that this is not enough.

To minimize the risk of devastating consequences, like death, in any sport – whether it’s track, basketball or football – students not only need a typical sports physical, they also need to have a cardiac physical done as well.  This has to involve several types of tests, including:

-       Family history of cardiac disease

-       An electrocardiograph (EKG)

-       An ultrasound of the heart

These elements, unlike a mere sports physical, would be able to shed light on hidden clinical conditions such as hypertrophic cardiomyopathy (HCM), cardiac arrhythmias and valvular abnormalities that may be present but completely asymptomatic in a young person.  These conditions could have catastrophic consequences if the child does any kind of strenuous physical exercise.

There also must be an automated external defibrillator on site in any school, town or community gym, because if something terrible does happen, without the proper equipment, you will not be able to bring that person back in time.

This is supported by data, which shows that when an AED is used within the first 10 minutes of cardiac arrest, survival rates increase to 80 percent.  However, it typically takes emergency responders at least seven minutes to arrive.

Schools in Italy have these policies and I urge American high schools to implement these procedures as well: require cardiac physical and always keep an AED handy at sporting events.  When it comes to a matter of life or death, the benefits far outweigh the costs.