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Concussion in Young Athletes

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Injury in Pediatric and Adolescent Sports

Part of the book series: Contemporary Pediatric and Adolescent Sports Medicine ((PASM))

Abstract

Concussions are common injuries associated with sports, particularly in children and adolescents. Two thirds of sport-related concussions (SRCs) occur in children and adolescents and the incidence of SRCs has been increasing in the last decade. The incidence of SRCs is especially high in football, soccer, basketball, and ice hockey and females appear to be at higher risk compared with males in gender-comparable sports. Recognition and proper management of SRCs is very important to prevent possible secondary injury and worsening or prolongation of concussive symptoms. Any athlete who is suspected of sustaining a head injury should immediately be removed from play, evaluated by an experienced, qualified health care professional (HCP), and not be allowed to return to play (RTP) until medically cleared. The key to management is physical and cognitive rest to allow symptoms to abate, followed by gradual return to cognitive activities, including school, then physical activity via a medically supervised stepwise exertion protocol.

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References

  1. Gulli C. Concussions: the untold story. http://www.macleans.ca/society/concussions-the-untold-story/ Accessed July 23, 2014.

  2. Gulli C. The damage done by concussions. http://www.macleans.ca/society/the-damage-done/ Accessed July 23, 2014.

  3. Kelly KD, Lissel HL, Rowe BH, et al. Sport and recreation-related head injuries treated in the emergency department. Clin J Sport Med. 2001;11(2):77–81.

    Article  CAS  PubMed  Google Scholar 

  4. McCrory P, Meeuwisse W, Aubry M, et al. Consensus statement on concussion in sport—4th International Conference on Concussion in Sport held in Zurich, November 2012. Clin J Sport Med. 2013;23(2):89–117.

    Article  PubMed  Google Scholar 

  5. Purcell LK, Healthy Active Living and Sport Medicine Committee, Canadian Paediatric Society. Sport-related concussion: evaluation and management. Paediatr Child Health. 2014;19(3):153–8. http://www.cps.ca/en/documents/position/sport-related-concussion-evaluation-management. Accessed July 26, 2014.

    PubMed Central  PubMed  Google Scholar 

  6. Halstead ME, Walter KD, Council on Sports Medicine and Fitness, American Academy of Pediatrics. Clinical report–sport-related concussion in children and adolescents. Pediatrics. 2010;126(3):597–615.

    Article  PubMed  Google Scholar 

  7. Field M, Collins MW, Lovell MR, et al. Does age play a role in recovery from sports-related concussion? A comparison of high school and collegiate athletes. J Pediatr. 2003;142(5):546–53.

    Article  PubMed  Google Scholar 

  8. Sim A, Terryberry-Spohr L, Wilson KR. Prolonged recovery of memory functioning after mild traumatic brain injury in adolescent athletes. J Neurosurg. 2008;108(3):511–6.

    Article  PubMed  Google Scholar 

  9. Fazio VC, Lovell MR, Pardini JE, et al. The relation between post concussion symptoms and neurocognitive performance in concussed athletes. NeuroRehabilitation. 2007;22(3):207–16.

    PubMed  Google Scholar 

  10. Zemek R, Duval S, Dematteo C et al. Guidelines for diagnosing and managing pediatric concussion, first edition. Ontario Neurotrauma Foundation, June 2014. www.onf.org/documents/guidelines-for-pediatric-concussion. Accessed July 30, 2014.

  11. Caine D, Purcell L, Maffulli N. The child and adolescent athlete: a review of three potentially serious injuries. BMC Sports Med Sci Rehabil. 2014;6:22. http://biomedcentral.com/2052-1847/6/22. Accessed July 30, 2014.

    Article  Google Scholar 

  12. Institute of Medicine, National Research Council. Sports-related concussions in youth: Improving the science, changing the culture. Washington, DC: The National Academies Press; 2014. http://www.nap.edu/catalog.php?record_id=18377. Accessed July 30, 2014.

    Google Scholar 

  13. Meehan WP, Taylor AM, Proctor M. The pediatric athlete: younger athletes with sport-related concussion. Clin Sport Med. 2011;30(1):33–144.

    Article  Google Scholar 

  14. Bakhos LL, Lockhart GR, Myers R, et al. Emergency department visits for concussion in young child athletes. Pediatrics. 2010;126:e550–6.

    Article  PubMed  Google Scholar 

  15. Chrisman SP, Schiff MA, Chung SK, et al. Implementation of concussion legislation and extent of concussion education for athletes, parents, and coaches in Washington State. Am J Sports Med. 2014;42:1190–6. doi:10.1177/ 0363546513519073.

