Just as students return to school — with many planning to spend time on the football field — the Centers for Disease Control has released a list of recommended actions to help healthcare providers diagnose and manage the recovery of children who suffer from concussions, or mild traumatic brain injury (mTBI).
“More than 800,000 children seek care for TBI in U.S. emergency departments each year, and until today, there was no evidence-based guideline in the United States on pediatric mTBI — inclusive of all causes,” Deb Houry, MD, MPH, director of CDC’s National Center for Injury Prevention and Control said in a press release announcing the extensive set of guidelines, which was published on Tuesday in JAMMA Pediatrics.
One of the new guidelines states that unless a child exhibits signs of a potentially more serious injury — like vomiting, amnesia and severe or worsening headaches — CT imaging scans are not recommended, as they are not effective at determining whether a child has a concussion.
Another reason to avoid unnecessary imagining is that “higher doses of radiation attributable to this type of imagining in children have been associated in studies with an increase in the lifetime cancer rate,” according to the guidelines.
The guidelines also say that “health care professionals should use an age-appropriate, validated symptom rating scale” and not just the the Standardized Assessment of Concussion, to diagnose children suffering from acute concussions.
While recovering from concussions, children should “observe more restrictive physical and cognitive activity during the first several days,” although prolonged inactivity can actually make the recovery process worse, according to the guidelines.
After a several days of rest, children should resume a “gradual schedule of activity that does not exacerbate symptoms” after which health professionals recommend reintroducing “noncontact aerobic activity” into the child’s routine.
Then, if the child remains symptom-free, doctors will help determine when they can “return to full activity.”
Typically, children can expect to stop exhibiting symptoms within one to three months.
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Dr. Matthew J. Breiding, the lead author of the study, also pointed out how important it is for children to tell their parents right away if they think they may have been concussed.
“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. Remind them that it’s better to miss one game than the whole season,” he told the Associated Press.
Concussions have been linked to chronic traumatic encephalopathy, or CTE — a degenerative brain disease. Symptoms include depression, short-term memory loss, impulsive behavior and confusion, and they can begin to appear long after a football player’s career. Mounting evidence suggests a link between the disease and playing football.
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