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Published on: September 25, 2014
Assessment and Treatment of Concussion in the Pediatric Population
Giancarlo J Lugo1, Maria Beletanga1, Laura Goldstein2
1Division of Pediatric Neurology, Department of Pediatrics, Boston Medical Center, Boston, Massachusetts.
Insights
Pediatric traumatic brain injury (TBI) management often lacks specific research, relying on adult data and expert opinion. This review highlights key considerations for neurologists managing TBI in children.
Area of Science:
- Pediatric Neurology
- Neurotrauma
- Clinical Management
Background:
- Traumatic brain injury (TBI) is prevalent in children, yet clinical practice heavily relies on adult research.
- A significant gap exists in pediatric-specific TBI research, leading to recommendations based on expert consensus rather than robust evidence.
- The heterogeneity of the pediatric population (infants to adolescents) and co-existing neurodevelopmental disabilities complicate TBI evaluation and management.
Purpose of the Study:
- To provide adult neurologists with a focused review of pediatric traumatic brain injury (TBI).
- To address specific challenges and considerations unique to evaluating and managing TBI in the pediatric population.
- To bridge the gap between adult-based TBI research and pediatric clinical practice.
Main Methods:
- Literature review focusing on pediatric TBI.
- Synthesis of existing research and expert opinion relevant to child TBI.
- Identification of age-specific and condition-specific management nuances.
Main Results:
- Current pediatric TBI guidelines are often extrapolated from adult studies.
- Expert opinion frequently informs practice due to limited pediatric research.
- Management strategies must account for developmental differences across pediatric age groups.
Conclusions:
- There is a critical need for more research specifically investigating TBI in children.
- Adult neurologists require tailored guidance for effective pediatric TBI care.
- Evidence-based practice in pediatric TBI necessitates ongoing scientific advancement and physician education.
Abstract:
Traumatic brain injury (TBI) is common in children. The evaluation and management of children with TBI is based on the research performed in adults. There is a relative paucity of research in the literature involving children and many of the practice recommendations for this age are based on expert opinion in the absence of good research studies in both sports and non-sports-related injuries. The pediatric population is heterogeneous and the approach might be specific for infants, preschoolers, school age children, and adolescents. Children may also suffer from neurodevelopmental disabilities, making their evaluation even more challenging. Adult neurologists are often asked to see children due to increasing demands. This review will focus on specific issues related to TBI in children that might be useful to adult neurologists. Science, however, is evolving rapidly and physicians should make sure to remain up to date to offer evidence-based services to their patients.
