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Concussion is “a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces.” Concussion results from acceleration and deceleration forces which may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an 'impulsive' force transmitted to the head.

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Bottom Line Recommendations English (5) French (1) All (6)

Bottom Line: Management of Acute Symptoms Algorithm

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Ontario Neurotrauma Foundation

This document is intended to guide health care professionals in diagnosing and managing pediatric concussion. See Page 48 of this document for the Management of Acute Symptoms Algorithm (Tool 2.1).

Bottom Line Recommendations: Concussion

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Zemek R & TREKK Network

Bottom line recommendations for the treatment and management of concussion. Updated: August 2018.

Bottom Line: The Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5)

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Davis GA, Purcell L, Schneider KJ, Yeates KO, Gioia GA, Anderson V, Ellenboge...

The Child SCAT5 is a standardized tool for evaluating concussions designed for use by physicians and licensed healthcare professionals. The Child SCAT5 is to be used for evaluating Children aged 5 to 12 years. For athletes aged 13 years and older, please use the SCAT5.

Bottom Line: The Sport Concussion Assessment Tool 5th Edition (SCAT5)

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Echemendia RJ, Meeuwisse W, McCrory P, Davis GA, Putukian M, Leddy J, Makdiss...

The SCAT5 is a standardized tool for evaluating concussions designed for use by physicians and licensed healthcare professionals. The SCAT5 is to be used for evaluating athletes aged 13 years and older. For children aged 12 years or younger, please use the Child SCAT5.

Bottom Line: Acute Concussion Evaluation (ACE): Physician/Clinician Office Version

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Goia G, Collins M

The ACE is intended to provide an evidence-based clinical protocol to conduct an initial evaluation and diagnosis of patients (both children and adults) with known or suspected mild traumatic brain injury.

Recommandations de Base: Commotion crbrale (TCC lger)

Download

Zemek R and TREKK Network

Bottom line recommendations for the treatment and management of concussion - en francais. Updated: August 2018.

Bottom Line: Management of Acute Symptoms Algorithm

Visit

Ontario Neurotrauma Foundation

This document is intended to guide health care professionals in diagnosing and managing pediatric concussion. See Page 48 of this document for the Management of Acute Symptoms Algorithm (Tool 2.1).

Bottom Line Recommendations: Concussion

Download

Zemek R & TREKK Network

Bottom line recommendations for the treatment and management of concussion. Updated: August 2018.

Recommandations de Base: Commotion crbrale (TCC lger)

Download

Zemek R and TREKK Network

Bottom line recommendations for the treatment and management of concussion - en francais. Updated: August 2018.

Bottom Line: The Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5)

Visit

Davis GA, Purcell L, Schneider KJ, Yeates KO, Gioia GA, Anderson V, Ellenboge...

The Child SCAT5 is a standardized tool for evaluating concussions designed for use by physicians and licensed healthcare professionals. The Child SCAT5 is to be used for evaluating Children aged 5 to 12 years. For athletes aged 13 years and older, please use the SCAT5.

Bottom Line: The Sport Concussion Assessment Tool 5th Edition (SCAT5)

Visit

Echemendia RJ, Meeuwisse W, McCrory P, Davis GA, Putukian M, Leddy J, Makdiss...

The SCAT5 is a standardized tool for evaluating concussions designed for use by physicians and licensed healthcare professionals. The SCAT5 is to be used for evaluating athletes aged 13 years and older. For children aged 12 years or younger, please use the Child SCAT5.

Bottom Line: Acute Concussion Evaluation (ACE): Physician/Clinician Office Version

Visit

Goia G, Collins M

The ACE is intended to provide an evidence-based clinical protocol to conduct an initial evaluation and diagnosis of patients (both children and adults) with known or suspected mild traumatic brain injury.

Clinical guidelines English (8) French All (8)

Guideline: Telemedicine and Virtual Concussion Care

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Ontario Neurotrauma Foundation

Preliminary research has demonstrated that telemedicine can be used to provide timely access to safe and cost-effective medical care of carefully selected concussion patients living in underserved regions. Research from the teleneurology, telepsychiatry and teleneuropsychology literature suggests that patients with prolonged concussion symptoms including those with headaches, mental health disorders, and cognitive impairment may also benefit from accessing care via telemedicine.

Living Guideline For Diagnosing And Managing Pediatric Concussion

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Ontario Neurotrauma Foundation

In 2019, the Ontario Neurotrauma Foundation worked with
concussion experts and researchers to create a living clinical
practice guideline for pediatric concussion.

Concussions and Head Injuries in Children: Care Instructions

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Resources on Concussion in a Virtual Environment (Recover)

RECOVER (Resources on Concussion in a Virtual Environment) was a study being conducted by researchers at Alberta Health Services, the University of Calgary and the University of Alberta. To improve outcomes for children with concussion who are seen in emergency departments, the study developed tools to help physicians and nurses provide better care and to help families to learn more about, assess, and monitor concussion.

Guideline: Considerations for Telemedicine and Virtual Care Algorithm

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Ontario Neurotrauma Foundation

Algorithm for telemedicine and virtual care

Guideline: Italian guidelines on the assessment and management of pediatric head injury in the emergency department

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Da Dalt L, Parri N, Amigoni A, et al.

We aim to formulate evidence-based recommendations to assist physicians decision-making in the assessment and management of children younger than 16 years presenting to the emergency department (ED) following a blunt head trauma with no suspicion of non-accidental injury.

Guidelines: Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children

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Lumba-Brown A, Yeates KO, Sarmiento K, et al.

Based on a previous systematic review of the literature, this guideline includes 19 sets of recommendations on diagnosis, prognosis, and management/treatment of pediatric mTBI. Each recommendation was assigned a level of obligation (ie, must, should, or may) based on confidence in the evidence.

Consensus Statement: Consensus statement on concussion in sport-the 5(th) international conference on concussion in sport held in Berlin, October 2016

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McCrory P, Meeuwisse W, Dvorak J, Aubry M, Bailes J, Broglio S, Cantu RC, Cas...

The 2017 Concussion in Sport Group (CISG) consensus statement is designed to build on the principles outlined in the previous statements and to develop further conceptual understanding of sport-related concussion (SRC) using an expert consensus-based approach.

Guidelines: Standards for Post-Concussion Care: from diagnosis to the interdisciplinary concussion clinic

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The Concussion Advisory Subcommittee of the Ontario Neurotrauma Foundation

A pathway of post-concussion care was developed that would be applicable across the province to patients while accounting for the vast regional differences.

Guideline: Telemedicine and Virtual Concussion Care

Visit

Ontario Neurotrauma Foundation

Preliminary research has demonstrated that telemedicine can be used to provide timely access to safe and cost-effective medical care of carefully selected concussion patients living in underserved regions. Research from the teleneurology, telepsychiatry and teleneuropsychology literature suggests that patients with prolonged concussion symptoms including those with headaches, mental health disorders, and cognitive impairment may also benefit from accessing care via telemedicine.

