The Age Variable in Childhood Concussion Management: A Systematic Review

Area of Science:

• Pediatric Sports Medicine
• Neuroscience
• Public Health

Background:

• Sports-related concussion is a growing concern in young children globally.
• Existing research lacks specific age-based management protocols for pediatric concussion.
• This review addresses when to manage young children differently for concussion compared to older individuals.

Purpose of the Study:

• To review the existing literature on sports concussion in children and adolescents.
• To investigate age-related differences in concussion presentation and management.
• To identify gaps in current research regarding pediatric concussion management.

Main Methods:

• Systematic review adhering to PROSPERO and PRISMA guidelines.
• Included 37 original research studies on sports concussion examining age as a variable (5-18 years).
• Applied specific inclusion and exclusion criteria for study selection.

Main Results:

• No defined, evidence-based age groups exist for differential pediatric concussion management.
• Concussion presentation and symptom severity may vary across developmental stages.
• Adolescents may report more symptoms with increasing age; 12-13 years is a common age cutoff.
• Age has been classified variously (educational, developmental, continuous) in research.
• Common groupings include pre-puberty, early, and late adolescence.

Conclusions:

• Limited understanding of childhood concussion due to assessment challenges in younger children.
• Studies often lack clear rationales for age groupings or cutoffs.
• Further research is essential to understand developmental variations in concussion from preschool to late adolescence to inform diagnosis and management.