Sports-Related Concussions

Abstract

During the past decade, awareness of concussions has exploded as both the media and the medical literature have given more focus to this common problem. Concussions after recreational activities, especially athletics, are a frequent complaint in the emergency department. In the past few years, care of these patients has been simplified as grading systems and classifications have been abandoned. However, questions remain as to the best way to rehabilitate these patients to avoid long-term sequelae, especially in children and adolescents. The purpose of this review is to discuss the demographic characteristics, the pathophysiology, definition, clinical characteristics, and management of concussions in children and adolescents.

An epidemiologic profile of pediatric concussions

“…Attitudes have changed drastically of what was once considered a ''ding,'' and young athletes were often told to ''shake it off,'' to the recognition of the potential serious and long-lasting effects of concussions. 7,13,14 The symptoms following a concussion can be highly variable and range from short-lived disturbances to profound and persistent disabilities, cognitive impairments, behavioral changes, and in rare cases, death from second-impact syndrome. 7,14,15 Concussions are of particular concern for youth because their brains are still developing and may be more susceptible to the effects of a concussion, 14Y16 with several studies finding the rates of concussion and mean time to normalization to preconcussion baseline to be higher for adolescents, as compared with adults.…”

“…19,20 Sports-and recreation-related concussions were the most common mechanism for concussion in our population, as demonstrated by many other studies. 7,13,19,21,22 Participation in sporting activities, both organized and not, is very common for youth, putting them at higher risk for sports-related injury. 22 Our proportion of sports-related concussions increased with age, with just more half of adolescent's (10Y17 year olds) concussion the result of this mechanism, similar to a recent study in US EDs, which found 41% of adolescents' concussions to be sports related.…”

Use of the King–Devick test for sideline concussion screening in junior rugby league

“…Clashes to the head that were often thought of as "just a ding" [2] and "playing through the pain" were regarded as a sign of the individual's toughness and commitment to the team [1]. All sports participants are at risk of receiving a concussive event [3].…”

Assessment of Parental Knowledge and Attitudes Toward Pediatric Sports-Related Concussions

“… 10 Pediatric athletes experiencing concussions may experience more serious symptoms and longer recovery times. 12 , 20 Although recent SRC prevention and education efforts have increased awareness among pediatric athletic and medical professionals, many pediatric SRCs still go unreported, undiagnosed, untreated, and mismanaged. 11 , 16 …”

“… 19 Currently, conspicuous gaps in basic and translational research exploring the at-home recognition and management of pediatric SRCs are preventing the implementation of effective and comprehensive education programs and risk-reduction protocols. 16 , 20 …”