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Concussion pediatric

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https://www.readbyqxmd.com/read/28812053/emergency-medical-service-personnel-recognize-pediatric-concussions
#1
Joshua N Speirs, Matthew I Lyons, Bert E Johansson
Concussions are a major cause of morbidity in pediatrics. Many concussions occur during activities with emergency medical service (EMS) providers present to determine if a higher level of care is needed. Data are limited on how capable these providers are. We assessed the ability of EMS providers to recognize pediatric concussions. Fifty-six total responses were included, 38 from EMS and 18 from our MD/RN (medical doctor/registered nurse) group. No statistical differences were found between the 2 groups when adjusted for age, gender, number of years in practice, and number of pediatric concussions managed...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28777774/symptom-guided-emergency-department-discharge-instructions-for-children-with-concussion
#2
Talia M Brooks, Marissa M Smith, Renee M Silvis, Trudy Lerer, Christine Henry Mulvey, Ralynne Maitland, Amy L Dunn, Kelsey Logan, Sharon R Smith
OBJECTIVES: The objective was to evaluate the use and utility of a novel set of emergency department discharge instructions (DIs) for concussion based on a child's ongoing symptoms: symptom-guided DIs (symptom DIs). Differences in clinical outcomes were also assessed. METHODS: A convenience sample of 114 children aged 7 to 17 years presenting to an urban pediatric emergency department with a complaint of concussion was assembled. Children were randomized to standard DIs or symptom DIs...
August 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28762893/overlapping-microrna-expression-in-saliva-and-cerebrospinal-fluid-accurately-identifies-pediatric-traumatic-brain-injury
#3
Steven Daniel Hicks, Jeremiah Johnson, Molly C Carney, Harry Bramley, Robert P Olympia, Andrea C Loeffert, Neal J Thomas
Objectives To assess the accuracy and physiologic relevance of circulating microRNA (miRNA) as a biomarker of pediatric concussion, we compared changes in salivary miRNA and cerebrospinal fluid (CSF) miRNA following childhood traumatic brain injury (TBI). Study Design A case-cohort design was used to compare longitudinal miRNA concentrations in CSF of seven children with severe TBI against three controls without TBI. The miRNAs "altered" in CSF were interrogated in saliva of 60 children with mild TBI and compared with 18 age- and gender- matched controls...
August 1, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28710227/advancing-concussion-assessment-in-pediatrics-a-cap-a-prospective-concurrent-cohort-longitudinal-study-of-mild-traumatic-brain-injury-in-children-protocol-study
#4
Keith Owen Yeates, Miriam Beauchamp, William Craig, Quynh Doan, Roger Zemek, Bruce Bjornson, Jocelyn Gravel, Angelo Mikrogianakis, Bradley Goodyear, Nishard Abdeen, Christian Beaulieu, Mathieu Dehaes, Sylvain Deschenes, Ashley Harris, Catherine Lebel, Ryan Lamont, Tyler Williamson, Karen Maria Barlow, Francois Bernier, Brian L Brooks, Carolyn Emery, Stephen B Freedman, Kristina Kowalski, Kelly Mrklas, Lianne Tomfohr-Madsen, Kathryn J Schneider
INTRODUCTION: Paediatric mild traumatic brain injury (mTBI) is a public health burden. Clinicians urgently need evidence-based guidance to manage mTBI, but gold standards for diagnosing and predicting the outcomes of mTBI are lacking. The objective of the Advancing Concussion Assessment in Pediatrics (A-CAP) study is to assess a broad pool of neurobiological and psychosocial markers to examine associations with postinjury outcomes in a large sample of children with either mTBI or orthopaedic injury (OI), with the goal of improving the diagnosis and prognostication of outcomes of paediatric mTBI...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28701360/multicentre-randomised-clinical-trial-of-paediatric-concussion-assessment-of-rest-and-exertion-pedcare-a-study-to-determine-when-to-resume-physical-activities-following-concussion-in-children
#5
Andrée-Anne Ledoux, Nicholas J Barrowman, Kathy Boutis, Adrienne Davis, Sarah Reid, Gurinder Sangha, Ken J Farion, Kevin Belanger, Mark S Tremblay, Keith Owen Yeates, Carol DeMatteo, Nick Reed, Roger Zemek
INTRODUCTION: Rest until symptom-free, followed by a progressive stepwise return to activities, is often prescribed in the management of paediatric concussions. Recent evidence suggests prolonged rest may hinder recovery, and early resumption of physical activity may be associated with more rapid recovery postconcussion. The primary objective is to determine whether the early reintroduction of non-contact physical activity beginning 72 hours postinjury reduces postconcussive symptoms at 2 weeks in children following an acute concussion as compared with a rest until asymptomatic protocol...
July 12, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28689685/-home-and-recreational-injuries-in-children-under-1year-10years-of-experience
#6
B Lacarra, S Guyet-Job, G Pédrono, M A Le Rouzic, D Dufour, B Thélot, P Le Roux
BACKGROUND: There is little research on the prevalence and characteristics of home and recreational injuries in infants under 12months of age. However, domestic accidents result in an average of 50 infant deaths in France every year. METHODS: A descriptive and retrospective study was conducted, based on data from the permanent investigation on home and recreational injuries in infants under 12months of age (EPAC) published by the Institute for Public Health. Data were collected from 2004 to 2013 in the pediatric emergency department of Le Havre hospital...
