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In the United States, the new guidelines on concussions in children recommend avoiding radiological examinations and routine blood tests for diagnosis and reassure parents that most children's symptoms are no longer evident. Here one to three months.
Signs of potentially more serious injuries that may warrant CT imaging include vomiting, unconsciousness and severe and aggravated headache, according to guidelines published last week.
The guidelines of the US Centers for Disease Control and Prevention are the first evidence-based general recommendations for the diagnosis and treatment of concussions in children. They evaluated 25 years of scientific research on the management of concussions in children and chose procedures that had the most positive benefits.
The American Academy of Neurology has guidelines based on similar evidence, but strictly intended for concussions in children and adult athletes and aimed at limiting the return to play. The American Academy of Pediatrics also offers tips for managing concussions and returning to school after a concussion.
The CDC guidelines address concussions of all causes, including falls, sports and auto accidents. They recommend the rest of physical and mental activity, including in school and sport, immediately after a concussion, gradually resuming normal routines.
Matthew Breiding, a brain injury specialist at CDC and co-authored the guidelines, said parents should tell their children to report any symptoms of concussion immediately, whether at home or during sports activities .
"Some kids and teenagers think that concussions are not serious or worry about whether they report a concussion, they will lose their position in the team, or they will seem weak. It's better to miss a game than the whole season. "
According to some estimates, at least 1 million American children suffer concussions every year, although the actual frequency is not known because there is no national effort to follow them and many are not treated. The CDC has proposed to develop a surveillance system to fill this gap and the new guidelines, published in JAMA Pediatrics, aim to improve detection and treatment.
The guidelines provide important guidance to parents and physicians about managing concussions in children and could contribute to a "personalized approach to advanced care," according to an editorial published by Medical College of Wisconsin and University. from California, San Francisco.
Concussions, also known as mild traumatic brain injuries, are caused by a lump or jolt in the head. The impact bounces or twists the brain, which can damage brain cells. Repeated concussions have been associated with debilitating brain disease found at autopsies on retired football players.
Breiding, many people mistakenly believe that "you must lose consciousness or be stunned to suffer a concussion".
Headaches, dizziness, sensitivity to light or sound and sleep problems are other possible symptoms that experts say deserve medical attention.
The guidelines stress in particular:
• X-rays and CT scans are not effective in detecting concussions. They are sometimes performed if doctors suspect a skull fracture or cerebral hemorrhage, but CT scanning is best if a serious injury seems likely. Families should be informed of the potential risks associated with computed tomography, including radiation.
• It has not been proven that blood tests to detect concussions work and should not be done outside of research.
• Most of the children's symptoms disappear in one to three months, but their recovery varies and can be delayed in children who have already suffered a concussion.
• Adolescents, children with learning disabilities and those with mental illness all tend to recover more slowly than younger children.
• Rest, the main treatment, is recommended for the first three days, but inactivity beyond can worsen the symptoms.
• Children with an undiagnosed concussion are at risk for another longer recovery.
• The Associated Press Department of Health and Science receives support from the Department of Science Education at the Howard Hughes Medical Institute. The AP is solely responsible for all content.
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