    Article  PubMed  Google Scholar 

  16. Get a heads up on concussion in sports policies: information for parents, coaches, and school and sports professionals. http://www.cdc.gov/concussion/policies.html. Accessed July 23, 2014.

  17. Traumatic brain injury legislation. http://www.ncsl.org/research/health/traumatic-brain-injury-legislation.aspx. Accessed July 23, 2014.

  18. Ministry of Education of Ontario. Policy/program memorandum (PPM) 158: School board policies on concussion. http://www.health.gov.on.ca/en/public/programs/concussions/resources.aspx. Accessed July 31, 2014.

  19. Funding to address concussions and brain injuries in children and youth playing team sports in Canada. http://www.phac-aspc.gc.ca/media/nr-rp/2012/2012_0119-fs-fi-eng.php. Accessed July 23, 2014.

  20. Gilchrist J, Thomas KE, Xu L, Centers for Disease Control and Prevention, et al. Nonfatal traumatic brain injuries related to sports and recreation activities among persons aged ≤19 years – United States 2001–2009. MMWR. 2011;60:1337–42.

    Google Scholar 

  21. Harris AW, Jones CA, Rowe BH, et al. A population-based study of sport and recreation-related head injuries treated in a Canadian health region. J Sci Med Sport. 2012;15:298–304.

    Article  PubMed  Google Scholar 

  22. Meehan WP, Mannix R. Pediatric concussions in United States emergency departments in the years 2002 to 2006. J Pediatr. 2010;157(6):889–93.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Browne GJ, Lam LT. Concussive head injury in children and adolescents related to sports and other leisure physical activities. Br J Sports Med. 2006;40:163–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  24. Fridman L, Fraser-Thomas JL, McFaull SR, et al. Epidemiology of sports-related injuries in children and youth presenting to Canadian emergency departments 2007–2010. BMC Sport Med Rehabil. 2013;5:30. http://biomedcentral.com/2052-1847/5/30.

    Article  Google Scholar 

  25. Giannotti M, Al-Sahab B, McFaull S, et al. Epidemiology of acute soccer injuries in Canadian children and youth. Pediatr Emerg Care. 2011;27:81–5.

    Article  PubMed  Google Scholar 

  26. Lawson BR, Comstock RD, Smith GA. Baseball-related injuries to children treated in hospital emergency departments in the United States, 1994–2006. Pediatrics. 2009;123:e1028–34.

    Article  PubMed  Google Scholar 

  27. Mehan TJ, Gardner R, Smith GA, et al. Bicycle-related injuries among children and adolescents in the United States. Clin Pediatr. 2009;48(2):166–73.

    Article  Google Scholar 

  28. Nation AD, Nelson NG, Yard EE, et al. Football-related injuries among 6- to 17-year olds treated in US emergency departments, 1990–2007. Clin Pediatr. 2011;50(3):200–7.

    Article  Google Scholar 

  29. Singh S, Smith GA, Fields SK, et al. Gymnastics-related injuries to children treated in emergency departments in the United States, 1995–2005. Pediatrics. 2008;121:e954–60.

    Article  PubMed  Google Scholar 

  30. Thomas KE, Annest JL, Gilchrist J, et al. Non-fatal horse related injuries treated in emergency departments in the United States, 2001–2003. Br J Sports Med. 2006;40:619–26.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  31. Deits J, Yard EE, Collins C, et al. Patients with ice hockey injuries presenting to US emergency departments, 1990–2006. J Athl Train. 2010;45(5):467–74.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Adams AL, Schiff MA. Childhood soccer injuries treated in US emergency departments. Acad Emerg Med. 2006;13:571–4.

    Article  PubMed  Google Scholar 

  33. Pollard KA, Shields BA, Smith GA. Pediatric volleyball-related injuries treated in US emergency departments, 1990–2009. Clin Pediatr. 2011;50(9):844–52.

    Article  Google Scholar 

  34. Dick RW. Is there a gender difference in concussion incidence and outcomes? Br J Sports Med. 2009;43 Suppl 1:i46–50.

    Article  PubMed  Google Scholar 

  35. Marar M, McIlvain NM, Fields SK, et al. Epidemiology of concussions among United States high school athletes in 20 sports. Am J Sports Med. 2012;40:747–55.

    Article  PubMed  Google Scholar 

  36. Delaney JS, Lacroix VJ, Leclerc S, et al. Concussions among university football and soccer players. Clin J Sport Med. 2002;12(6):331–8.

    Article  PubMed  Google Scholar 

  37. Halstead ME, McAvoy K, Devore CD et al. Returning to learning following a concussion. http://pediatrics.aappublications.org/content/132/5/948.full.pdf+html?sid=0063ae90-fbb1-40bb-ae32-a33a4bcfda80. Accessed July 26, 2014.

