New Guidelines For Kids' Concussion Recovery Ease Burden For Doctors, Parents

They include avoiding routine X-rays, CT scans and blood tests for diagnosis.

CALGARY — New concussion guidelines in the United States could change care for all children with mild traumatic brain injuries, says a University of Calgary researcher.

The guidelines, initiated by the U.S. Centers for Disease Control and Prevention (CDC) and released Tuesday, include recommendations on the diagnosis, prognosis and treatment of mild concussions in children.

According to the new study, mild traumatic brain injury (mTBI), or concussion, in children is a rapidly growing public health concern because there has been an increase in the number of emergency department visits for mTBI over the past decade.

From 2005 to 2009, the CDC says children made more than two million outpatient visits and almost three million emergency department visits for mTBI.In a subset of pediatric patients, post-concussive symptoms persist beyond two weeks and can continue for longer than three months. Symptoms (both acute and long-term) affect a child's ability to function physically, cognitively, and psychologically after mTBI.

Senior female emergency room doctor holds up two fingers to young injured soccer player.
Senior female emergency room doctor holds up two fingers to young injured soccer player.

Keith Yeates, who runs the Integrated Concussion Research Program at the University of Calgary and co-authored the report, said the new guidelines will better help doctors deal with the cases.

"What we hope they do will affect how kids with concussion and mild traumatic brain injury are cared for — not just in the United States but hopefully have an impact worldwide," he said.

Some of the key recommendations include avoiding routine X-rays, CT scans and blood tests for diagnosis. They recommend that rest not last longer than one to three days after the injury. They also reassure parents that most children's symptoms clear up within one to three months.

The guidelines suggest signs of potentially more serious injuries that may warrant imaging scans include vomiting, unconsciousness and severe worsening headaches.

Concussions, also called mild traumatic brain injuries, are caused by incidents that cause the brain to ricochet off the skull. The impact causes the brain to bounce or twist, potentially damaging brain cells.

Yeates said it's difficult to come up with exact numbers on how many children in Canada get concussions, because some don't seek medical attention. By some estimates, it's at least 250,000 each year and growing.

"The number of kids coming for medical attention has doubled in the last five to 10 years," he said.

Yeates said that's because there's an increasing awareness about the effects of concussions, likely due to some high-profile cases among professional athletes, so parents are more likely to seek treatment for their children. But concussions can happen outside of sports participation in every day activities such as falling, car or bike accidents, or by banging the head or body against hard objects, which can cause the brain to shake inside the skull.

The CDC guidelines, which were published in the health journal JAMA Pediatrics, are based on an evaluation of 25 years of scientific research on managing concussions in children.

Similar information is available through the Public Health Agency of Canada and Ministry of Sport, but Yeates said the newest guidelines take it a step further by looking at more serious injuries and extending it beyond sport concussions.

"These are all meant to compliment each other," he said.

With files from The Associated Press and Charmaine Noronha