Taylor, A M; Nigrovic, L E; Saillant, M L; Trudell, E K; Proctor, M R; Modest, J R; Vernacchio, L
Trends in Ambulatory Care for Children with Concussion and Minor Head Injury from Eastern Massachusetts between 2007 and 2013 Journal Article
In: Journal of Pediatrics, vol. 167, pp. 738–744, 2015.
Abstract | Links | BibTeX | Tags: Children Under 13
@article{Taylor2015,
title = {Trends in Ambulatory Care for Children with Concussion and Minor Head Injury from Eastern Massachusetts between 2007 and 2013},
author = {Taylor, A M and Nigrovic, L E and Saillant, M L and Trudell, E K and Proctor, M R and Modest, J R and Vernacchio, L},
doi = {10.1016/j.jpeds.2015.05.036},
year = {2015},
date = {2015-01-01},
journal = {Journal of Pediatrics},
volume = {167},
pages = {738--744},
abstract = {Objective: To characterize trends in health care utilization and costs for children diagnosed with concussion or minor head injury within a large pediatric primary-care association. Study design: We conducted a retrospective cohort analysis from 2007 through 2013 examining all outpatient medical claims related to concussion and minor head injury from 4 commercial insurance companies for children 6-21years of age who were patients within a large pediatric independent practice association located throughout eastern Massachusetts. Results: Health care visits for concussion and minor head injury increased more than 4-fold during the study period, with primary-care and specialty clinics experiencing the greatest increases in the rate of visits while emergency department visits increased comparatively less. These increases were accounted for by both the proportion of children diagnosed with concussion or minor head injury (1.3% of all children in 2007 vs 3.3% in 2013) and the number of encounters per diagnosed patient (1.0 encounters per patient in 2007 vs 1.7 in 2013). Although the overall population costs devoted to care for concussion or minor head injury increased 34%, the cost per individual diagnosed child decreased 31%. Conclusions: Over the past 7years, health care encounters for children diagnosed with concussion or minor head injury increased substantially in eastern Massachusetts. Care for these injuries increasingly shifted from the emergency department to primary-care and specialty providers. © 2015 Elsevier Inc.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Urban, K J; Barlow, K M; Jimenez, J J; Goodyear, B G; Dunn, J F
Functional near-infrared spectroscopy reveals reduced interhemispheric cortical communication after pediatric concussion Journal Article
In: Journal of Neurotrauma, vol. 32, pp. 833–840, 2015.
Abstract | BibTeX | Tags: Children Under 13
@article{Urban2015,
title = {Functional near-infrared spectroscopy reveals reduced interhemispheric cortical communication after pediatric concussion},
author = {Urban, K J and Barlow, K M and Jimenez, J J and Goodyear, B G and Dunn, J F},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurotrauma},
volume = {32},
pages = {833--840},
address = {Urban,Karolina J. 1Department of Radiology, University of Calgary, Calgary, Alberta, Canada. Urban,Karolina J. 2Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada. Urban,Karolina J. 3Experimental Imaging Center, University of Calga},
abstract = {Concussion, or mild traumatic brain injury (mTBI), is a growing concern, especially among the pediatric population. By age 25, as many as 30% of the population are likely to have had a concussion. Many result in long-term disability, with some evolving to postconcussion syndrome. Treatments are being developed, but are difficult to assess given the lack of measures to quantitatively monitor concussion. There is no accepted quantitative imaging metric for monitoring concussion. We hypothesized that because cognitive function and fiber tracks are often impacted in concussion, interhemispheric brain communication may be impaired. We used functional near-infrared spectroscopy (fNIRS) to quantify functional coherence between the left and right motor cortex as a marker of interhemispheric communication. Studies were undertaken during the resting state and with a finger-tapping task to activate the motor cortex. Pediatric patients (ages 12-18) had symptoms for 31-473 days, compared to controls, who have not had reported a previous concussion. We detected differences between patients and controls in coherence between the contralateral motor cortices using measurements of total hemoglobin and oxy-hemoglobin with a p\<0.01 (n=8, control; n=12mTBI). Given the critical need for a quantitative biomarker for recovery after a concussion, we present these data to highlight the potential of fNIRS coupled with interhemispheric coherence analysis as a biomarker of concussion injury.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Yuan, W; Wade, S L; Babcock, L
Structural connectivity abnormality in children with acute mild traumatic brain injury using graph theoretical analysis Journal Article
In: Human Brain Mapping, vol. 36, pp. 779–792, 2015.
Abstract | BibTeX | Tags: Children Under 13
@article{Yuan2015,
title = {Structural connectivity abnormality in children with acute mild traumatic brain injury using graph theoretical analysis},
author = {Yuan, W and Wade, S L and Babcock, L},
year = {2015},
date = {2015-01-01},
journal = {Human Brain Mapping},
volume = {36},
pages = {779--792},
address = {Yuan,Weihong. Pediatric Neuroimaging Research Consortium, Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; College of Medicine University of Cincinnati, Cincinnati, Ohio.},
abstract = {The traumatic biomechanical forces associated with mild traumatic brain injury (mTBI) typically impart diffuse, as opposed to focal, brain injury potentially disrupting the structural connectivity between neural networks. Graph theoretical analysis using diffusion tensor imaging was used to assess injury-related differences in structural connectivity between 23 children (age 11-16 years) with mTBI and 20 age-matched children with isolated orthopedic injuries (OI) scanned within 96 h postinjury. The distribution of hub regions and the associations between alterations in regional network measures and symptom burden, as assessed by the postconcussion symptom scale score (PCSS), were also examined. In comparison to the OI group, the mTBI group was found to have significantly higher small-worldness (P\<0.0001), higher normalized clustering coefficients (P\<0.0001), higher normalized characteristic path length (P=0.007), higher modularity (P=0.0005), and lower global efficiency (P\<0.0001). A series of hub regions in the mTBI group were found to have significant alterations in regional network measures including nodal degree, nodal clustering coefficient, and nodal between-ness centrality. Correlation analysis showed that PCSS total score acquired at the time of imaging was significantly associated with the nodal degree of two hubs, the superior frontal gyrus at orbital section and the middle frontal gyrus. These findings provide new evidence of acute white matter alteration at both global and regional network level following mTBI in children furthering our understanding of underlying mechanisms of acute neurological insult associated with mTBI.Copyright © 2014 Wiley Periodicals, Inc.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Chan, V; Thurairajah, P; Colantonio, A
Defining pediatric traumatic brain injury using International Classification of Diseases Version 10 Codes: a systematic review Journal Article
In: BMC Neurology, vol. 15, pp. 7, 2015.
Abstract | BibTeX | Tags: Children Under 13
@article{Chan2015a,
title = {Defining pediatric traumatic brain injury using International Classification of Diseases Version 10 Codes: a systematic review},
author = {Chan, V and Thurairajah, P and Colantonio, A},
year = {2015},
date = {2015-01-01},
journal = {BMC Neurology},
volume = {15},
pages = {7},
address = {Chan,Vincy. Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada. vincy.chan@uhn.ca. Chan,Vincy. Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON, M5G},
abstract = {BACKGROUND: Although healthcare administrative data are commonly used for traumatic brain injury (TBI) research, there is currently no consensus or consistency on the International Classification of Diseases Version 10 (ICD-10) codes used to define TBI among children and youth internationally. This study systematically reviewed the literature to explore the range of ICD-10 codes that are used to define TBI in this population. The identification of the range of ICD-10 codes to define this population in administrative data is crucial, as it has implications for policy, resource allocation, planning of healthcare services, and prevention strategies. METHODS: The databases MEDLINE, MEDLINE In-Process, Embase, PsychINFO, CINAHL, SPORTDiscus, and Cochrane Database of Systematic Reviews were systematically searched. Grey literature was searched using Grey Matters and Google. Reference lists of included articles were also searched for relevant studies. Two reviewers independently screened all titles and abstracts using pre-defined inclusion and exclusion criteria. A full text screen was conducted on articles that met the first screen inclusion criteria. All full text articles that met the pre-defined inclusion criteria were included for analysis in this systematic review. RESULTS: A total of 1,326 publications were identified through the predetermined search strategy and 32 articles/reports met all eligibility criteria for inclusion in this review. Five articles specifically examined children and youth aged 19 years or under with TBI. ICD-10 case definitions ranged from the broad injuries to the head codes (ICD-10 S00 to S09) to concussion only (S06.0). There was overwhelming consensus on the inclusion of ICD-10 code S06, intracranial injury, while codes S00 (superficial injury of the head), S03 (dislocation, sprain, and strain of joints and ligaments of head), and S05 (injury of eye and orbit) were only used by articles that examined head injury, none of which specifically examined children and youth. CONCLUSION: This review provides evidence for discussion on how best to use ICD codes for different goals. This is an important first step in reaching an appropriate definition and can inform future work on reaching consensus on the ICD-10 codes to define TBI for this vulnerable population.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Upchurch, C; Morgan, C D; Umfress, A; Yang, G; Riederer, M F
Discharge instructions for youth sports-related concussions in the emergency department, 2004 to 2012 Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, pp. 297–299, 2015.
Abstract | BibTeX | Tags: Children Under 13
@article{Upchurch2015,
title = {Discharge instructions for youth sports-related concussions in the emergency department, 2004 to 2012},
author = {Upchurch, C and Morgan, C D and Umfress, A and Yang, G and Riederer, M F},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
pages = {297--299},
address = {Upchurch,Cameron. *Vanderbilt School of Medicine, Nashville, Tennessee; and +Department of Pediatric Orthopaedic Surgery, C.S. Mott Children's Hospital, Ann Arbor, Michigan.},
abstract = {OBJECTIVE: To evaluate the effect of the Centers for Disease Control and Prevention (CDC) Heads-Up concussion campaign on appropriateness of discharge instructions for youth sports-related concussion (SRC) patients presenting to a pediatric emergency department (ED). DESIGN: Retrospective cohort study. SETTING: Pediatric ED. PATIENTS: Children up to 18 years. ASSESSMENT OF RISK FACTORS: A retrospective chart review was conducted on patients evaluated from 2004 to 2012. Patients were selected by ICD-9 code for having a concussion during a sporting activity. MAIN OUTCOME MEASURES: Discharge instructions were reviewed for recommendations for cognitive rest, physical rest, primary care physician follow-up, and referral to a concussion specialist or center. RESULTS: There were 497 youth SRCs from 392 908 total ED visits. Overall, only 66% had appropriate discharge recommendations. This improved to 75% after 2010, which was not statistically significant (odds ratio = 1.02},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Kirkwood, G; Parekh, N; Ofori-Asenso, R; Pollock, A M
Concussion in youth rugby union and rugby league: a systematic review Journal Article
In: British Journal of Sports Medicine, vol. 49, pp. 506–510, 2015.