Living Guideline For Diagnosing And Managing Pediatric Concussion

Visit

Ontario Neurotrauma Foundation

In 2019, the Ontario Neurotrauma Foundation worked with
concussion experts and researchers to create a living clinical
practice guideline for pediatric concussion.

Concussions and Head Injuries in Children: Care Instructions

Visit

Resources on Concussion in a Virtual Environment (Recover)

RECOVER (Resources on Concussion in a Virtual Environment) was a study being conducted by researchers at Alberta Health Services, the University of Calgary and the University of Alberta. To improve outcomes for children with concussion who are seen in emergency departments, the study developed tools to help physicians and nurses provide better care and to help families to learn more about, assess, and monitor concussion.

Guideline: Considerations for Telemedicine and Virtual Care Algorithm

Visit

Ontario Neurotrauma Foundation

Algorithm for telemedicine and virtual care

Guideline: Italian guidelines on the assessment and management of pediatric head injury in the emergency department

Visit

Da Dalt L, Parri N, Amigoni A, et al.

We aim to formulate evidence-based recommendations to assist physicians decision-making in the assessment and management of children younger than 16 years presenting to the emergency department (ED) following a blunt head trauma with no suspicion of non-accidental injury.

Guidelines: Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children

Visit

Lumba-Brown A, Yeates KO, Sarmiento K, et al.

Based on a previous systematic review of the literature, this guideline includes 19 sets of recommendations on diagnosis, prognosis, and management/treatment of pediatric mTBI. Each recommendation was assigned a level of obligation (ie, must, should, or may) based on confidence in the evidence.

Consensus Statement: Consensus statement on concussion in sport-the 5(th) international conference on concussion in sport held in Berlin, October 2016

Visit

McCrory P, Meeuwisse W, Dvorak J, Aubry M, Bailes J, Broglio S, Cantu RC, Cas...

The 2017 Concussion in Sport Group (CISG) consensus statement is designed to build on the principles outlined in the previous statements and to develop further conceptual understanding of sport-related concussion (SRC) using an expert consensus-based approach.

Guidelines: Standards for Post-Concussion Care: from diagnosis to the interdisciplinary concussion clinic

Visit

The Concussion Advisory Subcommittee of the Ontario Neurotrauma Foundation

A pathway of post-concussion care was developed that would be applicable across the province to patients while accounting for the vast regional differences.

Summaries of systematic reviews English (1) French All (1)

Multimedia: Heads Up App (2013)

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National Center for Injury Prevention and Control,

The Heads Up app will help you learn how to spot and what to do if you think your child or teen has a concussion or other serious brain injury.

Multimedia: Heads Up App (2013)

Visit

National Center for Injury Prevention and Control,

The Heads Up app will help you learn how to spot and what to do if you think your child or teen has a concussion or other serious brain injury.

Systematic reviews English (15) French All (15)

Systematic review: Aerobic exercise for sport-related concussion: a systematic review and meta-analysis

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Langevin P, Frmont P, Fait P, Dub MO, Bertrand-Charrette M, Roy JS.

The objective of this systematic review is to assess the effects of symptom-limited aerobic exercise programs compared with control interventions on symptom intensity in individuals with sports-related concussion.

Systematic review: Effectiveness of return to activity and return to school protocols for children postconcussion: a systematic review

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DeMatteo C, Bednar ED, Randall S, Falla K.

Objective: To determine the effects of following return to activity (RTA) and return to school (RTS) protocols on clinical outcomes for children with concussion. The 12 subquestions of this review focus on the effectiveness of protocols, guidelines and recommendations, and the evidence supporting content of the protocols including rest, exercise and school accommodations.

Systematic review: Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery

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Luther M, Poppert Cordts KM, Williams CN

Objectives: Sleep is vital for brain development and healing after injury, placing children with sleep-wake disturbances (SWD) after traumatic brain injury (TBI) at risk for worse outcomes. We conducted a systematic review to quantify SWD after pediatric TBI including prevalence, phenotypes, and risk factors. We also evaluated interventions for SWD and the association between SWD and other posttraumatic outcomes.

Systematic review: A systematic review of sleep-wake disturbances in childhood traumatic brain injury: relationship with fatigue, depression, and quality of life

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Botchway EN, Godfrey C, Anderson V, Catroppa C.

Objective: To systematically appraise the literature on the prevalence, types, and predictors of sleep-wake disturbances (SWD), and on the relationship between SWD, fatigue, depression, and quality of life in children and adolescents with traumatic brain injury (TBI).

Systematic review: Pediatric traumatic brain injury and antisocial behavior: are they linked? A systematic review

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Bellesi G, Barker ED, Brown L, Valmaggia L.

This review aimed to explore systematically previous literature on the association between TBI before the age of 19 and severe behavioral problems such as violence, aggression and assault.

Systematic review: What factors must be considered in return to school following concussion and what strategies or accommodations should be followed? A systematic review

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Purcell LK, Davis GA, Gioia GA.

Objective: To evaluate the evidence regarding (1) factors affecting return to school (RTS) and (2) strategies/accommodations for RTS following a sport-related concussion (SRC) in children and adolescents.

Systematic review: A systematic review and quality analysis of pediatric traumatic brain injury clinical practice guidelines

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Appenteng R, Nelp T, Abdelgadir J, et al.

Traumatic brain injuries (TBI) are a significant cause of mortality and morbidity for children globally. Adherence to evidence-based treatment guidelines have been shown to improve TBI outcomes. To inform the creation of a pediatric TBI management guideline for a low and middle income country context, we assessed the quality of available clinical practice guidelines (CPGs) for the acute management pediatric TBI.

Systematic review: A systematic review of criteria used to define recovery from sport-related concussion in youth athletes

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Haider MN, Leddy JJ, Pavlesen S, et al.

Objective: The Concussion in Sport Group guidelines recommend a multifaceted approach to help clinicians make return to sport decisions. The purpose of this study was to identify the most common multifaceted measures used to define clinical recovery from sport-related concussion in young athletes (high school and/or college level) and to summarise existing knowledge of criteria used to make return to sport decisions.

Systematic review: A systematic review of neuroimaging findings in children and adolescents with sports-related concussion

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Chamard E, Lichtenstein JD.

The aim of this review is to systematically explore the literature on magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI), functional magnetic resonance imaging (fMRI), and cortical thickness following SRC in children and adolescents.

Systematic review: Chronic post-traumatic headache in children and adolescents: systematic review of prevalence and headache features

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Shaw L, Morozova M, Abu-Arafeh I.

The aim of this systematic review is to determine the prevalence and clinical features of chronic post-traumatic headache (CPTH) in children and adolescents.

Systematic review: Diagnosis and management of mild traumatic brain injury in children: a systematic review

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Lumba-Brown A, Yeates KO, Sarmiento K, et al.

Objective: To conduct a systematic review of the pediatric mTBI literature to serve as the foundation for an evidence-based guideline with clinical recommendations associated with the diagnosis and management of pediatric mTBI.

