Related Experiment Video
Updated: May 15, 2026
A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
Published on: February 7, 2025
Prognosticators of persistent symptoms following pediatric concussion: a systematic review
Roger L Zemek1, Ken J Farion, Margaret Sampson
1Division of Pediatric Emergency Medicine, Children’s Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, Ontario, Canada. rzemek@cheo.on.ca
Insights
Predicting persistent concussion symptoms (PCS) in children is challenging, with limited evidence associating factors like age, loss of consciousness, and premorbid conditions with PCS development.
Area of Science:
- Pediatric Neurology
- Sports Medicine
- Neuroscience
Background:
- Concussion is a common injury in children.
- Persistent concussion symptoms (PCS) can significantly impact a child's quality of life.
- Identifying predictors of PCS is crucial for timely intervention.
Purpose of the Study:
- To systematically review and identify predictors of persistent concussion symptoms (PCS) in children aged 2 to 18 years.
- To analyze the association of clinically available factors with the development of PCS.
- To synthesize current evidence on prognostic factors for pediatric concussion.
Main Methods:
- Systematic literature review of MEDLINE, Embase, and Cochrane Library up to April 2012.
- Inclusion of studies evaluating pediatric patients (2-18 years) with PCS.
- Descriptive analysis of 15 studies due to heterogeneity precluding meta-analysis.
Main Results:
- Larger studies suggest older children, loss of consciousness, headache, and nausea/vomiting increase PCS risk.
- Smaller studies indicated initial dizziness as a potential predictor.
- Premorbid conditions like previous head injury or learning difficulties may also elevate PCS risk.
Conclusions:
- Current evidence linking clinical factors to PCS in children is minimal and sometimes contradictory.
- Future research requires adequately powered trials to identify reliable predictors of symptom resolution.
- Standardized assessment measures and expert consensus are needed to reduce heterogeneity in pediatric concussion research.
Abstract:
OBJECTIVE To identify predictors of persistent concussion symptoms (PCS) in children following concussion. DATA SOURCES We searched MEDLINE, Embase, and the Cochrane Library to April 2012. STUDY SELECTION A systematic review of the literature to identify prognosticators of PCS following pediatric concussion was conducted. Studies evaluating patients aged 2 years to 18 years with PCS were eligible. MAIN OUTCOME MEASURES The association of clinically available factors with PCS development. RESULTS A literature search yielded 824 records; 561 remained after removal of duplicates. Fifteen studies were included in descriptive analysis; heterogeneity precluded a meta-analysis. Larger prospective studies concluded that the risk for PCS was increased in older children with loss of consciousness, headache, and/or nausea/vomiting. Smaller studies noted that initial dizziness may predict PCS. Patients with premorbid conditions (eg, previous head injury, learning difficulties, or behavioral problems) may also have increased risk. CONCLUSIONS Minimal, and at times contradictory, evidence exists to associate clinically available factors with eventual development of PCS in children. Future trials must be adequately powered to determine which variables best predict the time to full symptom resolution. Expert consensus should delineate which postconcussion assessment measures are preferred to reduce heterogeneity going forward. Research to improve care for the epidemic of pediatric concussion depends on early identification of those most in need of intervention.