Abstract | BibTeX | Tags: Children Under 13
@article{Kirkwood2015,
title = {Concussion in youth rugby union and rugby league: a systematic review},
author = {Kirkwood, G and Parekh, N and Ofori-Asenso, R and Pollock, A M},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
pages = {506--510},
address = {Kirkwood,Graham. Centre for Primary Care and Public Health, Queen Mary University of London, London, UK. Parekh,Nikesh. Lewisham and Greenwich NHS Trust, London, UK. Ofori-Asenso,Richard. Centre for Primary Care and Public Health, Queen Mary University of},
abstract = {BACKGROUND: Children and adolescents who play rugby are at increased risk of concussion and its effects. Competitive rugby union and rugby league feature as major sports in the school sport curriculum in the UK. There is a need for a thorough understanding of the epidemiology of concussion in youth rugby, the mechanisms involved in injuries and predisposing risk factors. DATA SOURCES: The publication databases Pubmed, Embase and SportDISCUS were searched in April 2014 for primary research studies of child and adolescent rugby union and rugby league (under 20 years) in English language with data on concussion injuries. The review was conducted within a larger all injury systematic review on rugby union and rugby league where key words used in the search included rugby, injury and concussion with child, adolescent, paediatric and youth. RESULTS: There were 25 studies retrieved with data on child or adolescent rugby and concussion, 20 were on rugby union, three on rugby league and in two the code of rugby was unspecified. There was significant heterogeneity in the definitions of injuries and of concussion. The incidence of child and adolescent match concussion ranged from 0.2 to 6.9 concussions per 1000 player-hours for rugby union and was 4.6 and 14.7 concussions per 1000 player-hours for rugby league, equivalent to a probability of between 0.3% and 11.4% for rugby union and of 7.7% and 22.7% for rugby league. CONCLUSIONS: There is a significant risk of concussion in children and adolescents playing rugby union and rugby league evident from the studies included in this systematic review. There is a need for reliable data through routine monitoring and reporting in schools and clubs and in hospital emergency departments in order to inform prevention. Concussion protocols should be implemented and tested.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Hodgson, L; Patricios, J
Clarifying concussion in youth rugby: recognise and remove Journal Article
In: British Journal of Sports Medicine, vol. 49, pp. 966–967, 2015, ISSN: 03063674.
Links | BibTeX | Tags: Children Under 13
@article{Hodgson2015,
title = {Clarifying concussion in youth rugby: recognise and remove},
author = {Hodgson, L and Patricios, J},
doi = {10.1136/bjsports-2014-094561},
issn = {03063674},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
pages = {966--967},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Walter, K D
Addressing concussion in youth sports Journal Article
In: The Virtual Mentor, vol. 16, pp. 559–564, 2014.
BibTeX | Tags: Children Under 13
@article{Walter2014,
title = {Addressing concussion in youth sports},
author = {Walter, K D},
year = {2014},
date = {2014-01-01},
journal = {The Virtual Mentor},
volume = {16},
pages = {559--564},
address = {Walter,Kevin D. Associate professor of orthopedic surgery at the Medical College of Wisconsin, and the program director of pediatric and adolescent primary care sports medicine at Children's Hospital of Wisconsin, and a member of the Wisconsin Interschola},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Caswell, S V; Ambegaonkar, J P; Cortes, N; York, M; Caswell, A M
Neck strengthening recommendations for concussion risk reduction in youth sport Journal Article
In: International Journal of Athletic Therapy & Training, vol. 19, pp. 22–27, 2014.
Links | BibTeX | Tags: Children Under 13
@article{Caswell2014,
title = {Neck strengthening recommendations for concussion risk reduction in youth sport},
author = {Caswell, S V and Ambegaonkar, J P and Cortes, N and York, M and Caswell, A M},
doi = {10.1123/ijatt.2014-0043},
year = {2014},
date = {2014-01-01},
journal = {International Journal of Athletic Therapy \& Training},
volume = {19},
pages = {22--27},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Kerr, H A
Concussion risk factors and strategies for prevention Journal Article
In: Pediatric Annals, vol. 43, pp. e309–15, 2014.
Abstract | BibTeX | Tags: Children Under 13
@article{Kerr2014b,
title = {Concussion risk factors and strategies for prevention},
author = {Kerr, H A},
year = {2014},
date = {2014-01-01},
journal = {Pediatric Annals},
volume = {43},
pages = {e309--15},
abstract = {Concussion in children is frequently related to participation in sports. It requires a traumatic event to occur that transmits acceleration to the brain. Some children may have intrinsic risk factors that place them at greater risk for this type of injury. Comorbidities such as attention-deficit/hyperactivity disorder, migraine headaches, and mood disorders may place athletes at increased risk of more severe injury. A previous concussion is probably the most important influence on risk for future injury. Extrinsic risk factors include coaching techniques, officiating, and choice of sport. Helmet choice does not diminish concussion risk, nor does the use of mouth guards. Education of athletes, coaches, parents, and physicians is very important in improving recognition of potential concussive injury and helping child athletes and their parents understand the risks involved in sport participation.Copyright 2014, SLACK Incorporated.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Giza, C C
Pediatric issues in sports concussions Journal Article
In: CONTINUUM: Lifelong Learning in Neurology, vol. 20, pp. 1570–1587, 2014.
Abstract | BibTeX | Tags: Children Under 13
@article{Giza2014a,
title = {Pediatric issues in sports concussions},
author = {Giza, C C},
year = {2014},
date = {2014-01-01},
journal = {CONTINUUM: Lifelong Learning in Neurology},
volume = {20},
pages = {1570--1587},
abstract = {PURPOSE OF REVIEW: Sports-related concussions are receiving increasing attention in both the lay press and medical literature. While most media attention has been on high-profile collegiate or professional athletes, the vast majority of individuals participating in contact and collision sports are adolescents and children. This review provides a practical approach toward youth sports-related concussion with a foundation in the recent guidelines, but including specific considerations when applying these management principles to children and adolescents. RECENT FINDINGS: Objective measurement of early signs and symptoms is challenging in younger patients, and many commonly used assessment tools await rigorous validation for younger patients. Excellent evidence-based guidelines exist for CT evaluation of mild traumatic brain injury presenting to the emergency department. Evidence suggests that recovery from sports-related concussion takes longer in high school athletes compared with collegiate or professionals; however, rigorous studies below high school age are still lacking. SUMMARY: Proper care for concussion in youth requires a delicate balance of clinical skills, age-appropriate assessment, and individualized management to achieve optimal outcomes.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Cartwright, C
Pediatric athletic concussion Journal Article
In: Journal of Neuroscience Nursing, vol. 46, pp. 313, 2014.
BibTeX | Tags: Children Under 13
@article{Cartwright2014,
title = {Pediatric athletic concussion},
author = {Cartwright, C},
year = {2014},
date = {2014-01-01},
journal = {Journal of Neuroscience Nursing},
volume = {46},
pages = {313},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Macpherson, A; Fridman, L; Scolnik, M; Corallo, A; Guttmann, A
A population-based study of paediatric emergency department and office visits for concussions from 2003 to 2010 Journal Article
In: Paediatrics & Child Health, vol. 19, pp. 543–546, 2014.
Abstract | BibTeX | Tags: Children Under 13
@article{Macpherson2014,
title = {A population-based study of paediatric emergency department and office visits for concussions from 2003 to 2010},
author = {Macpherson, A and Fridman, L and Scolnik, M and Corallo, A and Guttmann, A},
year = {2014},
date = {2014-01-01},
journal = {Paediatrics \& Child Health},
volume = {19},
pages = {543--546},
address = {Macpherson,Alison. York University; ; Institute for Clinical Evaluative Sciences, The Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto, Ontario. Fridman,Liraz. York University; Scolnik,Michal. York University; Coral},
abstract = {BACKGROUND: There is a paucity of information regarding descriptive epidemiology of paediatric concussions over time, and few studies include both emergency department (ED) and physician office visits. OBJECTIVE: To describe trends in visits for paediatric concussions in both EDs and physician offices according to age and sex. A secondary objective was to describe the cause of concussion for children treated in EDs. METHODS: A retrospective, population-based study using linked health administrative data from all concussion-related visits to the ED or a physician office by school-age children and youth (three to 18 years of age) in Ontario between April 1, 2003 and March 3, 2011 was conducted. RESULTS: The number of children evaluated in both EDs and a physician offices increased between 2003 and 2010, and this linear trend was statistically significant (P=0.002 for ED visits and P=0.001 for office visits). The rate per 100,000 increased from 466.7 to 754.3 for boys and from 208.6 to 440.7 for girls during the study period. Falls accounted for approximately one-third of the paediatric concussions. Hockey/skating was the most common specific cause of paediatric sports-related concussions. CONCLUSIONS: The increasing use of health care services for concussions is likely related to changes in incidence over time and increased awareness of concussion as a health issue. Evidence-based prevention initiatives to help reduce the incidence of concussion are warranted, particularly in sports and recreation programs.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Purcell, Laura; Kissick, Jamie; Rizos, John
Concussion Journal Article
In: CMAJ: Canadian Medical Association Journal, vol. 185, no. 11, pp. 981, 2013, ISBN: 08203946.
Abstract | Links | BibTeX | Tags: Assessment/Testing, BRAIN -- Concussion, BRAIN -- Diseases, BRAIN -- Imaging, BRAIN -- Wounds & injuries, BRAIN function localization, Children Under 13, Overviews
@article{Purcell2013,
title = {Concussion},
author = {Purcell, Laura and Kissick, Jamie and Rizos, John},
doi = {10.1503/cmaj.120039},
isbn = {08203946},
year = {2013},
date = {2013-01-01},
journal = {CMAJ: Canadian Medical Association Journal},
volume = {185},
number = {11},
pages = {981},
abstract = {The article offers information on several topics related to concussions which includes effects of brain trauma on brain functioning, Sport Concussion Assessment Tool 3 and ChildSCAT3 for evaluation of concussion and standard imaging. It also mentions that physical and mental rest is involved in management of acute concussion.},
keywords = {Assessment/Testing, BRAIN -- Concussion, BRAIN -- Diseases, BRAIN -- Imaging, BRAIN -- Wounds \& injuries, BRAIN function localization, Children Under 13, Overviews},
pubstate = {published},
tppubtype = {article}
}
Merkel, D L; Molony Jr., J T
Medical sports injuries in the youth athlete: emergency management Journal Article
In: International Journal of Sports Physical Therapy, vol. 7, pp. 242–251, 2012.
Abstract | BibTeX | Tags: Children Under 13
@article{Merkel2012,
title = {Medical sports injuries in the youth athlete: emergency management},
author = {Merkel, D L and {Molony Jr.}, J T},
year = {2012},
date = {2012-01-01},
journal = {International Journal of Sports Physical Therapy},
volume = {7},
pages = {242--251},
abstract = {As the number of youth sports participants continues to rise over the past decade, so too have sports related injuries and emergency department visits. With low levels of oversight and regulation observed in youth sports, the responsibility for safety education of coaches, parents, law makers, organizations and institutions falls largely on the sports medicine practitioner. The highly publicized catastrophic events of concussion, sudden cardiac death, and heat related illness have moved these topics to the forefront of sports medicine discussions. Updated guidelines for concussion in youth athletes call for a more conservative approach to management in both the acute and return to sport phases. Athletes younger than eighteen suspected of having a concussion are no longer allowed to return to play on the same day. Reducing the risk of sudden cardiac death in the young athlete is a multi-factorial process encompassing pre-participation screenings, proper use of safety equipment, proper rules and regulations, and immediate access to Automated External Defibrillators (AED) as corner stones. Susceptibility to heat related illness for youth athletes is no longer viewed as rooted in physiologic variations from adults, but instead, as the result of various situations and conditions in which participation takes place. Hydration before, during and after strenuous exercise in a high heat stress environment is of significant importance. Knowledge of identification, management and risk reduction in emergency medical conditions of the young athlete positions the sports physical therapist as an effective provider, advocate and resource for safety in youth sports participation. This manuscript provides the basis for management of 3 major youth emergency sports medicine conditions.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Halstead, Mark E
Contact sports for young athletes: keys to safety Journal Article
In: Pediatric Annals, vol. 39, pp. 275–278, 2010.