Systematic review: Imaging in pediatric concussion: a systematic review

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Schmidt J, Hayward KS, Brown KE, et al.

Objective: To investigate the differences in neuroimaging findings in children/youth with mTBI. Measures of behavior, symptoms, time since injury, and age at injury were also considered.

Systematic review: The age variable in childhood concussion management: a systematic review

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Moser RS, Davis GA, Schatz P.

This paper reviews the research literature in an effort to shed light on the question, "At what age should young children be managed differently than adults or older adolescents?"

Systematic Review: Predictors of clinical recovery from concussion: a systematic review

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Iverson GL, Gardner AJ, Terry DP, Ponsford JL, Sills AK, Broshek DK, Solomon GS

This is a systematic review of factors that might be associated with, or influence, clinical recovery from sport-related concussion

Systematic Review: Rest and treatment/rehabilitation following sport-related concussion: a systematic review

Visit

Schneider KJ, Leddy JJ, Guskiewicz KM, Seifert T, McCrea M, Silverberg ND, Fe...

The objective of this systematic review was to evaluate the evidence regarding rest and active treatment/rehabilitation following sport-related concussion (SRC).

Systematic review: Aerobic exercise for sport-related concussion: a systematic review and meta-analysis

Visit

Langevin P, Frmont P, Fait P, Dub MO, Bertrand-Charrette M, Roy JS.

The objective of this systematic review is to assess the effects of symptom-limited aerobic exercise programs compared with control interventions on symptom intensity in individuals with sports-related concussion.

Systematic review: Effectiveness of return to activity and return to school protocols for children postconcussion: a systematic review

Visit

DeMatteo C, Bednar ED, Randall S, Falla K.

Objective: To determine the effects of following return to activity (RTA) and return to school (RTS) protocols on clinical outcomes for children with concussion. The 12 subquestions of this review focus on the effectiveness of protocols, guidelines and recommendations, and the evidence supporting content of the protocols including rest, exercise and school accommodations.

Systematic review: Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery

Visit

Luther M, Poppert Cordts KM, Williams CN

Objectives: Sleep is vital for brain development and healing after injury, placing children with sleep-wake disturbances (SWD) after traumatic brain injury (TBI) at risk for worse outcomes. We conducted a systematic review to quantify SWD after pediatric TBI including prevalence, phenotypes, and risk factors. We also evaluated interventions for SWD and the association between SWD and other posttraumatic outcomes.

Systematic review: A systematic review of sleep-wake disturbances in childhood traumatic brain injury: relationship with fatigue, depression, and quality of life

Visit

Botchway EN, Godfrey C, Anderson V, Catroppa C.

Objective: To systematically appraise the literature on the prevalence, types, and predictors of sleep-wake disturbances (SWD), and on the relationship between SWD, fatigue, depression, and quality of life in children and adolescents with traumatic brain injury (TBI).

Systematic review: Pediatric traumatic brain injury and antisocial behavior: are they linked? A systematic review

Visit

Bellesi G, Barker ED, Brown L, Valmaggia L.

This review aimed to explore systematically previous literature on the association between TBI before the age of 19 and severe behavioral problems such as violence, aggression and assault.

Systematic review: What factors must be considered in return to school following concussion and what strategies or accommodations should be followed? A systematic review

Visit

Purcell LK, Davis GA, Gioia GA.

Objective: To evaluate the evidence regarding (1) factors affecting return to school (RTS) and (2) strategies/accommodations for RTS following a sport-related concussion (SRC) in children and adolescents.

Systematic review: A systematic review and quality analysis of pediatric traumatic brain injury clinical practice guidelines

Visit

Appenteng R, Nelp T, Abdelgadir J, et al.

Traumatic brain injuries (TBI) are a significant cause of mortality and morbidity for children globally. Adherence to evidence-based treatment guidelines have been shown to improve TBI outcomes. To inform the creation of a pediatric TBI management guideline for a low and middle income country context, we assessed the quality of available clinical practice guidelines (CPGs) for the acute management pediatric TBI.

Systematic review: A systematic review of criteria used to define recovery from sport-related concussion in youth athletes

Visit

Haider MN, Leddy JJ, Pavlesen S, et al.

Objective: The Concussion in Sport Group guidelines recommend a multifaceted approach to help clinicians make return to sport decisions. The purpose of this study was to identify the most common multifaceted measures used to define clinical recovery from sport-related concussion in young athletes (high school and/or college level) and to summarise existing knowledge of criteria used to make return to sport decisions.

Systematic review: A systematic review of neuroimaging findings in children and adolescents with sports-related concussion

Visit

Chamard E, Lichtenstein JD.

The aim of this review is to systematically explore the literature on magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI), functional magnetic resonance imaging (fMRI), and cortical thickness following SRC in children and adolescents.

Systematic review: Chronic post-traumatic headache in children and adolescents: systematic review of prevalence and headache features

Visit

Shaw L, Morozova M, Abu-Arafeh I.

The aim of this systematic review is to determine the prevalence and clinical features of chronic post-traumatic headache (CPTH) in children and adolescents.

Systematic review: Diagnosis and management of mild traumatic brain injury in children: a systematic review

Visit

Lumba-Brown A, Yeates KO, Sarmiento K, et al.

Objective: To conduct a systematic review of the pediatric mTBI literature to serve as the foundation for an evidence-based guideline with clinical recommendations associated with the diagnosis and management of pediatric mTBI.

Systematic review: Imaging in pediatric concussion: a systematic review

Visit

Schmidt J, Hayward KS, Brown KE, et al.

Objective: To investigate the differences in neuroimaging findings in children/youth with mTBI. Measures of behavior, symptoms, time since injury, and age at injury were also considered.

Systematic review: The age variable in childhood concussion management: a systematic review

Visit

Moser RS, Davis GA, Schatz P.

This paper reviews the research literature in an effort to shed light on the question, "At what age should young children be managed differently than adults or older adolescents?"

Systematic Review: Predictors of clinical recovery from concussion: a systematic review

Visit

Iverson GL, Gardner AJ, Terry DP, Ponsford JL, Sills AK, Broshek DK, Solomon GS

This is a systematic review of factors that might be associated with, or influence, clinical recovery from sport-related concussion

Systematic Review: Rest and treatment/rehabilitation following sport-related concussion: a systematic review

Visit

Schneider KJ, Leddy JJ, Guskiewicz KM, Seifert T, McCrea M, Silverberg ND, Fe...

The objective of this systematic review was to evaluate the evidence regarding rest and active treatment/rehabilitation following sport-related concussion (SRC).

Key studies English (45) French All (45)

Key study: Association between ondansetron use and symptom persistence in children with concussions: A 5P substudy

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Gravel J, Boutis K, Tang K, et al.

Ondansetron is increasingly administered to children suffering from concussion-associated nausea/vomiting. We examined the association between ondansetron administration and post-concussion symptoms in children at 1 week and 1 month following the concussion.

