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Traumatic Brain Injury l: Introduction01:28

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DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...
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Research Letter: Concussion Evaluation by Injury Setting Among US Children.

Todd Burus1, Jennifer D Burus, Svetla Slavova

  • 1Author Affiliations: Department of Internal Medicine (T. Burus), College of Medicine, University of Kentucky, Lexington, Kentucky; Markey Cancer Center, University of Kentucky (T. Burus), Lexington, Kentucky; Department of Outpatient Therapy (J. D. Burus), University of Kentucky Healthcare, Lexington, Kentucky; Department of Biostatistics (Slavova), College of Public Health, University of Kentucky, Lexington, Kentucky; Kentucky Injury Prevention & Research Center, University of Kentucky (Slavova), Lexington, Kentucky; and College of Medicine, University of Kentucky (van Zyl), Lexington, Kentucky.

The Journal of Head Trauma Rehabilitation
|May 4, 2026
PubMed
Summary
This summary is machine-generated.

Children with concussion symptoms after non-sports-related head trauma (SRHT) are significantly less likely to receive medical evaluation compared to those with sports-related head trauma (SRHT). This results in hundreds of thousands of missed concussion evaluations annually for non-sports-related injuries.

Keywords:
adolescenceconcussionhead injuriesprimary health careschool health services

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Area of Science:

  • Pediatric Traumatic Brain Injury
  • Public Health Surveillance
  • Healthcare Disparities

Background:

  • Concussion is a common injury in children, often resulting from head trauma.
  • Medical evaluation is crucial for diagnosing and managing concussion to prevent long-term complications.
  • Existing research primarily focuses on sports-related head trauma (SRHT), potentially overlooking non-SRHT injuries.

Purpose of the Study:

  • To investigate and quantify disparities in medical concussion evaluation between sports-related head trauma (SRHT) and non-SRHT in US school-aged children.
  • To identify factors influencing the likelihood of receiving a concussion evaluation after head trauma.
  • To estimate the number of missed concussion evaluations in non-SRHT cases.

Main Methods:

  • Utilized data from the National Health Interview Survey (2023-2024), a nationally representative sample of US children aged 5-17 years.
  • Caregivers reported on concussion-like symptoms after head trauma in the prior year, injury setting (sports vs. non-sports), and receipt of medical evaluation.
  • Statistical analyses, including adjusted prevalence ratios (aPR), were used to compare evaluation rates between SRHT and non-SRHT groups.

Main Results:

  • An estimated 2.6% of children experienced concussion-like symptoms after head trauma; most injuries (60.8%) occurred outside of sports.
  • Overall, 67.7% of injured children received medical evaluation, with higher rates in males and older children (13-17 years).
  • Children with non-SRHT had significantly lower evaluation rates (53.1%) compared to SRHT (90.4%), translating to an estimated 388,905 missed evaluations annually.

Conclusions:

  • Substantial disparities exist in concussion evaluation rates, with non-SRHT injuries being significantly under-evaluated compared to SRHT.
  • Increased awareness and targeted guidance for concussion recognition and referral in non-sports settings are needed for school personnel and healthcare providers.
  • Addressing these evaluation gaps is critical for improving timely diagnosis, appropriate management, and long-term recovery in pediatric concussion patients.