Minor traumatic brain injuries - what is new?

Abstract

IN A NUTSHELL
• Children are more prone to developing TBIs, and recover more slowly than adults
• Even minor concussions without LOC may be followed by a period of physical and cognitive dysfunction, which may last up to 3 weeks
• Children with a GCS ≤ 14 and a skull fracture or focal neurological signs, with a fixed dilated pupil, children under two with a scalp hematoma and any child with a drop in GCS should have an immediate CT scan
• Any child with a GCS ≤14, a skull fracture, focal neurological signs, coagulopathy or suspicion of child abuse should be admitted
• The cornerstones of management of mTBI are physical and cognitive rest, education and allowing time for the brain to recover
• The use of medications should be avoided in concussed children
• Return-to-play or return-to-school of a concussed child should be graded
• Neuropsychological and balance testing should be considered in any child recovering from a concussion.