Key study: Association of time since injury to the first clinic visit with recovery following concussion

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Kontos AP, Jorgensen-Wagers K, Trbovich AM, et al.

To investigate the association of time since injury with initiation of clinical care on recovery time following concussion.

Key study: Characteristics of concussion in elementary school-aged children: implications for clinical management

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Master CL, Curry AE, Pfeiffer MR, et al.

To comprehensively characterize the clinical presentation and course of care for concussion among 5- to 11-year-old children, identifying preinjury and injury factors potentially influencing clinical outcomes.

Key study: Characteristics of diagnosed concussions in children aged 0 to 4 years presenting to a large pediatric healthcare network

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Podolak OE, Chaudhary S, Haarbauer-Krupa J, et al.

The aim of the study was to comprehensively describe the natural history of concussion in early childhood between 0 and 4 years.

Key study: Concussion Guidelines Step 2: evidence for subtype classification

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Lumba-Brown A, Teramoto M, Bloom OJ, et al.

Objective: To use evidence-based methodology to characterize the 5 concussion subtypes and 2 associated conditions and report their prevalence in acute concussion patients as compared to baseline or controls within 3 d of injury.

Key study: Concussion-symptom rating correlation between pediatric patients and their parents

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Patsimas T, Howell DR, Potter MN, Potter MN, Provance AJ, Kirkwood MW, Wilson JC

To examine patient-parent correlations and agreement on concussion-symptom ratings, to identify differences in patient-parent symptom reporting between children (8-12 years of age) and adolescents (13-18 years of age), and to evaluate the correlation between patient and parent initial symptom-severity ratings with symptom duration and return-to-play time.

Key study: Continuing play, symptom severity, and symptom duration after concussion in youth athletes

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Howell DR, O'Brien MJ, Fraser J, Meehan WP.

Objective: To determine whether continuing to play after a concussion is associated with higher symptom burden or prolonged symptom duration.

Key study: Delayed symptom onset following pediatric sport-related concussion

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Olson A, Ellis MJ, Selci E, Russell K.

Objective: (1) To examine the prevalence of delayed symptom onset (DSO) among pediatric sport-related concussion (SRC) patients as well as the effect of symptom onset on initial symptom severity, length of recovery, and development of delayed recovery; (2) to evaluate the impact of symptom onset on sideline management.

Key study: Early versus delayed emergency department presentation following mild traumatic nrain injury and the presence of symptom at 1, 4 and 12 weeks in children

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Gravel J, Ledoux AA, Tang K, et al.

We evaluated the association between timing of presentation and postconcussive symptoms (PCS) at 1, 4 and 12 weeks after injury.

Key study: Effect of cognitive and physical rest on persistent postconcussive symptoms following a pediatric head injury

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Root JM, Sady MD, Gai J, Vaughan CG, Madati PJ

To evaluate the effect of cognitive and physical rest on persistent postconcussive symptoms in a pediatric population.

Key study: Participation in physical activity at time of presentation to a specialty concussion clinic is associated with shorter time to recovery

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Coslick AM, Chin KE, Kalb LG, Slomine BS, Suskauer SJ.

To determine if level of physical activity at presentation to a rehabilitation-based concussion specialty clinic predicted days from injury to recovery.

Key study: Pediatric minor head injury imaging practices: results from an ESPR survey

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Argyropoulou MI, Alexiou GA, Xydis VG, et al.

Objective: Computed tomography (CT) for minor head injury exposes a large number of children to ionizing radiation, with an associated increased lifetime risk of malignancy. To study imaging practices for children with minor head injury and the level of awareness of radiologists of the current clinical decision rules for minor traumatic brain injury (TBI).

Key study: Reliability of the visio-vestibular examination for concussion among providers in a pediatric emergency department

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Corwin DJ, Arbogast KB, Swann C, et al.

Our objective was to determine the inter-rater (IRR) and test-retest reliability (TRR) of the VVE in a pediatric ED.

Key study: Trajectories and predictors of clinician-determined recovery after child concussion

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Anderson V, Davis GA, Takagi M, et al.

We mapped concussion recovery to 3 months post-injury and explored non-modifiable (e.g., age, sex, pre-injury factors, injury mechanism, acute PCS) and modifiable (post-acute child symptoms) predictors of persisting symptoms in order to identify opportunities for early intervention.

Key study: Use of the sport concussion assessment tools in the emergency department to predict persistent post-concussive symptoms in children

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Bressan S, Clarke CJ, Anderson V, et al.

We aim to assess the predictive value of the main SCAT3/ChildSCAT3 components for PPCS when applied in the ED.

Key study: A longitudinal investigation of sleep and daytime wakefulness in children and youth with concussion

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Wiseman-Hakes C, Gosselin N, Sharma B, Langer L, Gagnon I.

In this study, we investigated the trajectory of sleep and daytime sleepiness in a prospective cohort of 40 children and youth (6-18 years old) with concussion, 40 age-and sex-matched healthy children and youth, and 40 with upper-extremity orthopedic injury.

Key study: Admission of pediatric concussion injury patients: is it necessary?

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Lindholm EB, DCruz R, Fajardo R, et al.

The purpose of this study was to determine if pediatric patients evaluated in the emergency department (ED) for concussion with a negative head CT scan require routine hospital admission.

Key study: Concussion symptom profiles among child, adolescent, and young adult athletes

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Howell DR, Kriz P, Mannix RC, Kirchberg T, Master C L, Meehan WP

(1) To examine how age influences initial symptom presentation following concussion; and (2) to determine whether specific symptom profiles are associated with duration of postconcussion symptoms, and whether they vary by age group.

Key study: Delayed presentations to emergency departments of children with head injury: A PREDICT Study

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Borland ML, Dalziel SR, Phillips N, et al.

Objective: Existing clinical decision rules guide management for head-injured children presenting 24 hours or sooner after injury, even though some may present greater than 24 hours afterward. We seek to determine the prevalence of traumatic brain injuries for patients presenting to emergency departments greater than 24 hours after injury and identify symptoms and signs to guide management.

Key study: Derivation and initial validation of clinical phenotypes of children presenting with concussion acutely in the emergency department: latent class analysis of a multi-center, prospective cohort, observational study

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Yeates KO, Tang K, Barrowman N, et al.

This study used latent class analysis (LCA) to identify discernible phenotypes among children with acute concussion and examine the association between phenotypes and persistent post-concussive symptoms (PPCS) at 4 and 12 weeks post-injury. We conducted LCA of variables representing pre-injury history, clinical presentation, and parent symptom ratings, derived from a prospective cohort, observational study that recruited participants from August 2013 until June 2015 at nine pediatric emergency departments within the Pediatric Emergency Research Canada network.

Key study: Early subthreshold aerobic exercise for sport-related concussion: a randomized clinical trial

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Leddy JJ, Haider MN, Ellis MJ, et al.

To assess the effectiveness of subsymptom threshold aerobic exercise vs a placebo-like stretching program prescribed to adolescents in the acute phase of recovery from SRC.

