Predicting Concussion Recovery in Children and Adolescents in the Emergency Department

Curr Neurol Neurosci Rep. 2018 Sep 19;18(11):78. doi: 10.1007/s11910-018-0881-z.

Abstract

Purpose of review: Concussion, or mild traumatic brain injury (mTBI), represents the majority of pediatric Emergency Department (ED) presentations of TBI. While most children and adolescents will recover within 4 weeks of injury, approximately one third will continue to experience persisting symptoms. This review aimed to provide an overview of literature from the past 5 years examining predictors of recovery in the ED.

Recent findings: Predictors could be characterized into three categories; (i) cognition, (ii) proteomics, and (iii) pre-injury/injury-related factors. There is preliminary support for the use of computerized neuropsychological testing. The prognostic use of proteomics is a promising area of future research. Pre-injury and injury-related characteristics have been thoroughly examined and developed into a clinical risk score for predicting delayed recovery. Substantial progress has been made in identifying risk factors for delayed recovery at ED presentation. The current evidence provides a platform for additional research that can refine and validate these predictors.

Keywords: Concussion; Emergency department; Mild traumatic brain injury; Pediatrics; Prediction; Recovery.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Brain Concussion / diagnosis*
  • Brain Concussion / psychology
  • Brain Concussion / therapy*
  • Child
  • Cognition / physiology
  • Cognition Disorders / diagnosis
  • Cognition Disorders / psychology
  • Cognition Disorders / therapy
  • Emergency Medical Services / methods*
  • Emergency Medical Services / trends
  • Emergency Service, Hospital / trends*
  • Female
  • Forecasting
  • Humans
  • Male
  • Neuropsychological Tests
  • Prognosis
  • Recovery of Function* / physiology