BibTeX | Tags: Children Under 13
@article{Halstead2010a,
title = {Contact sports for young athletes: keys to safety},
author = {Halstead, Mark E},
year = {2010},
date = {2010-01-01},
journal = {Pediatric Annals},
volume = {39},
pages = {275--278},
address = {Departments of Orthopedics and Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA. halsteadm@wustl.edu},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Bakhos, Lisa L; Lockhart, Gregory R; Myers, Richard; Linakis, James G
Emergency department visits for concussion in young child athletes Journal Article
In: Pediatrics, vol. 126, pp. e550–6, 2010.
Abstract | BibTeX | Tags: Children Under 13
@article{Bakhos2010,
title = {Emergency department visits for concussion in young child athletes},
author = {Bakhos, Lisa L and Lockhart, Gregory R and Myers, Richard and Linakis, James G},
year = {2010},
date = {2010-01-01},
journal = {Pediatrics},
volume = {126},
pages = {e550--6},
address = {Pediatric Emergency Medicine, Waren Alpert Medical School, Brown University, Injury Prevention Center, Rhode Island Hospital, 593 Eddy St, Claverick Building 2nd Floor, Providence, RI 02903, USA. lbakhos@gmail.com},
abstract = {OBJECTIVES: The objective of this study was to characterize emergency department (ED) visits for pediatric sport-related concussion (SRC) in pre-high school- versus high school-aged athletes. METHODS: A stratified probability sample of US hospitals that provide emergency services in the National Electronic Injury Surveillance System (1997-2007) and All Injury Program (2001-2005) was used. Concussion-related ED visits were analyzed for 8- to 13- and 14- to 19-year-old patients. Population data were obtained from the US Census Bureau; sport participation data were obtained from National Sporting Goods Association. RESULTS: From 2001 to 2005, US children who were aged 8 to 19 years had an estimated 502 000 ED visits for concussion. The 8- to 13-year-old group accounted for approximately 35% of these visits. Approximately half of all ED visits for concussion were SRC. The 8- to 13-year-old group sustained 40% of these, which represents 58% of all concussions in this group. Approximately 25% of all SRC visits in the 8- to 13-year-old group occurred during organized team sport (OTS). During the study period, approximately 4 in 1000 children aged 8 to 13 years and 6 in 1000 children aged 14 to 19 years had an ED visit for SRC, and 1 in 1000 children aged 8 to 13 years and 3 in 1000 children aged 14 to 19 years had an ED visit for concussion sustained during OTS. From 1997 to 2007, although participation had declined, ED visits for concussions in OTS in 8- to 13-year-old children had doubled and had increased by \>200% in the 14- to 19-year-old group. CONCLUSIONS: The number of SRCs in young athletes is noteworthy. Additional research is required.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Meehan III, William P; Bachur, Richard G
Sport-related concussion Journal Article
In: Pediatrics, vol. 123, pp. 114–123, 2009.
Abstract | Links | BibTeX | Tags: Children Under 13
@article{MeehanIII2009,
title = {Sport-related concussion},
author = {{Meehan III}, William P and Bachur, Richard G},
doi = {10.1542/peds.2008-0309},
year = {2009},
date = {2009-01-01},
journal = {Pediatrics},
volume = {123},
pages = {114--123},
abstract = {Sport-related concussion is a common injury in children and adolescents. Athletes seldom report concussive symptoms, which makes the diagnosis a challenge. The management of sport-related concussion has changed significantly over the last several years. The previously used grading systems and return-to-play guidelines have been abandoned in favor of more individualized assessment and management. Neuropsychological testing is being used more frequently to assist in management. After recovery, it is recommended that an athlete's return-to-play progress in a gradual, stepwise fashion while being monitored by a health care provider. Proper assessment and management of a sport-related concussion is crucial, because repeat concussions can result in decreased neurocognitive functioning, increased symptomatology, and, at times, catastrophic outcomes.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Purcell, Laura; Carson, James
Sport-related concussion in pediatric athletes Journal Article
In: Clinical Pediatrics, vol. 47, pp. 106–113, 2008.
BibTeX | Tags: Children Under 13
@article{Purcell2008,
title = {Sport-related concussion in pediatric athletes},
author = {Purcell, Laura and Carson, James},
year = {2008},
date = {2008-01-01},
journal = {Clinical Pediatrics},
volume = {47},
pages = {106--113},
address = {Division of Emergency Medicine, University of Western Ontario, London, ON. lpurcell1015@rogers.com},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Yeates, Keith Owen; Bigler, Erin D; Dennis, Maureen.; Gerhardt, Cynthia A; Rubin, Kenneth H; Stancin, Terry.; Taylor, H Gerry.; Vannatta, Kathryn.
Social outcomes in childhood brain disorder: a heuristic integration of social neuroscience and developmental psychology Journal Article
In: Psychological Bulletin, vol. 133, pp. 535–556, 2007.
Abstract | BibTeX | Tags: Children Under 13
@article{Yeates2007,
title = {Social outcomes in childhood brain disorder: a heuristic integration of social neuroscience and developmental psychology},
author = {Yeates, Keith Owen and Bigler, Erin D and Dennis, Maureen. and Gerhardt, Cynthia A and Rubin, Kenneth H and Stancin, Terry. and Taylor, H Gerry. and Vannatta, Kathryn.},
year = {2007},
date = {2007-01-01},
journal = {Psychological Bulletin},
volume = {133},
pages = {535--556},
abstract = {The authors propose a heuristic model of the social outcomes of childhood brain disorder that draws on models and methods from both the emerging field of social cognitive neuroscience and the study of social competence in developmental psychology/psychopathology. The heuristic model characterizes the relationships between social adjustment, peer interactions and relationships, social problem solving and communication, social-affective and cognitive-executive processes, and their neural substrates. The model is illustrated by research on a specific form of childhood brain disorder, traumatic brain injury. The heuristic model may promote research regarding the neural and cognitive-affective substrates of children's social development. It also may engender more precise methods of measuring impairments and disabilities in children with brain disorder and suggest ways to promote their social adaptation.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Gordon, Kevin E
Pediatric minor traumatic brain injury Journal Article
In: Seminars in Pediatric Neurology, vol. 13, pp. 243–255, 2006.
Abstract | BibTeX | Tags: Children Under 13
@article{Gordon2006c,
title = {Pediatric minor traumatic brain injury},
author = {Gordon, Kevin E},
year = {2006},
date = {2006-01-01},
journal = {Seminars in Pediatric Neurology},
volume = {13},
pages = {243--255},
address = {Department of Pediatrics, Division of Pediatric Neurology, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia, Canada. KEGOR@DAL.CA},
abstract = {The literature surrounding minor traumatic brain injury is complex, methodologically challenging, and controversial. Although we lack a consistent standardized definition, the annual rate is likely in excess of 200 per 100,000 children. The proportion of children with minor traumatic brain injury who will require neurosurgery is certainly \<1%. Several studies are underway that have the potential to significantly advance our understanding of the specific risk factors for intracranial injury and more specifically neurosurgical injury. The mortality within children is very low, with estimates of 0% to 0.25%. Virtually all studies of the prognosis of minor brain injury in children have reported no long-term behavioral or cognitive sequelae as a specific result of the brain injury. Symptoms fall in 4 domains: somatic, cognitive, sleep/fatigue, and affective. Limited pediatric studies are available to assist clinicians in the prognosis or in optimizing recovery. Until further studies are available, a conservative approach is recommended. Children with suspected concussions should be removed from activity and observed. Children with symptomatic concussions must be limited to no physical activity. Adolescents and families need to self-monitor symptoms and limit environments or circumstances that exacerbate any symptoms. When symptoms resolve, a gradual progressive return to play is currently recommended. The recurrence risk for subsequent concussions is elevated, but there is limited documentation of the effectiveness of preventative efforts. Much remains to be learned. [References: 145]},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Polissar, N L; Fay, G C; Jaffe, K M; Liao, S; Martin, K M; Shurtleff, H A; Rivara, J B; Winn, H R
Mild pediatric traumatic brain injury: adjusting significance levels for multiple comparisons Journal Article
In: Brain Injury, vol. 8, pp. 249–263, 1994.
Abstract | BibTeX | Tags: Children Under 13
@article{Polissar1994,
title = {Mild pediatric traumatic brain injury: adjusting significance levels for multiple comparisons},
author = {Polissar, N L and Fay, G C and Jaffe, K M and Liao, S and Martin, K M and Shurtleff, H A and Rivara, J B and Winn, H R},
year = {1994},
date = {1994-01-01},
journal = {Brain Injury},
volume = {8},
pages = {249--263},
address = {Department of Biostatistics, University of Washington, Seattle.},
abstract = {The outcome following mild traumatic brain injury (TBI) is controversial. We addressed this topic in a study of neurobehavioural and 'real-world' functioning among 53 children with mild TBI and their matched controls, using statistical methods recently developed for multiple comparisons. Because the study involved calculation of 414 p-values, four methods of adjustment for multiple comparisons, including the Bonferroni method, were used to avoid 'false-positive' statistical significance. The additional three methods allowed greater insight into the data than provided by the standard Bonferroni adjustment. Results showed that at initial testing, three areas of 'real-world' functioning (eating, domestic and home/community living skills) had weak but statistically significant associations with mild injury. No other specific areas of neuro-behavioural or 'real-world' functioning had plausible associations with the injury either initially, at 1 year, or when changes over the year were considered. However, the adjustment for multiple comparisons provided additional results. There were statistical significant associations of the injury with the entire domain of neurobehavioural variables both initially and at 1 year. These results suggest that the injury affects a spectrum of neurobehavioural skills weakly, rather than a single area substantially. The gain from using multiple comparison methods is discussed.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Taylor, A M; Nigrovic, L E; Saillant, M L; Trudell, E K; Proctor, M R; Modest, J R; Vernacchio, L
Trends in Ambulatory Care for Children with Concussion and Minor Head Injury from Eastern Massachusetts between 2007 and 2013 Journal Article
In: Journal of Pediatrics, vol. 167, pp. 738–744, 2015.
@article{Taylor2015,
title = {Trends in Ambulatory Care for Children with Concussion and Minor Head Injury from Eastern Massachusetts between 2007 and 2013},
author = {Taylor, A M and Nigrovic, L E and Saillant, M L and Trudell, E K and Proctor, M R and Modest, J R and Vernacchio, L},
doi = {10.1016/j.jpeds.2015.05.036},
year = {2015},
date = {2015-01-01},
journal = {Journal of Pediatrics},
volume = {167},
pages = {738--744},
abstract = {Objective: To characterize trends in health care utilization and costs for children diagnosed with concussion or minor head injury within a large pediatric primary-care association. Study design: We conducted a retrospective cohort analysis from 2007 through 2013 examining all outpatient medical claims related to concussion and minor head injury from 4 commercial insurance companies for children 6-21years of age who were patients within a large pediatric independent practice association located throughout eastern Massachusetts. Results: Health care visits for concussion and minor head injury increased more than 4-fold during the study period, with primary-care and specialty clinics experiencing the greatest increases in the rate of visits while emergency department visits increased comparatively less. These increases were accounted for by both the proportion of children diagnosed with concussion or minor head injury (1.3% of all children in 2007 vs 3.3% in 2013) and the number of encounters per diagnosed patient (1.0 encounters per patient in 2007 vs 1.7 in 2013). Although the overall population costs devoted to care for concussion or minor head injury increased 34%, the cost per individual diagnosed child decreased 31%. Conclusions: Over the past 7years, health care encounters for children diagnosed with concussion or minor head injury increased substantially in eastern Massachusetts. Care for these injuries increasingly shifted from the emergency department to primary-care and specialty providers. © 2015 Elsevier Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Urban, K J; Barlow, K M; Jimenez, J J; Goodyear, B G; Dunn, J F
Functional near-infrared spectroscopy reveals reduced interhemispheric cortical communication after pediatric concussion Journal Article
In: Journal of Neurotrauma, vol. 32, pp. 833–840, 2015.