Key study: Insomnia in adolescents with slow recovery from concussion

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Brooks BL, Sayers PQ, Virani S, Rajaram AA, Tomfohr-Madsen L.

This study examined: 1) some of the psychometric properties of the Insomnia Severity Index (ISI), 2) the prevalence and severity of insomnia symptoms, and 3) associations between insomnia symptoms and clinical measures of post-concussion symptoms, mental health symptoms, and cognitive tests in adolescents with slow recovery from concussion.

Key study: Low-value diagnostic imaging use in the pediatric emergency department in the United States and Canada

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Cohen E, Rodean J, Diong C, et al.

Objective To compare overall and low-value use of diagnostic imaging across pediatric ED visits in Ontario, Canada, and the United States.

Key study: Natural progression of symptom change and recovery from concussion in a pediatric population

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Ledoux AA, Tang K, Yeates KO, et al.

Objectives: To describe the natural progression of symptom change by age group (5-7, 8-12, and 13-18 years) and sex, as well as to develop centile curves to inform families about children after injury recovery.

Key study: Persistent vestibular-ocular impairment following concussion in adolescents

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Sinnott AM, Elbin RJ, Collins MW, Reeves VL, Holland CL, Kontos AP.

Objectives: The current study investigated the role of persistent vestibular-ocular symptoms and impairment following sport-related concussion on recovery time and clinical outcomes among adolescents.

Key study: Physical activity after mild traumatic brain injury: what are the relationships with fatigue and sleep quality?

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van Markus-Doornbosch F, Peeters E, van der Pas S, Vlieland TV, Meesters J.

To determine self-reported physical activity (PA) levels and relationships with fatigue and sleep quality in adolescents and young adults after mild traumatic brain injury (mTBI).

Key study: Practice patterns in pharmacological and non-pharmacological therapies for children with mild traumatic brain injury: a survey of 15 canadian and United States centers

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Mannix R, Zemek R, Yeates KO, et al.

Given the lack of evidence regarding effective pharmacological and non-pharmacological interventions for pediatric mild traumatic brain injury (mTBI) and the resultant lack of treatment recommendations reflected in consensus guidelines, variation in the management of pediatric mTBI is to be expected. We therefore surveyed practitioners across 15 centers in the United States and Canada who care for children with pediatric mTBI to evaluate common-practice variation in the management of pediatric mTBI.

Key study: Quality of life and symptom burden 1 month after concussion in children and adolescents

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Howell DR, Wilson JC, Kirkwood MW, Grubenhoff JA.

We conducted a prospective study of children and adolescents (n = 176; mean age = 13.0 2.7 years; 38% female) assessed acutely post-concussion and again 30 days later. We investigated the association between symptom burden and quality of life (QOL) outcomes, as well as the effect of age on QOL.

Key study: Reduction of computed tomography use for pediatric closed head injury evaluation at a nonpediatric community emergency department

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Puffenbarger MS, Ahmad FA, Argent M, Gu H, Samson C, Quayle KS, Saito JM.

The purpose of this study was to determine if implementation of a Pediatric Emergency Care Applied Research Network (PECARN)-based Closed Head Injury Assessment Tool could safely decrease computed tomography (CT) use for pediatric head injury evaluation at a nonpediatric community emergency department (ED).

Key study: Risk factors for prolonged symptoms of mild traumatic brain injury: a pediatric sports concussion clinic cohort

Visit

Fehr SD, Nelson LD, Scharer KR, et al.

To examine predictors of prolonged symptom duration from mild traumatic brain injury (mTBI) in a pediatric sports medicine specialty clinic cohort as these predictors may be distinct in this population.

Key study: Trouble falling asleep after concussion is associated with higher symptom burden among children and adolescents

Visit

Howell DR, Oldham JR, Brilliant AN, Meehan WP.

Our objective was to identify factors associated with trouble falling asleep postconcussion.

Key study: Use of the vestibular and oculomotor examination for concussion in a pediatric emergency department

Visit

Corwin DJ, Propert KJ, Zorc JJ, Zonfrillo MR, Wiebe DJ.

We aimed to measure rates of exam performance after implementation of training and support tools in a pediatric emergency department.

Key study: What comes first: return to school or return to activity for youth after concussion? Maybe we dont have to choose.

Visit

DeMatteo CA, Randall S, Lin CA, Claridge EA.

This study investigates recovery trajectories of children/youth while following RTA and RTS protocols simultaneously, with the following objectives: (1) to compare rates and patterns of progression through the stages of both protocols; (2) to evaluate symptom trajectories of youth post-concussion while progressing through stages of RTS and RTA; and (3) to propose a new model for concussion management in youth that involves the integration of Return to Activity and Return to School protocols.

Key study: Characterizing hospitalizations for pediatric concussion and trends in care

Visit

Rhine T, Byczkowski T, Altaye M, Wade SL, Babcock L.

Objective: Delineate a cohort of children admitted for concussion, describe care practices received, examine factors associated with prolonged length of stay (LOS) or emergency department (ED) readmission, and investigate changes in care over time.

Key study: Identifying persistent postconcussion symptom risk in a pediatric sports medicine clinic

Visit

Howell DR, Zemek R, Brilliant AN, Mannix RC, Master CL, Meehan WP.

To determine if the Predicting Persistent Post-concussive Problems in Pediatrics (5P) clinical risk score, an emergency department (ED)derived and validated tool, is associated with developing PPCS when obtained in a primary care sports concussion setting.

Key study: MRI in mild pediatric traumatic brain injury: diagnostic overkill or useful tool?

Visit

Cohrs, G., Huhndorf, M., Niemczyk, N. et al.

Magnetic resonance imaging (MRI) is a sensitive imaging tool which lacks the burden of ionizing radiation. It is not established as primary diagnostic tool in traumatic brain injury (TBI). The purpose of this study was to evaluate the usefulness of MRI as initial imaging modality in the emergency management of mild pediatric TBI.

Key study: No association between metoclopramide treatment in ED and reduced risk of post-concussion headache

Visit

Bresee N, Aglipay M, Dubrovsky AS, et al.

There is a lack of definitive pediatric literature on effective pharmacotherapy for persistent post-concussion headache symptoms. This study assessed whether acute metoclopramide treatment in the Emergency Department (ED) was associated with a reduction in persistent headache in children at 1- and 4-weeks post-concussion.

Key study: Resumption of physical activity within 7 days of a concussion was associated with lower rates of persistent postconcussive symptoms (PPCS)

Visit

Kanani AN, Hartshorn S.

A planned secondary analysis of nine pediatric emergency departments of return to physical activity within 7 days postinjury (ranging from light exercise to a full return to competitive sports).

Key study: The diagnosis of concussion in pediatric emergency departments: a prospective multicenter study

Visit

Boutis K, Gravel J, Freedman SB, et al.

Objectives: We compared the frequency of persistent concussion symptoms in children who were provided the diagnosis of concussion by an emergency physician versus those who met Berlin/Zurich international criteria for this diagnosis. We also determined the clinical variables independently associated with a physician-diagnosed concussion.

