Assault-Related Concussion in a Pediatric Population

Area of Science:

• Pediatric neurology
• Traumatic brain injury research
• Public health

Background:

• Concussion diagnosis and management can vary based on injury mechanism.
• Understanding differences between assault-related concussion (ARC) and sports/recreation-related concussion (SRC) is crucial for equitable care.
• Pediatric patients represent a vulnerable population requiring specific attention in concussion management.

Purpose of the Study:

• To compare demographic characteristics, medical care, and outcomes of pediatric patients with ARC versus SRC.
• To identify potential disparities in the evaluation and recovery process for different concussion injury types.
• To inform future research and clinical practice for improved concussion management.

Main Methods:

• Retrospective chart review of 124 pediatric patients (aged 8-17) diagnosed with concussion.
• Comparison of patients with assault-related concussion (ARC) and sports/recreation-related concussion (SRC) (62 in each group).
• Analysis of patient demographics, initial medical care, and outcomes using statistical tests (χ2, Fisher exact, Wilcoxon rank sum).

Main Results:

• Patients with ARC were more likely to be Black, publicly insured, and initially present to the emergency department.
• Fewer ARC patients received visio-vestibular testing at initial visit compared to SRC patients (27% vs 74%).
• ARC patients reported significantly more decline in grades post-injury (47% vs 20%) and trends toward prolonged recovery.

Conclusions:

• Assault-related concussion (ARC) in pediatric patients is associated with potential disparities in initial evaluation and worse educational outcomes.
• Fewer ARC patients received concussion-specific diagnostic evaluations, indicating differences in management.
• Further prospective studies are needed to address potential inequities in concussion care for assault-injured patients.