@article{Urban2015,
title = {Functional near-infrared spectroscopy reveals reduced interhemispheric cortical communication after pediatric concussion},
author = {Urban, K J and Barlow, K M and Jimenez, J J and Goodyear, B G and Dunn, J F},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurotrauma},
volume = {32},
pages = {833--840},
address = {Urban,Karolina J. 1Department of Radiology, University of Calgary, Calgary, Alberta, Canada. Urban,Karolina J. 2Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada. Urban,Karolina J. 3Experimental Imaging Center, University of Calga},
abstract = {Concussion, or mild traumatic brain injury (mTBI), is a growing concern, especially among the pediatric population. By age 25, as many as 30% of the population are likely to have had a concussion. Many result in long-term disability, with some evolving to postconcussion syndrome. Treatments are being developed, but are difficult to assess given the lack of measures to quantitatively monitor concussion. There is no accepted quantitative imaging metric for monitoring concussion. We hypothesized that because cognitive function and fiber tracks are often impacted in concussion, interhemispheric brain communication may be impaired. We used functional near-infrared spectroscopy (fNIRS) to quantify functional coherence between the left and right motor cortex as a marker of interhemispheric communication. Studies were undertaken during the resting state and with a finger-tapping task to activate the motor cortex. Pediatric patients (ages 12-18) had symptoms for 31-473 days, compared to controls, who have not had reported a previous concussion. We detected differences between patients and controls in coherence between the contralateral motor cortices using measurements of total hemoglobin and oxy-hemoglobin with a p\<0.01 (n=8, control; n=12mTBI). Given the critical need for a quantitative biomarker for recovery after a concussion, we present these data to highlight the potential of fNIRS coupled with interhemispheric coherence analysis as a biomarker of concussion injury.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Yuan, W; Wade, S L; Babcock, L
Structural connectivity abnormality in children with acute mild traumatic brain injury using graph theoretical analysis Journal Article
In: Human Brain Mapping, vol. 36, pp. 779–792, 2015.
@article{Yuan2015,
title = {Structural connectivity abnormality in children with acute mild traumatic brain injury using graph theoretical analysis},
author = {Yuan, W and Wade, S L and Babcock, L},
year = {2015},
date = {2015-01-01},
journal = {Human Brain Mapping},
volume = {36},
pages = {779--792},
address = {Yuan,Weihong. Pediatric Neuroimaging Research Consortium, Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; College of Medicine University of Cincinnati, Cincinnati, Ohio.},
abstract = {The traumatic biomechanical forces associated with mild traumatic brain injury (mTBI) typically impart diffuse, as opposed to focal, brain injury potentially disrupting the structural connectivity between neural networks. Graph theoretical analysis using diffusion tensor imaging was used to assess injury-related differences in structural connectivity between 23 children (age 11-16 years) with mTBI and 20 age-matched children with isolated orthopedic injuries (OI) scanned within 96 h postinjury. The distribution of hub regions and the associations between alterations in regional network measures and symptom burden, as assessed by the postconcussion symptom scale score (PCSS), were also examined. In comparison to the OI group, the mTBI group was found to have significantly higher small-worldness (P\<0.0001), higher normalized clustering coefficients (P\<0.0001), higher normalized characteristic path length (P=0.007), higher modularity (P=0.0005), and lower global efficiency (P\<0.0001). A series of hub regions in the mTBI group were found to have significant alterations in regional network measures including nodal degree, nodal clustering coefficient, and nodal between-ness centrality. Correlation analysis showed that PCSS total score acquired at the time of imaging was significantly associated with the nodal degree of two hubs, the superior frontal gyrus at orbital section and the middle frontal gyrus. These findings provide new evidence of acute white matter alteration at both global and regional network level following mTBI in children furthering our understanding of underlying mechanisms of acute neurological insult associated with mTBI.Copyright © 2014 Wiley Periodicals, Inc.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Chan, V; Thurairajah, P; Colantonio, A
Defining pediatric traumatic brain injury using International Classification of Diseases Version 10 Codes: a systematic review Journal Article
In: BMC Neurology, vol. 15, pp. 7, 2015.
@article{Chan2015a,
title = {Defining pediatric traumatic brain injury using International Classification of Diseases Version 10 Codes: a systematic review},
author = {Chan, V and Thurairajah, P and Colantonio, A},
year = {2015},
date = {2015-01-01},
journal = {BMC Neurology},
volume = {15},
pages = {7},
address = {Chan,Vincy. Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada. vincy.chan@uhn.ca. Chan,Vincy. Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON, M5G},
abstract = {BACKGROUND: Although healthcare administrative data are commonly used for traumatic brain injury (TBI) research, there is currently no consensus or consistency on the International Classification of Diseases Version 10 (ICD-10) codes used to define TBI among children and youth internationally. This study systematically reviewed the literature to explore the range of ICD-10 codes that are used to define TBI in this population. The identification of the range of ICD-10 codes to define this population in administrative data is crucial, as it has implications for policy, resource allocation, planning of healthcare services, and prevention strategies. METHODS: The databases MEDLINE, MEDLINE In-Process, Embase, PsychINFO, CINAHL, SPORTDiscus, and Cochrane Database of Systematic Reviews were systematically searched. Grey literature was searched using Grey Matters and Google. Reference lists of included articles were also searched for relevant studies. Two reviewers independently screened all titles and abstracts using pre-defined inclusion and exclusion criteria. A full text screen was conducted on articles that met the first screen inclusion criteria. All full text articles that met the pre-defined inclusion criteria were included for analysis in this systematic review. RESULTS: A total of 1,326 publications were identified through the predetermined search strategy and 32 articles/reports met all eligibility criteria for inclusion in this review. Five articles specifically examined children and youth aged 19 years or under with TBI. ICD-10 case definitions ranged from the broad injuries to the head codes (ICD-10 S00 to S09) to concussion only (S06.0). There was overwhelming consensus on the inclusion of ICD-10 code S06, intracranial injury, while codes S00 (superficial injury of the head), S03 (dislocation, sprain, and strain of joints and ligaments of head), and S05 (injury of eye and orbit) were only used by articles that examined head injury, none of which specifically examined children and youth. CONCLUSION: This review provides evidence for discussion on how best to use ICD codes for different goals. This is an important first step in reaching an appropriate definition and can inform future work on reaching consensus on the ICD-10 codes to define TBI for this vulnerable population.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Upchurch, C; Morgan, C D; Umfress, A; Yang, G; Riederer, M F
Discharge instructions for youth sports-related concussions in the emergency department, 2004 to 2012 Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, pp. 297–299, 2015.
@article{Upchurch2015,
title = {Discharge instructions for youth sports-related concussions in the emergency department, 2004 to 2012},
author = {Upchurch, C and Morgan, C D and Umfress, A and Yang, G and Riederer, M F},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
pages = {297--299},
address = {Upchurch,Cameron. *Vanderbilt School of Medicine, Nashville, Tennessee; and +Department of Pediatric Orthopaedic Surgery, C.S. Mott Children's Hospital, Ann Arbor, Michigan.},
abstract = {OBJECTIVE: To evaluate the effect of the Centers for Disease Control and Prevention (CDC) Heads-Up concussion campaign on appropriateness of discharge instructions for youth sports-related concussion (SRC) patients presenting to a pediatric emergency department (ED). DESIGN: Retrospective cohort study. SETTING: Pediatric ED. PATIENTS: Children up to 18 years. ASSESSMENT OF RISK FACTORS: A retrospective chart review was conducted on patients evaluated from 2004 to 2012. Patients were selected by ICD-9 code for having a concussion during a sporting activity. MAIN OUTCOME MEASURES: Discharge instructions were reviewed for recommendations for cognitive rest, physical rest, primary care physician follow-up, and referral to a concussion specialist or center. RESULTS: There were 497 youth SRCs from 392 908 total ED visits. Overall, only 66% had appropriate discharge recommendations. This improved to 75% after 2010, which was not statistically significant (odds ratio = 1.02},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Kirkwood, G; Parekh, N; Ofori-Asenso, R; Pollock, A M
Concussion in youth rugby union and rugby league: a systematic review Journal Article
In: British Journal of Sports Medicine, vol. 49, pp. 506–510, 2015.
@article{Kirkwood2015,
title = {Concussion in youth rugby union and rugby league: a systematic review},
author = {Kirkwood, G and Parekh, N and Ofori-Asenso, R and Pollock, A M},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
pages = {506--510},
address = {Kirkwood,Graham. Centre for Primary Care and Public Health, Queen Mary University of London, London, UK. Parekh,Nikesh. Lewisham and Greenwich NHS Trust, London, UK. Ofori-Asenso,Richard. Centre for Primary Care and Public Health, Queen Mary University of},
abstract = {BACKGROUND: Children and adolescents who play rugby are at increased risk of concussion and its effects. Competitive rugby union and rugby league feature as major sports in the school sport curriculum in the UK. There is a need for a thorough understanding of the epidemiology of concussion in youth rugby, the mechanisms involved in injuries and predisposing risk factors. DATA SOURCES: The publication databases Pubmed, Embase and SportDISCUS were searched in April 2014 for primary research studies of child and adolescent rugby union and rugby league (under 20 years) in English language with data on concussion injuries. The review was conducted within a larger all injury systematic review on rugby union and rugby league where key words used in the search included rugby, injury and concussion with child, adolescent, paediatric and youth. RESULTS: There were 25 studies retrieved with data on child or adolescent rugby and concussion, 20 were on rugby union, three on rugby league and in two the code of rugby was unspecified. There was significant heterogeneity in the definitions of injuries and of concussion. The incidence of child and adolescent match concussion ranged from 0.2 to 6.9 concussions per 1000 player-hours for rugby union and was 4.6 and 14.7 concussions per 1000 player-hours for rugby league, equivalent to a probability of between 0.3% and 11.4% for rugby union and of 7.7% and 22.7% for rugby league. CONCLUSIONS: There is a significant risk of concussion in children and adolescents playing rugby union and rugby league evident from the studies included in this systematic review. There is a need for reliable data through routine monitoring and reporting in schools and clubs and in hospital emergency departments in order to inform prevention. Concussion protocols should be implemented and tested.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hodgson, L; Patricios, J
Clarifying concussion in youth rugby: recognise and remove Journal Article
In: British Journal of Sports Medicine, vol. 49, pp. 966–967, 2015, ISSN: 03063674.
@article{Hodgson2015,
title = {Clarifying concussion in youth rugby: recognise and remove},
author = {Hodgson, L and Patricios, J},
doi = {10.1136/bjsports-2014-094561},
issn = {03063674},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
pages = {966--967},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Walter, K D
Addressing concussion in youth sports Journal Article
In: The Virtual Mentor, vol. 16, pp. 559–564, 2014.
@article{Walter2014,
title = {Addressing concussion in youth sports},
author = {Walter, K D},
year = {2014},
date = {2014-01-01},
journal = {The Virtual Mentor},
volume = {16},
pages = {559--564},
address = {Walter,Kevin D. Associate professor of orthopedic surgery at the Medical College of Wisconsin, and the program director of pediatric and adolescent primary care sports medicine at Children's Hospital of Wisconsin, and a member of the Wisconsin Interschola},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Caswell, S V; Ambegaonkar, J P; Cortes, N; York, M; Caswell, A M
Neck strengthening recommendations for concussion risk reduction in youth sport Journal Article
In: International Journal of Athletic Therapy & Training, vol. 19, pp. 22–27, 2014.
