Pediatric concussion


A trauma-induced alteration in mental status that may or may not involve loss of consciousness.

An abnormality in the biochemical processes leading to functional impairment without any evidence of structural findings on standard neuroimaging.

The effect and outcome of concussion are far worse in the developing brains of children as compared to that of adults.

Concussion in the pediatric age group significantly impacts school and sports-related performance, and it often leads to significant academic, social, and financial losses, and may even cause permanent damage and worsening of existing neuropsychological symptoms.

Repeated head injuries, particularly prolonged subconcussive injuries, may lead to a much more severe condition like the chronic traumatic encephalopathy.

The diagnosis of concussion is mostly clinical based on the presence of a constellation of symptoms following trauma to the head: headache, loss of consciousness, confusion, dizziness, and nausea and vomiting.

There are many assessment tools that aid in the diagnosis of concussion, the subjective nature of these assessment tools limits their utility.

There are no imaging or laboratory test to diagnosis concussion.

Brain CT scans and MRIs are used to rule out more serious traumatic brain injury are of little value in diagnosing concussion.

Concussion responds to adequate physical, cognitive. and psychological rest.

The patient should be removed from active sports to avoid another concussion or any form of additional injury that may exacerbate the present concussion symptoms and prolong recovery time.

The child should not attend school and avoids any mentally exhausting activities such as homework, video games, and excessive screen time.

Rest is encouraged until resolution of symptoms and the removal of stressful activity that worsens the condition.

Analgesics or nonsteroidal anti-inflammatory drugs may be used for headaches.

Sleep hygiene usually helps patients, as they often complain of sleep disturbances in the form of delayed onset sleep or excessive daytime sleepiness.

For patients experiencing nausea or vomiting, ondansetron is an optimal treatment

Metoclopramide and promethazine should be avoided in children because of their adverse effects.

Some patients have prolonged symptoms that may progress to post-concussive syndrome.

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