Assessment, Diagnosis, and Management of Childhood Concussions

Sponsoring Organization: Ontario Neurotrauma Foundation

Target Population: Healthcare professionals and others who deal with concussion, including physicians, neuropsychologists, physical therapists, family, and schools/community sports organizations

Background and Objective

The panel used an evidence-based, systematic review to standardize diagnosis, assessment, and management of children (age range, 5–18 years) with suspected concussion.

Key Recommendations

—For children participating in high-risk sports (contact and collision sports), consider baseline neurocognitive testing.

—On initial presentation, assess and treat physical, cognitive, and other neurologic deficits:

  • Manage acute symptoms, including identifying any so-called red flags and assessing need for emergent neuroimaging.
  • Perform an acute concussion evaluation based on a standardized tool.
  • Prescribe physical and cognitive rest.

—On discharge, provide education and a postconcussion care plan with explicit direction for teachers and school-based activities:

  • Educate about the risks for persistent symptoms including managing sleep, headaches, and fatigue.
  • Counsel patients on avoiding alcohol, recreational drugs, and driving during recovery.
  • Instruct patients to have close primary care follow-up and referral to a specialist in concussion management if symptoms persist beyond 1 month.

—On interim assessment, have return-to-learn and return-to-play stepwise plans and refer children with multiple concussions to specialized care by a concussion expert.

—At 1 month, if symptoms persist, patients should undergo a more comprehensive health evaluation

Guidelines can be viewed here: Link.


Read all articles in Hospital Procedures, medical procedures, Neurological diseases, Traumatology
Tags: childhood concussion, concussion, head trauma, HPC updates

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