@article{Caswell2014,
title = {Neck strengthening recommendations for concussion risk reduction in youth sport},
author = {Caswell, S V and Ambegaonkar, J P and Cortes, N and York, M and Caswell, A M},
doi = {10.1123/ijatt.2014-0043},
year = {2014},
date = {2014-01-01},
journal = {International Journal of Athletic Therapy \& Training},
volume = {19},
pages = {22--27},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Kerr, H A
Concussion risk factors and strategies for prevention Journal Article
In: Pediatric Annals, vol. 43, pp. e309–15, 2014.
@article{Kerr2014b,
title = {Concussion risk factors and strategies for prevention},
author = {Kerr, H A},
year = {2014},
date = {2014-01-01},
journal = {Pediatric Annals},
volume = {43},
pages = {e309--15},
abstract = {Concussion in children is frequently related to participation in sports. It requires a traumatic event to occur that transmits acceleration to the brain. Some children may have intrinsic risk factors that place them at greater risk for this type of injury. Comorbidities such as attention-deficit/hyperactivity disorder, migraine headaches, and mood disorders may place athletes at increased risk of more severe injury. A previous concussion is probably the most important influence on risk for future injury. Extrinsic risk factors include coaching techniques, officiating, and choice of sport. Helmet choice does not diminish concussion risk, nor does the use of mouth guards. Education of athletes, coaches, parents, and physicians is very important in improving recognition of potential concussive injury and helping child athletes and their parents understand the risks involved in sport participation.Copyright 2014, SLACK Incorporated.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Giza, C C
Pediatric issues in sports concussions Journal Article
In: CONTINUUM: Lifelong Learning in Neurology, vol. 20, pp. 1570–1587, 2014.
@article{Giza2014a,
title = {Pediatric issues in sports concussions},
author = {Giza, C C},
year = {2014},
date = {2014-01-01},
journal = {CONTINUUM: Lifelong Learning in Neurology},
volume = {20},
pages = {1570--1587},
abstract = {PURPOSE OF REVIEW: Sports-related concussions are receiving increasing attention in both the lay press and medical literature. While most media attention has been on high-profile collegiate or professional athletes, the vast majority of individuals participating in contact and collision sports are adolescents and children. This review provides a practical approach toward youth sports-related concussion with a foundation in the recent guidelines, but including specific considerations when applying these management principles to children and adolescents. RECENT FINDINGS: Objective measurement of early signs and symptoms is challenging in younger patients, and many commonly used assessment tools await rigorous validation for younger patients. Excellent evidence-based guidelines exist for CT evaluation of mild traumatic brain injury presenting to the emergency department. Evidence suggests that recovery from sports-related concussion takes longer in high school athletes compared with collegiate or professionals; however, rigorous studies below high school age are still lacking. SUMMARY: Proper care for concussion in youth requires a delicate balance of clinical skills, age-appropriate assessment, and individualized management to achieve optimal outcomes.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cartwright, C
Pediatric athletic concussion Journal Article
In: Journal of Neuroscience Nursing, vol. 46, pp. 313, 2014.
@article{Cartwright2014,
title = {Pediatric athletic concussion},
author = {Cartwright, C},
year = {2014},
date = {2014-01-01},
journal = {Journal of Neuroscience Nursing},
volume = {46},
pages = {313},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Macpherson, A; Fridman, L; Scolnik, M; Corallo, A; Guttmann, A
A population-based study of paediatric emergency department and office visits for concussions from 2003 to 2010 Journal Article
In: Paediatrics & Child Health, vol. 19, pp. 543–546, 2014.
@article{Macpherson2014,
title = {A population-based study of paediatric emergency department and office visits for concussions from 2003 to 2010},
author = {Macpherson, A and Fridman, L and Scolnik, M and Corallo, A and Guttmann, A},
year = {2014},
date = {2014-01-01},
journal = {Paediatrics \& Child Health},
volume = {19},
pages = {543--546},
address = {Macpherson,Alison. York University; ; Institute for Clinical Evaluative Sciences, The Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto, Ontario. Fridman,Liraz. York University; Scolnik,Michal. York University; Coral},
abstract = {BACKGROUND: There is a paucity of information regarding descriptive epidemiology of paediatric concussions over time, and few studies include both emergency department (ED) and physician office visits. OBJECTIVE: To describe trends in visits for paediatric concussions in both EDs and physician offices according to age and sex. A secondary objective was to describe the cause of concussion for children treated in EDs. METHODS: A retrospective, population-based study using linked health administrative data from all concussion-related visits to the ED or a physician office by school-age children and youth (three to 18 years of age) in Ontario between April 1, 2003 and March 3, 2011 was conducted. RESULTS: The number of children evaluated in both EDs and a physician offices increased between 2003 and 2010, and this linear trend was statistically significant (P=0.002 for ED visits and P=0.001 for office visits). The rate per 100,000 increased from 466.7 to 754.3 for boys and from 208.6 to 440.7 for girls during the study period. Falls accounted for approximately one-third of the paediatric concussions. Hockey/skating was the most common specific cause of paediatric sports-related concussions. CONCLUSIONS: The increasing use of health care services for concussions is likely related to changes in incidence over time and increased awareness of concussion as a health issue. Evidence-based prevention initiatives to help reduce the incidence of concussion are warranted, particularly in sports and recreation programs.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Purcell, Laura; Kissick, Jamie; Rizos, John
Concussion Journal Article
In: CMAJ: Canadian Medical Association Journal, vol. 185, no. 11, pp. 981, 2013, ISBN: 08203946.
@article{Purcell2013,
title = {Concussion},
author = {Purcell, Laura and Kissick, Jamie and Rizos, John},
doi = {10.1503/cmaj.120039},
isbn = {08203946},
year = {2013},
date = {2013-01-01},
journal = {CMAJ: Canadian Medical Association Journal},
volume = {185},
number = {11},
pages = {981},
abstract = {The article offers information on several topics related to concussions which includes effects of brain trauma on brain functioning, Sport Concussion Assessment Tool 3 and ChildSCAT3 for evaluation of concussion and standard imaging. It also mentions that physical and mental rest is involved in management of acute concussion.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Merkel, D L; Molony Jr., J T
Medical sports injuries in the youth athlete: emergency management Journal Article
In: International Journal of Sports Physical Therapy, vol. 7, pp. 242–251, 2012.
@article{Merkel2012,
title = {Medical sports injuries in the youth athlete: emergency management},
author = {Merkel, D L and {Molony Jr.}, J T},
year = {2012},
date = {2012-01-01},
journal = {International Journal of Sports Physical Therapy},
volume = {7},
pages = {242--251},
abstract = {As the number of youth sports participants continues to rise over the past decade, so too have sports related injuries and emergency department visits. With low levels of oversight and regulation observed in youth sports, the responsibility for safety education of coaches, parents, law makers, organizations and institutions falls largely on the sports medicine practitioner. The highly publicized catastrophic events of concussion, sudden cardiac death, and heat related illness have moved these topics to the forefront of sports medicine discussions. Updated guidelines for concussion in youth athletes call for a more conservative approach to management in both the acute and return to sport phases. Athletes younger than eighteen suspected of having a concussion are no longer allowed to return to play on the same day. Reducing the risk of sudden cardiac death in the young athlete is a multi-factorial process encompassing pre-participation screenings, proper use of safety equipment, proper rules and regulations, and immediate access to Automated External Defibrillators (AED) as corner stones. Susceptibility to heat related illness for youth athletes is no longer viewed as rooted in physiologic variations from adults, but instead, as the result of various situations and conditions in which participation takes place. Hydration before, during and after strenuous exercise in a high heat stress environment is of significant importance. Knowledge of identification, management and risk reduction in emergency medical conditions of the young athlete positions the sports physical therapist as an effective provider, advocate and resource for safety in youth sports participation. This manuscript provides the basis for management of 3 major youth emergency sports medicine conditions.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Halstead, Mark E
Contact sports for young athletes: keys to safety Journal Article
In: Pediatric Annals, vol. 39, pp. 275–278, 2010.
@article{Halstead2010a,
title = {Contact sports for young athletes: keys to safety},
author = {Halstead, Mark E},
year = {2010},
date = {2010-01-01},
journal = {Pediatric Annals},
volume = {39},
pages = {275--278},
address = {Departments of Orthopedics and Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA. halsteadm@wustl.edu},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bakhos, Lisa L; Lockhart, Gregory R; Myers, Richard; Linakis, James G
Emergency department visits for concussion in young child athletes Journal Article
In: Pediatrics, vol. 126, pp. e550–6, 2010.
@article{Bakhos2010,
title = {Emergency department visits for concussion in young child athletes},
author = {Bakhos, Lisa L and Lockhart, Gregory R and Myers, Richard and Linakis, James G},
year = {2010},
date = {2010-01-01},
journal = {Pediatrics},
volume = {126},
pages = {e550--6},
address = {Pediatric Emergency Medicine, Waren Alpert Medical School, Brown University, Injury Prevention Center, Rhode Island Hospital, 593 Eddy St, Claverick Building 2nd Floor, Providence, RI 02903, USA. lbakhos@gmail.com},
abstract = {OBJECTIVES: The objective of this study was to characterize emergency department (ED) visits for pediatric sport-related concussion (SRC) in pre-high school- versus high school-aged athletes. METHODS: A stratified probability sample of US hospitals that provide emergency services in the National Electronic Injury Surveillance System (1997-2007) and All Injury Program (2001-2005) was used. Concussion-related ED visits were analyzed for 8- to 13- and 14- to 19-year-old patients. Population data were obtained from the US Census Bureau; sport participation data were obtained from National Sporting Goods Association. RESULTS: From 2001 to 2005, US children who were aged 8 to 19 years had an estimated 502 000 ED visits for concussion. The 8- to 13-year-old group accounted for approximately 35% of these visits. Approximately half of all ED visits for concussion were SRC. The 8- to 13-year-old group sustained 40% of these, which represents 58% of all concussions in this group. Approximately 25% of all SRC visits in the 8- to 13-year-old group occurred during organized team sport (OTS). During the study period, approximately 4 in 1000 children aged 8 to 13 years and 6 in 1000 children aged 14 to 19 years had an ED visit for SRC, and 1 in 1000 children aged 8 to 13 years and 3 in 1000 children aged 14 to 19 years had an ED visit for concussion sustained during OTS. From 1997 to 2007, although participation had declined, ED visits for concussions in OTS in 8- to 13-year-old children had doubled and had increased by \>200% in the 14- to 19-year-old group. CONCLUSIONS: The number of SRCs in young athletes is noteworthy. Additional research is required.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Meehan III, William P; Bachur, Richard G
Sport-related concussion Journal Article
In: Pediatrics, vol. 123, pp. 114–123, 2009.
@article{MeehanIII2009,
title = {Sport-related concussion},
author = {{Meehan III}, William P and Bachur, Richard G},
doi = {10.1542/peds.2008-0309},
year = {2009},
date = {2009-01-01},
journal = {Pediatrics},
volume = {123},
pages = {114--123},
abstract = {Sport-related concussion is a common injury in children and adolescents. Athletes seldom report concussive symptoms, which makes the diagnosis a challenge. The management of sport-related concussion has changed significantly over the last several years. The previously used grading systems and return-to-play guidelines have been abandoned in favor of more individualized assessment and management. Neuropsychological testing is being used more frequently to assist in management. After recovery, it is recommended that an athlete's return-to-play progress in a gradual, stepwise fashion while being monitored by a health care provider. Proper assessment and management of a sport-related concussion is crucial, because repeat concussions can result in decreased neurocognitive functioning, increased symptomatology, and, at times, catastrophic outcomes.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Purcell, Laura; Carson, James
Sport-related concussion in pediatric athletes Journal Article
In: Clinical Pediatrics, vol. 47, pp. 106–113, 2008.