Key study: Vision and vestibular system dysfunction predicts prolonged concussion recovery in children

Visit

Master CL, Master SR, Wiebe DJ, et al.

Objective: Up to one-third of children with concussion have prolonged symptoms lasting beyond 4 weeks. Vision and vestibular dysfunction is common after concussion. It is unknown whether such dysfunction predicts prolonged recovery. We sought to determine which vision or vestibular problems predict prolonged recovery in children.

Key study: Symptom-guided emergency department discharge instructions for children with concussion

Visit

Brooks TM, Smith MM, Silvis RM, et al.

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.

Key study: The Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5): Background and rationale

Visit

Davis GA, Purcell L, Schneider KJ, et al.

This article presents the Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5). The Sport Concussion Assessment Tool was introduced in 2004, following the 2nd International Conference on Concussion in Sport in Prague, Czech Republic.

Key Study: Clinical risk score for persistent postconcussion symptoms among children with acute concussion in the ED

Visit

Zemek R, Barrowman N, Freedman SB, Gravel J, Gagnon I, McGahern C, Aglipay M,...

Objective: To derive and validate a clinical risk score for persistent postconcussion symptoms among children presenting to the emergency department.

Key study: Association between early participation in physical activity following acute concussion and persistent postconcussive symptoms in children and adolescents

Visit

Grool AM, Aglipay M, Momoli F, et al.

To investigate the association between participation in physical activity within 7 days postinjury and incidence of persistent postconcussive symptoms (PPCS).

Key Study: Comparison of PECARN, CATCH, and CHALICE rules for children with minor head injury: a prospective cohort study

Visit

Easter JS, Bakes K, Dhaliwal J, Miller M, Caruso E, Haukoos JS

Objective: To evaluate the diagnostic accuracy of clinical decision rules and physician judgment for identifying clinically important traumatic brain injuries in children with minor head injuries presenting to the emergency department.

Key study: Association between ondansetron use and symptom persistence in children with concussions: A 5P substudy

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Gravel J, Boutis K, Tang K, et al.

Ondansetron is increasingly administered to children suffering from concussion-associated nausea/vomiting. We examined the association between ondansetron administration and post-concussion symptoms in children at 1 week and 1 month following the concussion.

Key study: Association of time since injury to the first clinic visit with recovery following concussion

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Kontos AP, Jorgensen-Wagers K, Trbovich AM, et al.

To investigate the association of time since injury with initiation of clinical care on recovery time following concussion.

Key study: Characteristics of concussion in elementary school-aged children: implications for clinical management

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Master CL, Curry AE, Pfeiffer MR, et al.

To comprehensively characterize the clinical presentation and course of care for concussion among 5- to 11-year-old children, identifying preinjury and injury factors potentially influencing clinical outcomes.

Key study: Characteristics of diagnosed concussions in children aged 0 to 4 years presenting to a large pediatric healthcare network

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Podolak OE, Chaudhary S, Haarbauer-Krupa J, et al.

The aim of the study was to comprehensively describe the natural history of concussion in early childhood between 0 and 4 years.

Key study: Concussion Guidelines Step 2: evidence for subtype classification

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Lumba-Brown A, Teramoto M, Bloom OJ, et al.

Objective: To use evidence-based methodology to characterize the 5 concussion subtypes and 2 associated conditions and report their prevalence in acute concussion patients as compared to baseline or controls within 3 d of injury.

Key study: Concussion-symptom rating correlation between pediatric patients and their parents

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Patsimas T, Howell DR, Potter MN, Potter MN, Provance AJ, Kirkwood MW, Wilson JC

To examine patient-parent correlations and agreement on concussion-symptom ratings, to identify differences in patient-parent symptom reporting between children (8-12 years of age) and adolescents (13-18 years of age), and to evaluate the correlation between patient and parent initial symptom-severity ratings with symptom duration and return-to-play time.

Key study: Continuing play, symptom severity, and symptom duration after concussion in youth athletes

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Howell DR, O'Brien MJ, Fraser J, Meehan WP.

Objective: To determine whether continuing to play after a concussion is associated with higher symptom burden or prolonged symptom duration.

Key study: Delayed symptom onset following pediatric sport-related concussion

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Olson A, Ellis MJ, Selci E, Russell K.

Objective: (1) To examine the prevalence of delayed symptom onset (DSO) among pediatric sport-related concussion (SRC) patients as well as the effect of symptom onset on initial symptom severity, length of recovery, and development of delayed recovery; (2) to evaluate the impact of symptom onset on sideline management.

Key study: Early versus delayed emergency department presentation following mild traumatic nrain injury and the presence of symptom at 1, 4 and 12 weeks in children

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Gravel J, Ledoux AA, Tang K, et al.

We evaluated the association between timing of presentation and postconcussive symptoms (PCS) at 1, 4 and 12 weeks after injury.

Key study: Effect of cognitive and physical rest on persistent postconcussive symptoms following a pediatric head injury

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Root JM, Sady MD, Gai J, Vaughan CG, Madati PJ

To evaluate the effect of cognitive and physical rest on persistent postconcussive symptoms in a pediatric population.

Key study: Participation in physical activity at time of presentation to a specialty concussion clinic is associated with shorter time to recovery

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Coslick AM, Chin KE, Kalb LG, Slomine BS, Suskauer SJ.

To determine if level of physical activity at presentation to a rehabilitation-based concussion specialty clinic predicted days from injury to recovery.

Key study: Pediatric minor head injury imaging practices: results from an ESPR survey

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Argyropoulou MI, Alexiou GA, Xydis VG, et al.

Objective: Computed tomography (CT) for minor head injury exposes a large number of children to ionizing radiation, with an associated increased lifetime risk of malignancy. To study imaging practices for children with minor head injury and the level of awareness of radiologists of the current clinical decision rules for minor traumatic brain injury (TBI).

Key study: Reliability of the visio-vestibular examination for concussion among providers in a pediatric emergency department

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Corwin DJ, Arbogast KB, Swann C, et al.

Our objective was to determine the inter-rater (IRR) and test-retest reliability (TRR) of the VVE in a pediatric ED.

Key study: Trajectories and predictors of clinician-determined recovery after child concussion

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Anderson V, Davis GA, Takagi M, et al.

We mapped concussion recovery to 3 months post-injury and explored non-modifiable (e.g., age, sex, pre-injury factors, injury mechanism, acute PCS) and modifiable (post-acute child symptoms) predictors of persisting symptoms in order to identify opportunities for early intervention.

Key study: Use of the sport concussion assessment tools in the emergency department to predict persistent post-concussive symptoms in children

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Bressan S, Clarke CJ, Anderson V, et al.

We aim to assess the predictive value of the main SCAT3/ChildSCAT3 components for PPCS when applied in the ED.

Key study: A longitudinal investigation of sleep and daytime wakefulness in children and youth with concussion

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Wiseman-Hakes C, Gosselin N, Sharma B, Langer L, Gagnon I.