July 6, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28490224/prevalence-of-abnormal-magnetic-resonance-imaging-findings-in-children-with-persistent-symptoms-after-pediatric-sports-related-concussion
#7
Robert H Bonow, Seth D Friedman, Francisco A Perez, Richard G Ellenbogen, Samuel R Browd, Christine L Mac Donald, Monica S Vavilala, Frederick P Rivara
A subset of patients experience persistent symptoms after pediatric concussion, and magnetic resonance imaging (MRI) is commonly used to evaluate for pathology. The utility of this practice is unclear. We conducted a retrospective cohort study to describe the MRI findings in children with concussion. A registry of all patients seen at our institution from January 2010 through March 2016 with pediatric sports-related concussion was cross-referenced with a database of radiographical studies. Radiology reports were reviewed for abnormal findings...
July 19, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28414395/the-role-of-active-recovery-and-rest-after-concussion
#8
Jeff Strelzik, Raquel Langdon
For several years both cognitive and physical rest remained at the forefront in pediatric postconcussion management. However, the concept of "rest" has not been well defined and there remains significant variability both in terms of rest recommendations provided as well as adherence to such recommendations. More recently, there has been growing evidence to suggest that an earlier return to light or moderate activity is not detrimental and may, in fact, facilitate symptomatic improvement, thereby highlighting a new role for active rehabilitation in recovery from concussion...
April 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28403661/pediatric-cheerleading-injuries-treated-in-emergency-departments-in-the-united-states
#9
Nada Naiyer, Thiphalak Chounthirath, Gary A Smith
This study investigates the epidemiology of cheerleading injuries to children in the United States. Data were analyzed from the National Electronic Injury Surveillance System for children 5 through 18 years of age treated in US emergency departments for cheerleading injuries from 1990 through 2012. An estimated 497 095 children ages 5 to 18 years were treated in US emergency departments for a cheerleading injury during the 23-year study period, averaging 21 613 injured children per year. From 1990 to 2012, the annual cheerleading injury rate increased significantly by 189...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28398160/should-young-children-with-traumatic-brain-injury-be-compared-with-community-or-orthopedic-control-participants
#10
Miriam H Beauchamp, Catherine Landry-Roy, Jocelyn Gravel, Cindy Beaudoin, Annie Bernier
Pediatric traumatic brain injury (TBI) research depends on comparisons of profiles and outcomes between brain-injured individuals and groups consisting either of injured controls (e.g., orthopedic injuries, OI) or uninjured, typically developing children recruited from the community (community controls, CC). Children with OI are thought to provide optimal comparisons for individuals with TBI because they share injury-related experiences and pre-morbid characteristics; however, a study by Mathias and colleagues (2013) (1) in adults has called into question the added value of injury control groups in TBI research...
June 28, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28365025/the-effectiveness-of-prescribed-rest-depends-on-initial-presentation-after-concussion
#11
Alicia M Sufrinko, Anthony P Kontos, Jennifer N Apps, Michael McCrea, Robert W Hickey, Michael W Collins, Danny G Thomas
OBJECTIVE: To evaluate if patients with signs of injury respond differently to prescribed rest after concussion compared with patients with symptoms only. STUDY DESIGN: Secondary analysis was completed of a prospective randomized controlled trial (NCT01101724) of pediatric concussion patients aged 11-18 years. Patients completed computerized neurocognitive testing and standardized balance assessment at the emergency department within 24 hours of injury and on follow-up (3 and 10 days)...
June 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28347202/pediatric-concussion-biomechanical-differences-between-outcomes-of-transient-and-persistent-4-weeks-postconcussion-symptoms
#12
Andrew Post, T Blaine Hoshizaki, Roger Zemek, Michael D Gilchrist, David Koncan, Lauren Dawson, Wesley Chen, Andrée-Anne Ledoux
OBJECTIVE Currently, little is known about the biomechanics of head impact for concussion in youths (ages 5 to 18 years). Even less is known about the biomechanical characteristics and variables related to head impacts that may be useful in differentiating between transient and persistent postconcussion symptoms in a youth population. The purpose of this research was to examine the differences in biomechanics of youth head impact for transient postconcussion symptoms (TPCSs) and persistent postconcussion symptoms (PPCSs) by using data from a hospital population...
June 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28320567/gender-differences-in-concussion-and-postinjury-cognitive-findings-in-an-older-and-younger-pediatric-population
#13
Sarah Tanveer, Nassim Zecavati, Elizabeth Bronson Delasobera, Temitayo Oyefunmike Oyegbile
BACKGROUND: Studies have documented gender differences associated with concussion. The purpose of this study was to determine if these gender differences are also noted within a pediatric population. METHODS: This prospective study analyzed 1971 patients who had completed preconcussion and postconcussion neuropsychological testing within the Washington, DC, area. RESULTS: Our results showed that children and adolescents with concussion exhibit gender differences with respect to risk factors, recovery, and symptomatology...