@article{Purcell2008,
title = {Sport-related concussion in pediatric athletes},
author = {Purcell, Laura and Carson, James},
year = {2008},
date = {2008-01-01},
journal = {Clinical Pediatrics},
volume = {47},
pages = {106--113},
address = {Division of Emergency Medicine, University of Western Ontario, London, ON. lpurcell1015@rogers.com},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Yeates, Keith Owen; Bigler, Erin D; Dennis, Maureen.; Gerhardt, Cynthia A; Rubin, Kenneth H; Stancin, Terry.; Taylor, H Gerry.; Vannatta, Kathryn.
Social outcomes in childhood brain disorder: a heuristic integration of social neuroscience and developmental psychology Journal Article
In: Psychological Bulletin, vol. 133, pp. 535–556, 2007.
@article{Yeates2007,
title = {Social outcomes in childhood brain disorder: a heuristic integration of social neuroscience and developmental psychology},
author = {Yeates, Keith Owen and Bigler, Erin D and Dennis, Maureen. and Gerhardt, Cynthia A and Rubin, Kenneth H and Stancin, Terry. and Taylor, H Gerry. and Vannatta, Kathryn.},
year = {2007},
date = {2007-01-01},
journal = {Psychological Bulletin},
volume = {133},
pages = {535--556},
abstract = {The authors propose a heuristic model of the social outcomes of childhood brain disorder that draws on models and methods from both the emerging field of social cognitive neuroscience and the study of social competence in developmental psychology/psychopathology. The heuristic model characterizes the relationships between social adjustment, peer interactions and relationships, social problem solving and communication, social-affective and cognitive-executive processes, and their neural substrates. The model is illustrated by research on a specific form of childhood brain disorder, traumatic brain injury. The heuristic model may promote research regarding the neural and cognitive-affective substrates of children's social development. It also may engender more precise methods of measuring impairments and disabilities in children with brain disorder and suggest ways to promote their social adaptation.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Taylor, A M; Nigrovic, L E; Saillant, M L; Trudell, E K; Proctor, M R; Modest, J R; Vernacchio, L
Trends in Ambulatory Care for Children with Concussion and Minor Head Injury from Eastern Massachusetts between 2007 and 2013 Journal Article
In: Journal of Pediatrics, vol. 167, pp. 738–744, 2015.
Abstract | Links | BibTeX | Tags: Children Under 13
@article{Taylor2015,
title = {Trends in Ambulatory Care for Children with Concussion and Minor Head Injury from Eastern Massachusetts between 2007 and 2013},
author = {Taylor, A M and Nigrovic, L E and Saillant, M L and Trudell, E K and Proctor, M R and Modest, J R and Vernacchio, L},
doi = {10.1016/j.jpeds.2015.05.036},
year = {2015},
date = {2015-01-01},
journal = {Journal of Pediatrics},
volume = {167},
pages = {738--744},
abstract = {Objective: To characterize trends in health care utilization and costs for children diagnosed with concussion or minor head injury within a large pediatric primary-care association. Study design: We conducted a retrospective cohort analysis from 2007 through 2013 examining all outpatient medical claims related to concussion and minor head injury from 4 commercial insurance companies for children 6-21years of age who were patients within a large pediatric independent practice association located throughout eastern Massachusetts. Results: Health care visits for concussion and minor head injury increased more than 4-fold during the study period, with primary-care and specialty clinics experiencing the greatest increases in the rate of visits while emergency department visits increased comparatively less. These increases were accounted for by both the proportion of children diagnosed with concussion or minor head injury (1.3% of all children in 2007 vs 3.3% in 2013) and the number of encounters per diagnosed patient (1.0 encounters per patient in 2007 vs 1.7 in 2013). Although the overall population costs devoted to care for concussion or minor head injury increased 34%, the cost per individual diagnosed child decreased 31%. Conclusions: Over the past 7years, health care encounters for children diagnosed with concussion or minor head injury increased substantially in eastern Massachusetts. Care for these injuries increasingly shifted from the emergency department to primary-care and specialty providers. © 2015 Elsevier Inc.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Urban, K J; Barlow, K M; Jimenez, J J; Goodyear, B G; Dunn, J F
Functional near-infrared spectroscopy reveals reduced interhemispheric cortical communication after pediatric concussion Journal Article
In: Journal of Neurotrauma, vol. 32, pp. 833–840, 2015.
Abstract | BibTeX | Tags: Children Under 13
@article{Urban2015,
title = {Functional near-infrared spectroscopy reveals reduced interhemispheric cortical communication after pediatric concussion},
author = {Urban, K J and Barlow, K M and Jimenez, J J and Goodyear, B G and Dunn, J F},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurotrauma},
volume = {32},
pages = {833--840},
address = {Urban,Karolina J. 1Department of Radiology, University of Calgary, Calgary, Alberta, Canada. Urban,Karolina J. 2Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada. Urban,Karolina J. 3Experimental Imaging Center, University of Calga},
abstract = {Concussion, or mild traumatic brain injury (mTBI), is a growing concern, especially among the pediatric population. By age 25, as many as 30% of the population are likely to have had a concussion. Many result in long-term disability, with some evolving to postconcussion syndrome. Treatments are being developed, but are difficult to assess given the lack of measures to quantitatively monitor concussion. There is no accepted quantitative imaging metric for monitoring concussion. We hypothesized that because cognitive function and fiber tracks are often impacted in concussion, interhemispheric brain communication may be impaired. We used functional near-infrared spectroscopy (fNIRS) to quantify functional coherence between the left and right motor cortex as a marker of interhemispheric communication. Studies were undertaken during the resting state and with a finger-tapping task to activate the motor cortex. Pediatric patients (ages 12-18) had symptoms for 31-473 days, compared to controls, who have not had reported a previous concussion. We detected differences between patients and controls in coherence between the contralateral motor cortices using measurements of total hemoglobin and oxy-hemoglobin with a p\<0.01 (n=8, control; n=12mTBI). Given the critical need for a quantitative biomarker for recovery after a concussion, we present these data to highlight the potential of fNIRS coupled with interhemispheric coherence analysis as a biomarker of concussion injury.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Yuan, W; Wade, S L; Babcock, L
Structural connectivity abnormality in children with acute mild traumatic brain injury using graph theoretical analysis Journal Article
In: Human Brain Mapping, vol. 36, pp. 779–792, 2015.
Abstract | BibTeX | Tags: Children Under 13
@article{Yuan2015,
title = {Structural connectivity abnormality in children with acute mild traumatic brain injury using graph theoretical analysis},
author = {Yuan, W and Wade, S L and Babcock, L},
year = {2015},
date = {2015-01-01},
journal = {Human Brain Mapping},
volume = {36},
pages = {779--792},
address = {Yuan,Weihong. Pediatric Neuroimaging Research Consortium, Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; College of Medicine University of Cincinnati, Cincinnati, Ohio.},
abstract = {The traumatic biomechanical forces associated with mild traumatic brain injury (mTBI) typically impart diffuse, as opposed to focal, brain injury potentially disrupting the structural connectivity between neural networks. Graph theoretical analysis using diffusion tensor imaging was used to assess injury-related differences in structural connectivity between 23 children (age 11-16 years) with mTBI and 20 age-matched children with isolated orthopedic injuries (OI) scanned within 96 h postinjury. The distribution of hub regions and the associations between alterations in regional network measures and symptom burden, as assessed by the postconcussion symptom scale score (PCSS), were also examined. In comparison to the OI group, the mTBI group was found to have significantly higher small-worldness (P\<0.0001), higher normalized clustering coefficients (P\<0.0001), higher normalized characteristic path length (P=0.007), higher modularity (P=0.0005), and lower global efficiency (P\<0.0001). A series of hub regions in the mTBI group were found to have significant alterations in regional network measures including nodal degree, nodal clustering coefficient, and nodal between-ness centrality. Correlation analysis showed that PCSS total score acquired at the time of imaging was significantly associated with the nodal degree of two hubs, the superior frontal gyrus at orbital section and the middle frontal gyrus. These findings provide new evidence of acute white matter alteration at both global and regional network level following mTBI in children furthering our understanding of underlying mechanisms of acute neurological insult associated with mTBI.Copyright © 2014 Wiley Periodicals, Inc.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Chan, V; Thurairajah, P; Colantonio, A
Defining pediatric traumatic brain injury using International Classification of Diseases Version 10 Codes: a systematic review Journal Article
In: BMC Neurology, vol. 15, pp. 7, 2015.
Abstract | BibTeX | Tags: Children Under 13
@article{Chan2015a,
title = {Defining pediatric traumatic brain injury using International Classification of Diseases Version 10 Codes: a systematic review},
author = {Chan, V and Thurairajah, P and Colantonio, A},
year = {2015},
date = {2015-01-01},
journal = {BMC Neurology},
volume = {15},
pages = {7},
address = {Chan,Vincy. Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada. vincy.chan@uhn.ca. Chan,Vincy. Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON, M5G},
abstract = {BACKGROUND: Although healthcare administrative data are commonly used for traumatic brain injury (TBI) research, there is currently no consensus or consistency on the International Classification of Diseases Version 10 (ICD-10) codes used to define TBI among children and youth internationally. This study systematically reviewed the literature to explore the range of ICD-10 codes that are used to define TBI in this population. The identification of the range of ICD-10 codes to define this population in administrative data is crucial, as it has implications for policy, resource allocation, planning of healthcare services, and prevention strategies. METHODS: The databases MEDLINE, MEDLINE In-Process, Embase, PsychINFO, CINAHL, SPORTDiscus, and Cochrane Database of Systematic Reviews were systematically searched. Grey literature was searched using Grey Matters and Google. Reference lists of included articles were also searched for relevant studies. Two reviewers independently screened all titles and abstracts using pre-defined inclusion and exclusion criteria. A full text screen was conducted on articles that met the first screen inclusion criteria. All full text articles that met the pre-defined inclusion criteria were included for analysis in this systematic review. RESULTS: A total of 1,326 publications were identified through the predetermined search strategy and 32 articles/reports met all eligibility criteria for inclusion in this review. Five articles specifically examined children and youth aged 19 years or under with TBI. ICD-10 case definitions ranged from the broad injuries to the head codes (ICD-10 S00 to S09) to concussion only (S06.0). There was overwhelming consensus on the inclusion of ICD-10 code S06, intracranial injury, while codes S00 (superficial injury of the head), S03 (dislocation, sprain, and strain of joints and ligaments of head), and S05 (injury of eye and orbit) were only used by articles that examined head injury, none of which specifically examined children and youth. CONCLUSION: This review provides evidence for discussion on how best to use ICD codes for different goals. This is an important first step in reaching an appropriate definition and can inform future work on reaching consensus on the ICD-10 codes to define TBI for this vulnerable population.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Upchurch, C; Morgan, C D; Umfress, A; Yang, G; Riederer, M F
Discharge instructions for youth sports-related concussions in the emergency department, 2004 to 2012 Journal Article
In: Clinical Journal of Sport Medicine, vol. 25, pp. 297–299, 2015.
