This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
- Rose N. Gelineau-Morel, MD*
- Timothy P. Zinkus, MD†
- Jean-Baptiste Le Pichon, MD, PhD*
- *Division of Neurology and
- †Division of Radiology, Children’s Mercy Hospital, Kansas City, MO
AUTHOR DISCLOSURE
Drs Gelineau-Morel and Zinkus have disclosed no financial relationships relevant to this article. Dr Le Pichon has disclosed that he has served as a consultant for an AADC Deficiency Advisors Forum and as a medical legal expert and that he currently serves as the chair of the Subcommittee on Education for the American Academy of Pediatrics Section on Neurology Committee. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
- AAP:
- American Academy of Pediatrics
- AHT :
- abusive head trauma
- CDC:
- Centers for Disease Control and Prevention
- Child SCAT5:
- Child Sport Concussion Assessment Tool
- CISG:
- Concussion in Sport Group
- CT:
- computed tomography
- DAI:
- diffuse axonal injury
- FLAIR:
- fluid-attenuated inversion recovery
- GCS:
- Glasgow Coma Scale
- MRI:
- magnetic resonance imaging
- mTBI:
- mild traumatic brain injury
- TBI:
- traumatic brain injury
Practice Gaps
There is still a considerable amount of confusion when it comes to managing concussions. An excessive number of head computed tomographic scans are being obtained for concussions, resulting in unnecessary exposure to ionizing radiation. Clinicians should be aware of the most recent guidelines for the management of concussion, including the need for imaging, and should be able to differentiate mild from moderate and severe traumatic brain injury.
Objectives
After completing this article, readers should be able to:
Differentiate a mild from a moderate or severe traumatic brain injury (TBI).
Acutely manage a child with a TBI, including deciding when further imaging is necessary.
Manage a child with a postconcussion syndrome and identify when referral to a specialist is necessary.
Traumatic brain injury (TBI) is the leading cause of death or severe disability in children older than 1 year. (1)(2) In a report to Congress published by the Centers for Disease Control and Prevention (CDC) in 2018, (3) the CDC reported the public health burden of TBIs. They noted that 640,000 emergency department visits and 18,000 hospital stays were directly related to TBI. The etiology of TBI varies among age groups. In the 0- to 4-year-old age group, the most common cause of TBI is falls. On the other hand, in the 15- to 24-year-old age group the distribution of injuries caused by …
Individual Login
Institutional Login
You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.
Log in through your institution
Pay Per Article - You may access this article (from the computer you are currently using) for 2 days for US$25.00
Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.