Pediatric Mild Traumatic Brain Injury in the Acute Setting
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Daniel J Corwin1, Matthew F Grady, Mark D Joffe
1*Attending Physician (Corwin, Joffe), Division of Emergency Medicine, †Associate Fellow (Corwin), Center for Injury Research and Prevention, ‡Attending Physician (Grady), Sports Medicine and Performance Center, The Children's Hospital of Philadelphia, Philadelphia, PA; §Assistant Professor of Clinical Pediatrics (Grady), Associate Professor of Pediatrics (Joffe), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and ∥Attending Physician and Associate Professor (Zonfrillo), Departments of Emergency Medicine and Pediatrics, Alpert Medical School of Brown University and Hasbro Children's Hospital, Providence, RI.
Insights
Pediatric mild traumatic brain injuries, or concussions, are rising in emergency departments. This article reviews their definition, symptoms, and acute care for children, noting vulnerable groups for prolonged recovery.
Area of Science:
- Pediatric Emergency Medicine
- Neurology
- Sports Medicine
Background:
- Pediatric mild traumatic brain injuries (mTBI), primarily concussions, are a growing concern in emergency departments.
- The incidence of concussion diagnoses has significantly increased over the last decade.
- Acute care providers require current knowledge for managing pediatric concussions.
Purpose of the Study:
- To provide an updated overview of pediatric concussion for acute care providers.
- To detail the definition, pathophysiology, signs, symptoms, and acute management of pediatric concussion.
- To identify populations at risk for prolonged recovery and outline referral guidelines.
Main Methods:
- Literature review and synthesis of current evidence on pediatric concussion.
- Review of diagnostic criteria and clinical presentation.
- Discussion of acute management strategies and follow-up care.
Main Results:
- Concussion diagnosis in children is increasing, requiring specialized acute care knowledge.
- Comprehensive understanding of concussion's definition, pathophysiology, and clinical signs is essential.
- Identification of vulnerable pediatric populations aids in predicting recovery and guiding referrals.
Conclusions:
- Acute care for pediatric concussion necessitates up-to-date knowledge on diagnosis and management.
- Recognizing vulnerable populations is key to optimizing recovery and appropriate referrals.
- This review equips healthcare providers to manage the rising incidence of pediatric concussions effectively.
Abstract:
Pediatric mild traumatic brain injuries, most of which are concussions, are an increasingly common reason for presentation to emergency departments. The diagnosis of concussion has increased dramatically over the past decade, necessitating the acute care provider to have up-to-date knowledge of the definition, pathophysiology, signs and symptoms, physical examination findings, and acute management of pediatric concussion. This article also addresses populations most vulnerable to prolonged recovery from pediatric concussion and referral recommendations.