Abstract | BibTeX | Tags: Children Under 13
@article{Upchurch2015,
title = {Discharge instructions for youth sports-related concussions in the emergency department, 2004 to 2012},
author = {Upchurch, C and Morgan, C D and Umfress, A and Yang, G and Riederer, M F},
year = {2015},
date = {2015-01-01},
journal = {Clinical Journal of Sport Medicine},
volume = {25},
pages = {297--299},
address = {Upchurch,Cameron. *Vanderbilt School of Medicine, Nashville, Tennessee; and +Department of Pediatric Orthopaedic Surgery, C.S. Mott Children's Hospital, Ann Arbor, Michigan.},
abstract = {OBJECTIVE: To evaluate the effect of the Centers for Disease Control and Prevention (CDC) Heads-Up concussion campaign on appropriateness of discharge instructions for youth sports-related concussion (SRC) patients presenting to a pediatric emergency department (ED). DESIGN: Retrospective cohort study. SETTING: Pediatric ED. PATIENTS: Children up to 18 years. ASSESSMENT OF RISK FACTORS: A retrospective chart review was conducted on patients evaluated from 2004 to 2012. Patients were selected by ICD-9 code for having a concussion during a sporting activity. MAIN OUTCOME MEASURES: Discharge instructions were reviewed for recommendations for cognitive rest, physical rest, primary care physician follow-up, and referral to a concussion specialist or center. RESULTS: There were 497 youth SRCs from 392 908 total ED visits. Overall, only 66% had appropriate discharge recommendations. This improved to 75% after 2010, which was not statistically significant (odds ratio = 1.02},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Kirkwood, G; Parekh, N; Ofori-Asenso, R; Pollock, A M
Concussion in youth rugby union and rugby league: a systematic review Journal Article
In: British Journal of Sports Medicine, vol. 49, pp. 506–510, 2015.
Abstract | BibTeX | Tags: Children Under 13
@article{Kirkwood2015,
title = {Concussion in youth rugby union and rugby league: a systematic review},
author = {Kirkwood, G and Parekh, N and Ofori-Asenso, R and Pollock, A M},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
pages = {506--510},
address = {Kirkwood,Graham. Centre for Primary Care and Public Health, Queen Mary University of London, London, UK. Parekh,Nikesh. Lewisham and Greenwich NHS Trust, London, UK. Ofori-Asenso,Richard. Centre for Primary Care and Public Health, Queen Mary University of},
abstract = {BACKGROUND: Children and adolescents who play rugby are at increased risk of concussion and its effects. Competitive rugby union and rugby league feature as major sports in the school sport curriculum in the UK. There is a need for a thorough understanding of the epidemiology of concussion in youth rugby, the mechanisms involved in injuries and predisposing risk factors. DATA SOURCES: The publication databases Pubmed, Embase and SportDISCUS were searched in April 2014 for primary research studies of child and adolescent rugby union and rugby league (under 20 years) in English language with data on concussion injuries. The review was conducted within a larger all injury systematic review on rugby union and rugby league where key words used in the search included rugby, injury and concussion with child, adolescent, paediatric and youth. RESULTS: There were 25 studies retrieved with data on child or adolescent rugby and concussion, 20 were on rugby union, three on rugby league and in two the code of rugby was unspecified. There was significant heterogeneity in the definitions of injuries and of concussion. The incidence of child and adolescent match concussion ranged from 0.2 to 6.9 concussions per 1000 player-hours for rugby union and was 4.6 and 14.7 concussions per 1000 player-hours for rugby league, equivalent to a probability of between 0.3% and 11.4% for rugby union and of 7.7% and 22.7% for rugby league. CONCLUSIONS: There is a significant risk of concussion in children and adolescents playing rugby union and rugby league evident from the studies included in this systematic review. There is a need for reliable data through routine monitoring and reporting in schools and clubs and in hospital emergency departments in order to inform prevention. Concussion protocols should be implemented and tested.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Hodgson, L; Patricios, J
Clarifying concussion in youth rugby: recognise and remove Journal Article
In: British Journal of Sports Medicine, vol. 49, pp. 966–967, 2015, ISSN: 03063674.
Links | BibTeX | Tags: Children Under 13
@article{Hodgson2015,
title = {Clarifying concussion in youth rugby: recognise and remove},
author = {Hodgson, L and Patricios, J},
doi = {10.1136/bjsports-2014-094561},
issn = {03063674},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
pages = {966--967},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Walter, K D
Addressing concussion in youth sports Journal Article
In: The Virtual Mentor, vol. 16, pp. 559–564, 2014.
BibTeX | Tags: Children Under 13
@article{Walter2014,
title = {Addressing concussion in youth sports},
author = {Walter, K D},
year = {2014},
date = {2014-01-01},
journal = {The Virtual Mentor},
volume = {16},
pages = {559--564},
address = {Walter,Kevin D. Associate professor of orthopedic surgery at the Medical College of Wisconsin, and the program director of pediatric and adolescent primary care sports medicine at Children's Hospital of Wisconsin, and a member of the Wisconsin Interschola},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Caswell, S V; Ambegaonkar, J P; Cortes, N; York, M; Caswell, A M
Neck strengthening recommendations for concussion risk reduction in youth sport Journal Article
In: International Journal of Athletic Therapy & Training, vol. 19, pp. 22–27, 2014.
Links | BibTeX | Tags: Children Under 13
@article{Caswell2014,
title = {Neck strengthening recommendations for concussion risk reduction in youth sport},
author = {Caswell, S V and Ambegaonkar, J P and Cortes, N and York, M and Caswell, A M},
doi = {10.1123/ijatt.2014-0043},
year = {2014},
date = {2014-01-01},
journal = {International Journal of Athletic Therapy \& Training},
volume = {19},
pages = {22--27},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Kerr, H A
Concussion risk factors and strategies for prevention Journal Article
In: Pediatric Annals, vol. 43, pp. e309–15, 2014.
Abstract | BibTeX | Tags: Children Under 13
@article{Kerr2014b,
title = {Concussion risk factors and strategies for prevention},
author = {Kerr, H A},
year = {2014},
date = {2014-01-01},
journal = {Pediatric Annals},
volume = {43},
pages = {e309--15},
abstract = {Concussion in children is frequently related to participation in sports. It requires a traumatic event to occur that transmits acceleration to the brain. Some children may have intrinsic risk factors that place them at greater risk for this type of injury. Comorbidities such as attention-deficit/hyperactivity disorder, migraine headaches, and mood disorders may place athletes at increased risk of more severe injury. A previous concussion is probably the most important influence on risk for future injury. Extrinsic risk factors include coaching techniques, officiating, and choice of sport. Helmet choice does not diminish concussion risk, nor does the use of mouth guards. Education of athletes, coaches, parents, and physicians is very important in improving recognition of potential concussive injury and helping child athletes and their parents understand the risks involved in sport participation.Copyright 2014, SLACK Incorporated.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Giza, C C
Pediatric issues in sports concussions Journal Article
In: CONTINUUM: Lifelong Learning in Neurology, vol. 20, pp. 1570–1587, 2014.
Abstract | BibTeX | Tags: Children Under 13
@article{Giza2014a,
title = {Pediatric issues in sports concussions},
author = {Giza, C C},
year = {2014},
date = {2014-01-01},
journal = {CONTINUUM: Lifelong Learning in Neurology},
volume = {20},
pages = {1570--1587},
abstract = {PURPOSE OF REVIEW: Sports-related concussions are receiving increasing attention in both the lay press and medical literature. While most media attention has been on high-profile collegiate or professional athletes, the vast majority of individuals participating in contact and collision sports are adolescents and children. This review provides a practical approach toward youth sports-related concussion with a foundation in the recent guidelines, but including specific considerations when applying these management principles to children and adolescents. RECENT FINDINGS: Objective measurement of early signs and symptoms is challenging in younger patients, and many commonly used assessment tools await rigorous validation for younger patients. Excellent evidence-based guidelines exist for CT evaluation of mild traumatic brain injury presenting to the emergency department. Evidence suggests that recovery from sports-related concussion takes longer in high school athletes compared with collegiate or professionals; however, rigorous studies below high school age are still lacking. SUMMARY: Proper care for concussion in youth requires a delicate balance of clinical skills, age-appropriate assessment, and individualized management to achieve optimal outcomes.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Cartwright, C
Pediatric athletic concussion Journal Article
In: Journal of Neuroscience Nursing, vol. 46, pp. 313, 2014.
BibTeX | Tags: Children Under 13
@article{Cartwright2014,
title = {Pediatric athletic concussion},
author = {Cartwright, C},
year = {2014},
date = {2014-01-01},
journal = {Journal of Neuroscience Nursing},
volume = {46},
pages = {313},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Macpherson, A; Fridman, L; Scolnik, M; Corallo, A; Guttmann, A
A population-based study of paediatric emergency department and office visits for concussions from 2003 to 2010 Journal Article
In: Paediatrics & Child Health, vol. 19, pp. 543–546, 2014.
Abstract | BibTeX | Tags: Children Under 13
@article{Macpherson2014,
title = {A population-based study of paediatric emergency department and office visits for concussions from 2003 to 2010},
author = {Macpherson, A and Fridman, L and Scolnik, M and Corallo, A and Guttmann, A},
year = {2014},
date = {2014-01-01},
journal = {Paediatrics \& Child Health},
volume = {19},
pages = {543--546},
address = {Macpherson,Alison. York University; ; Institute for Clinical Evaluative Sciences, The Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto, Ontario. Fridman,Liraz. York University; Scolnik,Michal. York University; Coral},
abstract = {BACKGROUND: There is a paucity of information regarding descriptive epidemiology of paediatric concussions over time, and few studies include both emergency department (ED) and physician office visits. OBJECTIVE: To describe trends in visits for paediatric concussions in both EDs and physician offices according to age and sex. A secondary objective was to describe the cause of concussion for children treated in EDs. METHODS: A retrospective, population-based study using linked health administrative data from all concussion-related visits to the ED or a physician office by school-age children and youth (three to 18 years of age) in Ontario between April 1, 2003 and March 3, 2011 was conducted. RESULTS: The number of children evaluated in both EDs and a physician offices increased between 2003 and 2010, and this linear trend was statistically significant (P=0.002 for ED visits and P=0.001 for office visits). The rate per 100,000 increased from 466.7 to 754.3 for boys and from 208.6 to 440.7 for girls during the study period. Falls accounted for approximately one-third of the paediatric concussions. Hockey/skating was the most common specific cause of paediatric sports-related concussions. CONCLUSIONS: The increasing use of health care services for concussions is likely related to changes in incidence over time and increased awareness of concussion as a health issue. Evidence-based prevention initiatives to help reduce the incidence of concussion are warranted, particularly in sports and recreation programs.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Purcell, Laura; Kissick, Jamie; Rizos, John
Concussion Journal Article
In: CMAJ: Canadian Medical Association Journal, vol. 185, no. 11, pp. 981, 2013, ISBN: 08203946.
Abstract | Links | BibTeX | Tags: Assessment/Testing, BRAIN -- Concussion, BRAIN -- Diseases, BRAIN -- Imaging, BRAIN -- Wounds & injuries, BRAIN function localization, Children Under 13, Overviews
@article{Purcell2013,
title = {Concussion},
author = {Purcell, Laura and Kissick, Jamie and Rizos, John},
doi = {10.1503/cmaj.120039},
isbn = {08203946},
year = {2013},
date = {2013-01-01},
journal = {CMAJ: Canadian Medical Association Journal},
volume = {185},
number = {11},
pages = {981},
abstract = {The article offers information on several topics related to concussions which includes effects of brain trauma on brain functioning, Sport Concussion Assessment Tool 3 and ChildSCAT3 for evaluation of concussion and standard imaging. It also mentions that physical and mental rest is involved in management of acute concussion.},
keywords = {Assessment/Testing, BRAIN -- Concussion, BRAIN -- Diseases, BRAIN -- Imaging, BRAIN -- Wounds \& injuries, BRAIN function localization, Children Under 13, Overviews},
pubstate = {published},
tppubtype = {article}
}
Merkel, D L; Molony Jr., J T
Medical sports injuries in the youth athlete: emergency management Journal Article
In: International Journal of Sports Physical Therapy, vol. 7, pp. 242–251, 2012.
