The Grapevine

How To Spot Concussions In Children? Treatment Guidelines Issued By CDC

For the first time, the Centers for Disease Control and Prevention (CDC) issued a set of guidelines to improve how we deal with youth concussions, offering recommendations for doctors and reassuring parents. 

Based on 25 years of concussion-related scientific research, the new guidelines on the diagnosis and management of youth concussions were published in JAMA Pediatrics on Sept. 4.

Younger individuals, especially children and adolescent athletes, are at high risk of concussions which are also referred to as mild traumatic brain injuries (mTBI). They may often go undetected, but repeated concussions can increase the risk of conditions like dementia later in life.

When someone suffers a mild TBI, they experience changes in brain function that are usually temporary unless the impact to the head was severe. They are often associated with sports injuries, motor vehicle accidents, or falls.

Many people believe concussions cannot occur unless a person gets knocked out, but experts point this out as a widespread misconception. More than 90 percent of concussions occur without the loss of consciousness.

The first set of symptoms one should look for include headaches, dizziness, nausea, and blurred vision. While often they show up immediately, it is also possible for such symptoms to take hours or even days to start appearing. National Institutes of Health pediatric trauma specialist Dr. Valerie Maholmes advised people to "watch out for anything that seems out of the ordinary, changes in movement, mood, or trouble concentrating."

Blood tests and routine imaging were not recommended to diagnose mTBI in children, due to associated risks and lack of effectiveness. Instead, the guidelines said X-rays and CT scans are better opted to detect serious injuries like internal bleeding and skull fractures. 

Adequate rest period of two to three days is the main form of recommended treatment for concussions. However, inactivity extending longer than that might end up worsening symptoms. Children who remain undiagnosed are at risk of suffering another concussion and may need longer periods of rest.

The time taken for recovery was noted to vary. While most can expect their symptoms to disappear within three months, it may take longer for children who have suffered previous concussions, have some form of mental illness or learning difficulties.

"Some children and teens think concussions aren't serious or worry that if they report a concussion they will lose their position on the team or look weak," said Matthew Breiding, a CDC brain injury specialist and co-author of the new guidelines. "Remind them that it's better to miss one game than the whole season."

In a separate study from the University of British Columbia, Canada, researchers examined the brains of athletes and found some damage did not heal completely even two weeks after a concussion. This strengthened recommendations that athletes make a gradual return to activities like sports, even if they feel fine after brain-related injury.