May 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28293983/trajectories-and-risk-factors-for-post-traumatic-stress-symptoms-following-pediatric-concussion
#14
Katherine Truss, Celia Godfrey, Michael Takagi, Franz E Babl, Silvia Bressan, Stephen Hearps, Cathriona Clarke, Kevin Dunne, Vicki Anderson
A substantial minority of children experience post-traumatic stress symptoms (PTSS) following injury. Research indicates variation in the trajectory of PTSS following pediatric injury, but investigation of PTSS following concussion has assumed homogeneity. This study aimed to identify differential trajectories of PTSS following pediatric concussion and to investigate risk factors, including acute post-concussive symptoms (PCS), associated with these trajectories. A total of 120 children ages 8-18 years reported PTSS for 3 months following concussion diagnosis using the Child PTSD Symptom Scale, with a score of 16 or above indicating probable post-traumatic stress disorder diagnosis...
May 3, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28287682/return-to-school-and-learning-after-concussion-tips-for-pediatricians
#15
Matthew F Grady, Christina L Master
Concussion in children and adolescents is a common injury that is usually managed by the primary care provider. Students with a concussion may present with a variety of symptoms, and these symptoms interfere with regular school participation. Optimizing the timing and progression of return to school and learning is often challenging, but with a careful history and concussion-specific examination, the primary care provider can identify potential barriers to school reentry. This review focuses on developing a systematic approach to the initial concussion evaluation and developing customized school accommodations to aid in the school reentry process...
March 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28287681/the-preparticipation-physical-evaluation
#16
Patrick J Lehman, Rebecca L Carl
With rising rates of sports participation among children and adolescents, pediatricians are increasingly being called upon to perform preparticipation physical evaluations (PPEs) for young athletes. The purpose of this review article is to discuss the general structure of a comprehensive PPE and how the PPE differs from a typical health maintenance visit. The PPE focuses attention on screening for cardiac conditions that predispose athletes to sudden cardiac death with exercise. This review also addresses the debate over whether electrocardiogram screening should be a routine required part of the PPE...
March 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28277413/community-primary-care-provider-preferences-for-emergency-department-follow-up-recommendations-a-regional-study
#17
Marissa A Hendrickson, Eta Obeya, Andrew R Wey, Philippe R Gaillard
BACKGROUND: Children who present to emergency departments (EDs) for care are frequently advised to follow up with their primary care providers (PCPs) after discharge; little is known about whether PCPs agree that follow-up advised by EDs is appropriate for their patients. OBJECTIVES: The aims of this study were to determine PCP preferences for follow-up recommendations given to their pediatric patients at the time of ED visits and to compare these preferences to reported emergency medicine provider (EMP) practice...
March 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28238481/attitudes-and-counseling-practices-of-pediatricians-regarding-youth-sports-participation-and-concussion-risks
#18
Michael Fishman, Eleanor Taranto, Meryl Perlman, Kyran Quinlan, Holly J Benjamin, Lainie Friedman Ross
OBJECTIVE: To examine attitudes and practices of pediatricians toward sports-related head trauma and youth participation in tackle football and ice hockey. STUDY DESIGN: A respondent-anonymous electronic survey was distributed 3 times to members of the American Academy of Pediatrics Section of Bioethics, Council on Injury, Violence, and Poison Prevention, and Council on Sports Medicine and Fitness. RESULTS: Of 791 eligible pediatricians, 227 (29%) responded...
May 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28198194/assessing-the-clinical-utility-of-the-question-is-your-child-are-you-back-to-normal-in-pediatric-concussion-symptom-resolution
#19
Brandi L Vollmer, Michael W Kirkwood, R Dawn Comstock, Dustin Currie, Joseph A Grubenhoff
This study investigates the relationship between the general question, "Is your child/are you back to normal?" and a validated postconcussive symptom scale when assessing symptom resolution following concussion. Children with acute concussion were enrolled during an emergency department visit. Sensitivity and specificity analyses compared the true/false question, "My child is/I am back to normal" at 3 days postinjury with the Concussion Symptom Inventory (CSI; gold standard). A total of 201 participants were enrolled in the study with complete data...
February 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28159872/utilization-of-mental-health-services-after-mild-pediatric-traumatic-brain-injury
#20
COMPARATIVE STUDY
Nathalia Jimenez, Alex Quistberg, Monica S Vavilala, Kenneth M Jaffe, Frederick P Rivara
BACKGROUND: Mild traumatic brain injury injuries (mTBIs), including concussions, represent >2 million US pediatric emergency department visits annually. Post-mTBI mental health symptoms are prominent and often attributed to the mTBI. This study examined whether individuals seeking post-mTBI mental health care had previous mental health diagnoses or a new onset of such disorders, and determined if mental health care utilization differed by race/ethnicity. METHODS: Retrospective cohort study, using the Medicaid Marketscan claims national dataset (2007-2012)...
March 2017: Pediatrics
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