  38. Hanson HR, Pomerantz WJ, Gittelman M. ED utilization trends in sports-related traumatic brain injury. Pediatrics. 2013;132:e859–64.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Lovell MR, Fazio V. Concussion management in the child and adolescent athlete. Curr Sports Med Rep. 2008;7(1):12–5.

    Article  PubMed  Google Scholar 

  40. Covassin T, Elbin BJ, Nakayama Y. Tracking neurocognitive performance following concussion in high school athletes. Phys Sports Med. 2010;38(4):87–93. doi:10.3810/psm.2010.12-1830.

    Article  Google Scholar 

  41. Barlow KM, Crawford S, Stevenson A, et al. Epidemiology of postconcussion syndrome in pediatric mild traumatic brain injury. Pediatrics. 2010;126:e374–81.

    Article  PubMed  Google Scholar 

  42. Ponsford J, Willmott C, Rothwell A, et al. Cognitive and behavioural outcome following mild traumatic head injury in children. J Head Trauma Rehab. 1999;14(4):360–72.

    Article  CAS  Google Scholar 

  43. Lau BC, Collins MW, Lovell MR. Sensitivity and specificity of subacute computerized neurocognitive testing and symptom evaluation in predicting outcomes after sports-related concussion. Am J Sports Med. 2011;39(6):1209–16.

    Article  PubMed  Google Scholar 

  44. Eisenberg MA, Andrea J, Meehan W, et al. Time interval between concussions and symptom duration. Pediatrics. 2013;132:8–17.

    Article  PubMed  Google Scholar 

  45. Meehan WP, Mannix RC, Stracciolini A, et al. Symptom severity predicts prolonged recovery after sport-related concussion but age and amnesia do not. J Pediatr. 2013;163:721–5.

    Article  PubMed Central  PubMed  Google Scholar 

  46. Yeates KO, Luria J, Bartkowski H, et al. Postconcussive symptoms in children with mild closed head injuries. J Head Trauma Rehabil. 1999;14(4):337–50.

    Article  CAS  PubMed  Google Scholar 

  47. Purcell LK, Harvey J, Seaforth J. (2015) Patterns of recovery following sport-related concussion in children and adolescents. http://cpj.sagepub.com/content/early/2015/06/08/0009922815589915.full.pdf+html.

  48. Kirkwood MW, Yeates KO, Wilson PE. Pediatric sport-related concussion: a review of the clinical management of an oft-neglected population. Pediatrics. 2006;117(4):1359–71.

    Article  PubMed  Google Scholar 

  49. Sideline Concussion Assessment Tool. 3 http://links.lww.com/JSM/A30 Accessed July 31, 2014.

  50. Child SCAT 3 http://links.lww.com/JSM/A31 Accessed July 31, 2014.

  51. Concussion Recognition Tool. http://links.lww.com/JSM/A32. Accessed July 31, 2014.

  52. Osmond MH, Klassen TP, Wells GA, et al. CATCH: a clinical decision rule for the use of computed tomography in children with minor head injury. CMAJ. 2010;182(4):341–8.

    Article  PubMed Central  PubMed  Google Scholar 

  53. Collie A, Maruff P, Makdissi M, et al. CogSport: Reliability and correlation with conventional cognitive tests used in postconcussion medical evaluations. Clin J Sport Med. 2003;13(1):28–32.

    Article  PubMed  Google Scholar 

  54. Kirkwood MW, Yeates KO, Taylor HG, et al. Management of pediatric mild traumatic brain injury: a neuropsychological review from injury through recovery. Clin Neuropsychol. 2008;22(5):769–800.

    Article  PubMed Central  PubMed  Google Scholar 

  55. Kirkwood MW, Randolph C, Yeates KO. Returning pediatric athletes to play after concussion: the evidence (or lack thereof) behind baseline neuropsychological testing. Acta Paediatr. 2009;98(9):1409–11.

    Article  PubMed  Google Scholar 

  56. McCrory P, Collie A, Anderson V, et al. Can we manage sport-related concussion in children the same as in adults? Br J Sports Med. 2004;38(5):516–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  57. Moser RS, Glatts C, Schatz P. Efficacy of immediate and delayed cognitive and physical rest for treatment of sports-related concussion. J Pediatr. 2012;161(5):922–6.

    Article  PubMed  Google Scholar 

  58. Davis GA, Purcell LK. The evaluation and management of acute concussion differs in young children. Br J Sports Med. 2014;48(2):98–101.

