This fall, the Centers for Disease Control and Prevention released a comprehensive new guideline on diagnosing and treating children with mTBI. Based on extensive review of best practices, the guideline is a valuable tool providing clinical guidance for health care professionals.
Public awareness of mTBI has greatly increased over the past decade as injuries from professional football have been widely covered by the media. While some of these injuries are related to sports, many mTBIs result from falls at home, at school, or on the playground. According to the CDC, children seeking care for mTBI accounted for more than two million outpatient visits and three million emergency department visits in the U.S. from 2005 to 2009.
There are no blood tests for diagnosing mTBI; the diagnosis is made by clinical evaluation and observation. The new CDC guideline offers specific actions health providers can take to diagnose and treat young patients, including the following:
- Imaging studies, including CT scans, MRIs, and X-rays, should not be done routinely in diagnosing mTBI. Excessive scanning exposes younger children to significant amounts of radiation.
- Use age-appropriate symptom and cognitive scales to diagnose children. Symptoms of mTBI include headaches, dizziness, blurred vision, and sensitivity/intolerance to light or sound. Cognitive scales assess a child’s attention, concentration, and speed of information processing.
- Assess risk factors for prolonged recovery, including prior history of mTBI or other brain injury, particularly severe symptoms, or other underlying neurological conditions.
- Advise patients to rest following injury and return to school and non-sports activities after no more than two to three days of rest. Prolonged rest has not been found to be beneficial to recovery.
- Return to more rigorous activities, including sports, should be gradual, using a child’s symptoms as a guide. If symptoms recur, it’s time to slow down.
For most patients, recovery from mTBI occurs rapidly, typically within two weeks. Approximately 80 percent of children with mTBI have fully recovered by three months post-injury. A child with acute symptoms that persist and affect daily function should be referred to a specialty clinic for treatment. These symptoms may include dizziness, headaches, fatigue, sleep disturbance, irritability and anxiety.
The brain injury program at Children’s Specialized Hospital has a multidisciplinary team in place to treat the full range of brain injuries, including patients with serious, unresolved concussion. We welcome referrals from community physicians and encourage you to partner with us in providing patients with the best possible care.
As director of the brain injury program, I am board-certified in pediatrics and neurodevelopmental pediatrics. Other providers include pediatric physiatrists, nurse practitioners, a neuropsychologist, skilled nurses, and a dedicated team of therapists. We individually evaluate patients to develop a customized plan for rehabilitation, including physical, occupational, and/or speech therapy, individual cognitive remediation, and medications, if needed.
We have treated more than 3,000 patients in our inpatient rehabilitation program since its inception in 1985 with excellent outcomes. Our inpatient traumatic brain injury program specifically treats children with moderate to severe brain injuries. Our outcomes are significantly above the national average, our length of rehabilitation stay is shorter, and patients have higher functional independence and cognitive ability on discharge. We receive outstanding parent satisfaction ratings as well. More than 95 percent of parents/guardians whose children were treated here say that they would return to us or refer others here for care.
For more information, or to refer a patient to our brain injury program, please call: 888-244-5373.