Pediatric concussion

A pediatric concussion, also known as pediatric mild traumatic brain injury (mTBI), is a head trauma that impacts the brain capacity. Concussion can affect functional, emotional, cognitive and physical factors and can occur in people of all ages.[1] Symptoms following after the concussion vary and may include confusion, disorientation, lightheadedness, nausea, vomiting, blurred vision, loss of consciousness (LOC) and environment sensitivity. Concussion symptoms may vary based on the type, severity and location of the head injury.[2] Concussion symptoms in infants, children, and adolescents often appear immediately after the injury, however, some symptoms may arise multiple days following the injury leading to a concussion.[3] The majority of pediatric patients recover from the symptoms within one month (4 weeks) following the injury. 10-30% of children and adolescents have a higher risk of a delayed recovery or of experiencing concussion symptoms that are persisting.[4][5]

A medical assessment by a physician or nurse practitioner is required if a concussion is suspected in an infant, child, or adolescent to rule out a more serious head injury and diagnose the concussion.[6] Treatment for concussion includes a short cognitive and physical period of rest followed by gradual return to activity and school. Resting for more than 1–2 days is not recommended. Prescribed physical exercise may be helpful for recovery as early as 48–72 hours after the injury, however, all activities that have an inherent risk of another injury such as hitting the head or falling should be avoided completely until medically cleared by a doctor. Clinical practice guidelines do not suggest missing more than a week of school.[7]

Common causes of a pediatric concussion include falls, motor vehicle accidents, sports-related injuries, and blunt force trauma.[2] Approximately 48% of concussions consequently originate from falls in pediatric patients.[6] Within the United States, concussions resulting from sports-related injuries indicate that 3.8 million patients sustain this trauma each year.[8]

Concussions are a common head trauma with an estimated amount of 16% of children over the age of 10 having already experienced at least one head injury requiring immediate medical attention.[9] Prevention for concussions involves reducing common risks in the youth; wearing a helmet to avoid sports-related head trauma.[4] Treatment includes an initial period of 1–2 days of relative rest followed by a progressive return to physical and mental activities.[10]

  1. ^ Haas R, Zayat M, Sevrin A (September 2019). "Current Concepts in the Evaluation of the Pediatric Patient with Concussion". Current Reviews in Musculoskeletal Medicine. 12 (3): 340–345. doi:10.1007/s12178-019-09561-7. PMC 6684694. PMID 31342314.
  2. ^ a b "What are common symptoms of traumatic brain injury (TBI)?". National Institute of Health. 24 November 2020. Retrieved 2021-03-27.
  3. ^ "Symptoms of Traumatic Brain Injury (TBI) | Concussion | Traumatic Brain Injury | CDC Injury Center". www.cdc.gov. 2019-03-11. Retrieved 2021-03-27.
  4. ^ a b Lumba-Brown A, Yeates KO, Sarmiento K, Breiding MJ, Haegerich TM, Gioia GA, et al. (November 2018). "Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children". JAMA Pediatrics. 172 (11): e182853. doi:10.1001/jamapediatrics.2018.2853. PMC 7006878. PMID 30193284.
  5. ^ Davis GA, Anderson V, Babl FE, Gioia GA, Giza CC, Meehan W, et al. (June 2017). "What is the difference in concussion management in children as compared with adults? A systematic review". British Journal of Sports Medicine. 51 (12): 949–957. doi:10.1136/bjsports-2016-097415. PMID 28455361. S2CID 41199099.
  6. ^ a b "TBI: Get the Facts | Concussion | Traumatic Brain Injury | CDC Injury Center". www.cdc.gov. 2019-03-11. Retrieved 2021-03-27.
  7. ^ Reed, Nick; Zemek, Roger; Dawson, Jennifer; et al. (2021-01-25). "Living Guideline for Pediatric Concussion Care". www.pedsconcussion.com. doi:10.17605/OSF.IO/3VWN9.
  8. ^ "Pediatric Concussion - Conditions and Treatments | Children's National Hospital". childrensnational.org. Retrieved 2021-03-27.
  9. ^ "Traumatic Brain Injury / Concussion | Concussion | Traumatic Brain Injury | CDC Injury Center". www.cdc.gov. 2020-09-01. Retrieved 2021-03-27.
  10. ^ McCrory P, Meeuwisse W, Dvořák J, Aubry M, Bailes J, Broglio S, et al. (June 2017). "Consensus statement on concussion in sport-the 5th international conference on concussion in sport held in Berlin, October 2016". British Journal of Sports Medicine. 51 (11): 838–847. doi:10.1136/bjsports-2017-097699. hdl:2263/61384. PMID 28446457. S2CID 42329667.