Abstract | BibTeX | Tags: Children Under 13
@article{Merkel2012,
title = {Medical sports injuries in the youth athlete: emergency management},
author = {Merkel, D L and {Molony Jr.}, J T},
year = {2012},
date = {2012-01-01},
journal = {International Journal of Sports Physical Therapy},
volume = {7},
pages = {242--251},
abstract = {As the number of youth sports participants continues to rise over the past decade, so too have sports related injuries and emergency department visits. With low levels of oversight and regulation observed in youth sports, the responsibility for safety education of coaches, parents, law makers, organizations and institutions falls largely on the sports medicine practitioner. The highly publicized catastrophic events of concussion, sudden cardiac death, and heat related illness have moved these topics to the forefront of sports medicine discussions. Updated guidelines for concussion in youth athletes call for a more conservative approach to management in both the acute and return to sport phases. Athletes younger than eighteen suspected of having a concussion are no longer allowed to return to play on the same day. Reducing the risk of sudden cardiac death in the young athlete is a multi-factorial process encompassing pre-participation screenings, proper use of safety equipment, proper rules and regulations, and immediate access to Automated External Defibrillators (AED) as corner stones. Susceptibility to heat related illness for youth athletes is no longer viewed as rooted in physiologic variations from adults, but instead, as the result of various situations and conditions in which participation takes place. Hydration before, during and after strenuous exercise in a high heat stress environment is of significant importance. Knowledge of identification, management and risk reduction in emergency medical conditions of the young athlete positions the sports physical therapist as an effective provider, advocate and resource for safety in youth sports participation. This manuscript provides the basis for management of 3 major youth emergency sports medicine conditions.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Halstead, Mark E
Contact sports for young athletes: keys to safety Journal Article
In: Pediatric Annals, vol. 39, pp. 275–278, 2010.
BibTeX | Tags: Children Under 13
@article{Halstead2010a,
title = {Contact sports for young athletes: keys to safety},
author = {Halstead, Mark E},
year = {2010},
date = {2010-01-01},
journal = {Pediatric Annals},
volume = {39},
pages = {275--278},
address = {Departments of Orthopedics and Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA. halsteadm@wustl.edu},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Bakhos, Lisa L; Lockhart, Gregory R; Myers, Richard; Linakis, James G
Emergency department visits for concussion in young child athletes Journal Article
In: Pediatrics, vol. 126, pp. e550–6, 2010.
Abstract | BibTeX | Tags: Children Under 13
@article{Bakhos2010,
title = {Emergency department visits for concussion in young child athletes},
author = {Bakhos, Lisa L and Lockhart, Gregory R and Myers, Richard and Linakis, James G},
year = {2010},
date = {2010-01-01},
journal = {Pediatrics},
volume = {126},
pages = {e550--6},
address = {Pediatric Emergency Medicine, Waren Alpert Medical School, Brown University, Injury Prevention Center, Rhode Island Hospital, 593 Eddy St, Claverick Building 2nd Floor, Providence, RI 02903, USA. lbakhos@gmail.com},
abstract = {OBJECTIVES: The objective of this study was to characterize emergency department (ED) visits for pediatric sport-related concussion (SRC) in pre-high school- versus high school-aged athletes. METHODS: A stratified probability sample of US hospitals that provide emergency services in the National Electronic Injury Surveillance System (1997-2007) and All Injury Program (2001-2005) was used. Concussion-related ED visits were analyzed for 8- to 13- and 14- to 19-year-old patients. Population data were obtained from the US Census Bureau; sport participation data were obtained from National Sporting Goods Association. RESULTS: From 2001 to 2005, US children who were aged 8 to 19 years had an estimated 502 000 ED visits for concussion. The 8- to 13-year-old group accounted for approximately 35% of these visits. Approximately half of all ED visits for concussion were SRC. The 8- to 13-year-old group sustained 40% of these, which represents 58% of all concussions in this group. Approximately 25% of all SRC visits in the 8- to 13-year-old group occurred during organized team sport (OTS). During the study period, approximately 4 in 1000 children aged 8 to 13 years and 6 in 1000 children aged 14 to 19 years had an ED visit for SRC, and 1 in 1000 children aged 8 to 13 years and 3 in 1000 children aged 14 to 19 years had an ED visit for concussion sustained during OTS. From 1997 to 2007, although participation had declined, ED visits for concussions in OTS in 8- to 13-year-old children had doubled and had increased by \>200% in the 14- to 19-year-old group. CONCLUSIONS: The number of SRCs in young athletes is noteworthy. Additional research is required.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Meehan III, William P; Bachur, Richard G
Sport-related concussion Journal Article
In: Pediatrics, vol. 123, pp. 114–123, 2009.
Abstract | Links | BibTeX | Tags: Children Under 13
@article{MeehanIII2009,
title = {Sport-related concussion},
author = {{Meehan III}, William P and Bachur, Richard G},
doi = {10.1542/peds.2008-0309},
year = {2009},
date = {2009-01-01},
journal = {Pediatrics},
volume = {123},
pages = {114--123},
abstract = {Sport-related concussion is a common injury in children and adolescents. Athletes seldom report concussive symptoms, which makes the diagnosis a challenge. The management of sport-related concussion has changed significantly over the last several years. The previously used grading systems and return-to-play guidelines have been abandoned in favor of more individualized assessment and management. Neuropsychological testing is being used more frequently to assist in management. After recovery, it is recommended that an athlete's return-to-play progress in a gradual, stepwise fashion while being monitored by a health care provider. Proper assessment and management of a sport-related concussion is crucial, because repeat concussions can result in decreased neurocognitive functioning, increased symptomatology, and, at times, catastrophic outcomes.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Purcell, Laura; Carson, James
Sport-related concussion in pediatric athletes Journal Article
In: Clinical Pediatrics, vol. 47, pp. 106–113, 2008.
BibTeX | Tags: Children Under 13
@article{Purcell2008,
title = {Sport-related concussion in pediatric athletes},
author = {Purcell, Laura and Carson, James},
year = {2008},
date = {2008-01-01},
journal = {Clinical Pediatrics},
volume = {47},
pages = {106--113},
address = {Division of Emergency Medicine, University of Western Ontario, London, ON. lpurcell1015@rogers.com},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Yeates, Keith Owen; Bigler, Erin D; Dennis, Maureen.; Gerhardt, Cynthia A; Rubin, Kenneth H; Stancin, Terry.; Taylor, H Gerry.; Vannatta, Kathryn.
Social outcomes in childhood brain disorder: a heuristic integration of social neuroscience and developmental psychology Journal Article
In: Psychological Bulletin, vol. 133, pp. 535–556, 2007.
Abstract | BibTeX | Tags: Children Under 13
@article{Yeates2007,
title = {Social outcomes in childhood brain disorder: a heuristic integration of social neuroscience and developmental psychology},
author = {Yeates, Keith Owen and Bigler, Erin D and Dennis, Maureen. and Gerhardt, Cynthia A and Rubin, Kenneth H and Stancin, Terry. and Taylor, H Gerry. and Vannatta, Kathryn.},
year = {2007},
date = {2007-01-01},
journal = {Psychological Bulletin},
volume = {133},
pages = {535--556},
abstract = {The authors propose a heuristic model of the social outcomes of childhood brain disorder that draws on models and methods from both the emerging field of social cognitive neuroscience and the study of social competence in developmental psychology/psychopathology. The heuristic model characterizes the relationships between social adjustment, peer interactions and relationships, social problem solving and communication, social-affective and cognitive-executive processes, and their neural substrates. The model is illustrated by research on a specific form of childhood brain disorder, traumatic brain injury. The heuristic model may promote research regarding the neural and cognitive-affective substrates of children's social development. It also may engender more precise methods of measuring impairments and disabilities in children with brain disorder and suggest ways to promote their social adaptation.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Gordon, Kevin E
Pediatric minor traumatic brain injury Journal Article
In: Seminars in Pediatric Neurology, vol. 13, pp. 243–255, 2006.
Abstract | BibTeX | Tags: Children Under 13
@article{Gordon2006c,
title = {Pediatric minor traumatic brain injury},
author = {Gordon, Kevin E},
year = {2006},
date = {2006-01-01},
journal = {Seminars in Pediatric Neurology},
volume = {13},
pages = {243--255},
address = {Department of Pediatrics, Division of Pediatric Neurology, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia, Canada. KEGOR@DAL.CA},
abstract = {The literature surrounding minor traumatic brain injury is complex, methodologically challenging, and controversial. Although we lack a consistent standardized definition, the annual rate is likely in excess of 200 per 100,000 children. The proportion of children with minor traumatic brain injury who will require neurosurgery is certainly \<1%. Several studies are underway that have the potential to significantly advance our understanding of the specific risk factors for intracranial injury and more specifically neurosurgical injury. The mortality within children is very low, with estimates of 0% to 0.25%. Virtually all studies of the prognosis of minor brain injury in children have reported no long-term behavioral or cognitive sequelae as a specific result of the brain injury. Symptoms fall in 4 domains: somatic, cognitive, sleep/fatigue, and affective. Limited pediatric studies are available to assist clinicians in the prognosis or in optimizing recovery. Until further studies are available, a conservative approach is recommended. Children with suspected concussions should be removed from activity and observed. Children with symptomatic concussions must be limited to no physical activity. Adolescents and families need to self-monitor symptoms and limit environments or circumstances that exacerbate any symptoms. When symptoms resolve, a gradual progressive return to play is currently recommended. The recurrence risk for subsequent concussions is elevated, but there is limited documentation of the effectiveness of preventative efforts. Much remains to be learned. [References: 145]},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}
Polissar, N L; Fay, G C; Jaffe, K M; Liao, S; Martin, K M; Shurtleff, H A; Rivara, J B; Winn, H R
Mild pediatric traumatic brain injury: adjusting significance levels for multiple comparisons Journal Article
In: Brain Injury, vol. 8, pp. 249–263, 1994.
Abstract | BibTeX | Tags: Children Under 13
@article{Polissar1994,
title = {Mild pediatric traumatic brain injury: adjusting significance levels for multiple comparisons},
author = {Polissar, N L and Fay, G C and Jaffe, K M and Liao, S and Martin, K M and Shurtleff, H A and Rivara, J B and Winn, H R},
year = {1994},
date = {1994-01-01},
journal = {Brain Injury},
volume = {8},
pages = {249--263},
address = {Department of Biostatistics, University of Washington, Seattle.},
abstract = {The outcome following mild traumatic brain injury (TBI) is controversial. We addressed this topic in a study of neurobehavioural and 'real-world' functioning among 53 children with mild TBI and their matched controls, using statistical methods recently developed for multiple comparisons. Because the study involved calculation of 414 p-values, four methods of adjustment for multiple comparisons, including the Bonferroni method, were used to avoid 'false-positive' statistical significance. The additional three methods allowed greater insight into the data than provided by the standard Bonferroni adjustment. Results showed that at initial testing, three areas of 'real-world' functioning (eating, domestic and home/community living skills) had weak but statistically significant associations with mild injury. No other specific areas of neuro-behavioural or 'real-world' functioning had plausible associations with the injury either initially, at 1 year, or when changes over the year were considered. However, the adjustment for multiple comparisons provided additional results. There were statistical significant associations of the injury with the entire domain of neurobehavioural variables both initially and at 1 year. These results suggest that the injury affects a spectrum of neurobehavioural skills weakly, rather than a single area substantially. The gain from using multiple comparison methods is discussed.},
keywords = {Children Under 13},
pubstate = {published},
tppubtype = {article}
}