Acute concussion: making the diagnosis and state of the art management

Matthew Eisenberg1,2, Rebekah Mannix1,2

  • 1Division of Emergency Medicine, Boston Children's Hospital.

Insights

Pediatric concussion, a common brain injury, affects many children long-term. Early identification of at-risk youth and avoiding prolonged rest are crucial for better recovery outcomes.

Area of Science:

  • Pediatric neurology
  • Sports medicine
  • Traumatic brain injury research

Background:

  • Concussion is a frequent injury among children, often categorized as mild traumatic brain injury.
  • Emerging evidence indicates a significant percentage of children experience persistent symptoms one month post-injury.
  • Current objective measures for diagnosing concussion and monitoring recovery are still under development.

Purpose of the Study:

  • To review the fundamental epidemiology and acute management strategies for pediatric concussion.
  • To highlight recent research advancements in understanding and managing childhood concussion.
  • To emphasize the need for improved diagnostic tools and targeted therapies.

Main Methods:

  • Literature review of recent studies on pediatric concussion.
  • Analysis of epidemiological data related to concussion incidence and outcomes in children.
  • Synthesis of current understanding of concussion management protocols.

Main Results:

  • A substantial proportion of children (up to 30%) remain symptomatic one month after a concussion.
  • Objective diagnostic and recovery biomarkers (imaging, serum) are not yet clinically applicable.
  • Prolonged physical rest may negatively impact recovery, suggesting a need for revised management guidelines.

Conclusions:

  • Objective measures for concussion diagnosis and recovery are essential for clinical practice.
  • Identifying children at risk for prolonged symptoms is critical for timely intervention.
  • Targeted therapeutic approaches are needed to mitigate the risk of prolonged recovery after pediatric concussion.
Abstract

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