In this study, we investigated the trajectory of sleep and daytime sleepiness in a prospective cohort of 40 children and youth (6-18 years old) with concussion, 40 age-and sex-matched healthy children and youth, and 40 with upper-extremity orthopedic injury.

Key study: Admission of pediatric concussion injury patients: is it necessary?

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Lindholm EB, DCruz R, Fajardo R, et al.

The purpose of this study was to determine if pediatric patients evaluated in the emergency department (ED) for concussion with a negative head CT scan require routine hospital admission.

Key study: Concussion symptom profiles among child, adolescent, and young adult athletes

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Howell DR, Kriz P, Mannix RC, Kirchberg T, Master C L, Meehan WP

(1) To examine how age influences initial symptom presentation following concussion; and (2) to determine whether specific symptom profiles are associated with duration of postconcussion symptoms, and whether they vary by age group.

Key study: Delayed presentations to emergency departments of children with head injury: A PREDICT Study

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Borland ML, Dalziel SR, Phillips N, et al.

Objective: Existing clinical decision rules guide management for head-injured children presenting 24 hours or sooner after injury, even though some may present greater than 24 hours afterward. We seek to determine the prevalence of traumatic brain injuries for patients presenting to emergency departments greater than 24 hours after injury and identify symptoms and signs to guide management.

Key study: Derivation and initial validation of clinical phenotypes of children presenting with concussion acutely in the emergency department: latent class analysis of a multi-center, prospective cohort, observational study

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Yeates KO, Tang K, Barrowman N, et al.

This study used latent class analysis (LCA) to identify discernible phenotypes among children with acute concussion and examine the association between phenotypes and persistent post-concussive symptoms (PPCS) at 4 and 12 weeks post-injury. We conducted LCA of variables representing pre-injury history, clinical presentation, and parent symptom ratings, derived from a prospective cohort, observational study that recruited participants from August 2013 until June 2015 at nine pediatric emergency departments within the Pediatric Emergency Research Canada network.

Key study: Early subthreshold aerobic exercise for sport-related concussion: a randomized clinical trial

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Leddy JJ, Haider MN, Ellis MJ, et al.

To assess the effectiveness of subsymptom threshold aerobic exercise vs a placebo-like stretching program prescribed to adolescents in the acute phase of recovery from SRC.

Key study: Insomnia in adolescents with slow recovery from concussion

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Brooks BL, Sayers PQ, Virani S, Rajaram AA, Tomfohr-Madsen L.

This study examined: 1) some of the psychometric properties of the Insomnia Severity Index (ISI), 2) the prevalence and severity of insomnia symptoms, and 3) associations between insomnia symptoms and clinical measures of post-concussion symptoms, mental health symptoms, and cognitive tests in adolescents with slow recovery from concussion.

Key study: Low-value diagnostic imaging use in the pediatric emergency department in the United States and Canada

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Cohen E, Rodean J, Diong C, et al.

Objective To compare overall and low-value use of diagnostic imaging across pediatric ED visits in Ontario, Canada, and the United States.

Key study: Natural progression of symptom change and recovery from concussion in a pediatric population

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Ledoux AA, Tang K, Yeates KO, et al.

Objectives: To describe the natural progression of symptom change by age group (5-7, 8-12, and 13-18 years) and sex, as well as to develop centile curves to inform families about children after injury recovery.

Key study: Persistent vestibular-ocular impairment following concussion in adolescents

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Sinnott AM, Elbin RJ, Collins MW, Reeves VL, Holland CL, Kontos AP.

Objectives: The current study investigated the role of persistent vestibular-ocular symptoms and impairment following sport-related concussion on recovery time and clinical outcomes among adolescents.

Key study: Physical activity after mild traumatic brain injury: what are the relationships with fatigue and sleep quality?

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van Markus-Doornbosch F, Peeters E, van der Pas S, Vlieland TV, Meesters J.

To determine self-reported physical activity (PA) levels and relationships with fatigue and sleep quality in adolescents and young adults after mild traumatic brain injury (mTBI).

Key study: Practice patterns in pharmacological and non-pharmacological therapies for children with mild traumatic brain injury: a survey of 15 canadian and United States centers

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Mannix R, Zemek R, Yeates KO, et al.

Given the lack of evidence regarding effective pharmacological and non-pharmacological interventions for pediatric mild traumatic brain injury (mTBI) and the resultant lack of treatment recommendations reflected in consensus guidelines, variation in the management of pediatric mTBI is to be expected. We therefore surveyed practitioners across 15 centers in the United States and Canada who care for children with pediatric mTBI to evaluate common-practice variation in the management of pediatric mTBI.

Key study: Quality of life and symptom burden 1 month after concussion in children and adolescents

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Howell DR, Wilson JC, Kirkwood MW, Grubenhoff JA.

We conducted a prospective study of children and adolescents (n = 176; mean age = 13.0 2.7 years; 38% female) assessed acutely post-concussion and again 30 days later. We investigated the association between symptom burden and quality of life (QOL) outcomes, as well as the effect of age on QOL.

Key study: Reduction of computed tomography use for pediatric closed head injury evaluation at a nonpediatric community emergency department

Visit

Puffenbarger MS, Ahmad FA, Argent M, Gu H, Samson C, Quayle KS, Saito JM.

The purpose of this study was to determine if implementation of a Pediatric Emergency Care Applied Research Network (PECARN)-based Closed Head Injury Assessment Tool could safely decrease computed tomography (CT) use for pediatric head injury evaluation at a nonpediatric community emergency department (ED).

Key study: Risk factors for prolonged symptoms of mild traumatic brain injury: a pediatric sports concussion clinic cohort

Visit

Fehr SD, Nelson LD, Scharer KR, et al.

To examine predictors of prolonged symptom duration from mild traumatic brain injury (mTBI) in a pediatric sports medicine specialty clinic cohort as these predictors may be distinct in this population.

Key study: Trouble falling asleep after concussion is associated with higher symptom burden among children and adolescents

Visit

Howell DR, Oldham JR, Brilliant AN, Meehan WP.

Our objective was to identify factors associated with trouble falling asleep postconcussion.

Key study: Use of the vestibular and oculomotor examination for concussion in a pediatric emergency department

Visit

Corwin DJ, Propert KJ, Zorc JJ, Zonfrillo MR, Wiebe DJ.

We aimed to measure rates of exam performance after implementation of training and support tools in a pediatric emergency department.

Key study: What comes first: return to school or return to activity for youth after concussion? Maybe we dont have to choose.

Visit

DeMatteo CA, Randall S, Lin CA, Claridge EA.

This study investigates recovery trajectories of children/youth while following RTA and RTS protocols simultaneously, with the following objectives: (1) to compare rates and patterns of progression through the stages of both protocols; (2) to evaluate symptom trajectories of youth post-concussion while progressing through stages of RTS and RTA; and (3) to propose a new model for concussion management in youth that involves the integration of Return to Activity and Return to School protocols.