    Article  PubMed  Google Scholar 

  59. Makdissi M, Cantu RC, Johnston KM, et al. The difficult concussion patient: what is the best approach to investigation and management of persistent (>10 days) postconcussive symptoms? Br J Sports Med. 2013;47(5):308–13.

    Article  PubMed  Google Scholar 

  60. Sady MD, Vaughan CG, Gioia GA. School and the concussed youth: recommendations for concussion education and management. Phys Med Rehabil Clin N Am. 2011;22(4):701–19. ix.

    Article  PubMed Central  PubMed  Google Scholar 

  61. McGrath N. Supporting the student-athlete’s return to the classroom after a sport-related concussion. J Athl Train. 2010;45(5):492–8.

    Article  PubMed Central  PubMed  Google Scholar 

  62. Centers for Disease Control and Prevention, 2010. Heads up to schools: know your concussion ABCs: www.cdc.gov/concussion/HeadsUp/schools.html. Accessed January 13, 2014.

  63. Purcell L. What are the most appropriate return-to-play guidelines for concussed child athletes? Br J Sports Med. 2009;43 Suppl 1:i51–5.

    Article  PubMed  Google Scholar 

  64. Zemek RL, Farion KJ, Sampson M, et al. Prognosticators of persistent symptoms following pediatric concussion: a systematic review. JAMA Pediatr. 2013;167(3):259–65.

    Article  PubMed  Google Scholar 

  65. Moser RS, Schatz P, Jordan BD. Prolonged effects of concussion in high school athletes. Neurosurgery. 2005;57(2):300–6.

    Article  PubMed  Google Scholar 

  66. Lau BC, Kontos AP, Collins MW, et al. Which on-field signs/symptoms predict protracted recovery from sport-related concussion among high school football players? Am J Sports Med. 2011;39(11):2311–8.

    Article  PubMed  Google Scholar 

  67. Blume HK. Pediatric headache: a review. Pediatr Rev. 2012;33(12):562–76.

    Article  PubMed  Google Scholar 

  68. Alsalaheen BA, Mucha A, Morris LO, et al. Vestibular rehabilitation for dizziness and balance disorders after concussion. J Neurol Phys Ther. 2010;34(2):87–93.

    Article  PubMed  Google Scholar 

  69. Gagnon I, Galli C, Friedman D, et al. Active rehabilitation for children who are slow to recover following sport-related concussion. Brain Inj. 2009;23(12):956–64.

    Article  PubMed  Google Scholar 

  70. LeBlanc JC, Huybers S. Improving bicycle safety: the role of paediatricians and family physicians. Paediatr Child Health. 2004;9(5):315–8.

    PubMed Central  PubMed  Google Scholar 

  71. Russell K, Christie J, Hagel BE. The effect of helmets on the risk of head and neck injuries among skiers and snowboarders: a meta-analysis. CMAJ. 2010;182(4):333–40.

    Article  PubMed Central  PubMed  Google Scholar 

  72. Thompson RS, Rivara FP. Protective equipment for in-line skaters. N Engl J Med. 1996;335(22):1680–2.

    Article  CAS  PubMed  Google Scholar 

  73. Benson BW, Hamilton GM, Meeuwisse WH, et al. Is protective equipment useful in preventing concussion? A systematic review of the literature. Br J Sport Med. 2009;43 Suppl 1:i56–67.

    Article  Google Scholar 

  74. Parachute. Helmet FAQ. http://www.parachutecanada.org/injury-topics/topic/C8. Accessed July 31, 2014.

  75. Hagel B, Meeuwisse W. Risk compensation: a “side effect” of sport injury prevention? Clin J Sport Med. 2004;14(4):193–6.

    Article  PubMed  Google Scholar 

  76. Janda DH, Bir C, Wild B, et al. Goalpost injuries in soccer: a laboratory and field testing analysis of a preventive intervention. Am J Sport Med. 1995;23(3):340–4.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, McMaster University, Hamilton, ON, Canada

    Laura Purcell MD, FRCPC, Dip Sport Med.

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  1. Laura Purcell MD, FRCPC, Dip Sport Med.
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Correspondence to Laura Purcell MD, FRCPC, Dip Sport Med. .

Editor information

Editors and Affiliations

  1. University of North Dakota, Grand Forks, North Dakota, USA

    Dennis Caine

  2. McMaster University, Hamilton, Ontario, Canada

    Laura Purcell

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Purcell, L. (2016). Concussion in Young Athletes. In: Caine, D., Purcell, L. (eds) Injury in Pediatric and Adolescent Sports. Contemporary Pediatric and Adolescent Sports Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-18141-7_11

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  • DOI: https://doi.org/10.1007/978-3-319-18141-7_11

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