Key study: Characterizing hospitalizations for pediatric concussion and trends in care

Visit

Rhine T, Byczkowski T, Altaye M, Wade SL, Babcock L.

Objective: Delineate a cohort of children admitted for concussion, describe care practices received, examine factors associated with prolonged length of stay (LOS) or emergency department (ED) readmission, and investigate changes in care over time.

Key study: Identifying persistent postconcussion symptom risk in a pediatric sports medicine clinic

Visit

Howell DR, Zemek R, Brilliant AN, Mannix RC, Master CL, Meehan WP.

To determine if the Predicting Persistent Post-concussive Problems in Pediatrics (5P) clinical risk score, an emergency department (ED)derived and validated tool, is associated with developing PPCS when obtained in a primary care sports concussion setting.

Key study: MRI in mild pediatric traumatic brain injury: diagnostic overkill or useful tool?

Visit

Cohrs, G., Huhndorf, M., Niemczyk, N. et al.

Magnetic resonance imaging (MRI) is a sensitive imaging tool which lacks the burden of ionizing radiation. It is not established as primary diagnostic tool in traumatic brain injury (TBI). The purpose of this study was to evaluate the usefulness of MRI as initial imaging modality in the emergency management of mild pediatric TBI.

Key study: No association between metoclopramide treatment in ED and reduced risk of post-concussion headache

Visit

Bresee N, Aglipay M, Dubrovsky AS, et al.

There is a lack of definitive pediatric literature on effective pharmacotherapy for persistent post-concussion headache symptoms. This study assessed whether acute metoclopramide treatment in the Emergency Department (ED) was associated with a reduction in persistent headache in children at 1- and 4-weeks post-concussion.

Key study: Resumption of physical activity within 7 days of a concussion was associated with lower rates of persistent postconcussive symptoms (PPCS)

Visit

Kanani AN, Hartshorn S.

A planned secondary analysis of nine pediatric emergency departments of return to physical activity within 7 days postinjury (ranging from light exercise to a full return to competitive sports).

Key study: The diagnosis of concussion in pediatric emergency departments: a prospective multicenter study

Visit

Boutis K, Gravel J, Freedman SB, et al.

Objectives: We compared the frequency of persistent concussion symptoms in children who were provided the diagnosis of concussion by an emergency physician versus those who met Berlin/Zurich international criteria for this diagnosis. We also determined the clinical variables independently associated with a physician-diagnosed concussion.

Key study: Vision and vestibular system dysfunction predicts prolonged concussion recovery in children

Visit

Master CL, Master SR, Wiebe DJ, et al.

Objective: Up to one-third of children with concussion have prolonged symptoms lasting beyond 4 weeks. Vision and vestibular dysfunction is common after concussion. It is unknown whether such dysfunction predicts prolonged recovery. We sought to determine which vision or vestibular problems predict prolonged recovery in children.

Key study: Symptom-guided emergency department discharge instructions for children with concussion

Visit

Brooks TM, Smith MM, Silvis RM, et al.

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.

Key study: The Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5): Background and rationale

Visit

Davis GA, Purcell L, Schneider KJ, et al.

This article presents the Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5). The Sport Concussion Assessment Tool was introduced in 2004, following the 2nd International Conference on Concussion in Sport in Prague, Czech Republic.

Key Study: Clinical risk score for persistent postconcussion symptoms among children with acute concussion in the ED

Visit

Zemek R, Barrowman N, Freedman SB, Gravel J, Gagnon I, McGahern C, Aglipay M,...

Objective: To derive and validate a clinical risk score for persistent postconcussion symptoms among children presenting to the emergency department.

Key study: Association between early participation in physical activity following acute concussion and persistent postconcussive symptoms in children and adolescents

Visit

Grool AM, Aglipay M, Momoli F, et al.

To investigate the association between participation in physical activity within 7 days postinjury and incidence of persistent postconcussive symptoms (PPCS).

Key Study: Comparison of PECARN, CATCH, and CHALICE rules for children with minor head injury: a prospective cohort study

Visit

Easter JS, Bakes K, Dhaliwal J, Miller M, Caruso E, Haukoos JS

Objective: To evaluate the diagnostic accuracy of clinical decision rules and physician judgment for identifying clinically important traumatic brain injuries in children with minor head injuries presenting to the emergency department.

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Commentary: Concussion management for children has changed: new pediatric protocols using the latest evidence

Visit

DeMatteo C, Randall S, Falla K, et al.

This study aims to update CanChild's 2015 RTA and RTS protocols, on the basis of empirical data and feedback collected from our recently completed prospective cohort study, focusing on concussed children and their caregivers; systematic review of evidence published since 2015; and consultation with concussion management experts.

Review: Prognosis of concussion in children

Visit

Torres AR, Espinosa B

The objective of this paper is to review the literature about prognostic factors that influence recovery from concussion. Also, we provide an overview of the duration of the symptoms, criteria to return to school and sports, and retirement of sports.

Commentary: Options for evaluating and tracking pediatric concussion

Visit

Lynch W

The present article describes some of the principal providers of concussion detection and tracking technology available without attempting to critique or recommend one system over another.

Concussion Awareness Training Tool (CATT)

Visit

Dr. Shelina Babul and BC Injury Research and Prevention Unit, BC Children’s H...

The Concussion Awareness Training Tool (CATT) is a series of online educational modules and resources with­ the goal of standardizing concussion recognition, diagnosis, treatment, and management. Good concussion management may decrease the risk of brain damage and potentially reduce long-term health issues.

Video: Concussions 101, a Primer for Kids and Parents (2011)

Visit

Evans, M

This is a quick review of concussions: what they are and what they do.

Commentary: Concussion management for children has changed: new pediatric protocols using the latest evidence

Visit

DeMatteo C, Randall S, Falla K, et al.

This study aims to update CanChild's 2015 RTA and RTS protocols, on the basis of empirical data and feedback collected from our recently completed prospective cohort study, focusing on concussed children and their caregivers; systematic review of evidence published since 2015; and consultation with concussion management experts.

Review: Prognosis of concussion in children

Visit

Torres AR, Espinosa B

The objective of this paper is to review the literature about prognostic factors that influence recovery from concussion. Also, we provide an overview of the duration of the symptoms, criteria to return to school and sports, and retirement of sports.

Commentary: Options for evaluating and tracking pediatric concussion

Visit

Lynch W

The present article describes some of the principal providers of concussion detection and tracking technology available without attempting to critique or recommend one system over another.

Concussion Awareness Training Tool (CATT)

Visit

Dr. Shelina Babul and BC Injury Research and Prevention Unit, BC Children’s H...

The Concussion Awareness Training Tool (CATT) is a series of online educational modules and resources with­ the goal of standardizing concussion recognition, diagnosis, treatment, and management. Good concussion management may decrease the risk of brain damage and potentially reduce long-term health issues.

Video: Concussions 101, a Primer for Kids and Parents (2011)

Visit

Evans, M

This is a quick review of concussions: what they are and what they do.

Resources For Patients and Families...