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CHICAGO (AP) – The US government's concussion guidelines for children recommend that X-rays and routine blood tests not be used for diagnosis and reassure parents that most symptoms will disappear within one to three months.
Signs of potentially more serious injuries that may warrant CT imaging include vomiting, unconsciousness and severe headache, according to guidelines released on Tuesday.
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 that in case of a concussion, they will lose their place on the team or appear weak. Remind them it's better to miss a game than the whole season, "he said.
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.
According to 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 a concussion work and should not be done outside the research.
"Most of the children's symptoms disappear within one to three months, but recovery is variable and may be delayed in children who have had previous concussions.
-Young people, children with learning difficulties and those with mental illness all tend to recover more slowly than younger children.
-The main treatment is recommended for the first three days, but inactivity beyond that can aggravate the symptoms.
Children with an undiagnosed concussion may have another longer recovery period.
By LINDSEY TANNER, AP Medical Writer
(© Copyright 2018 The Associated Press Inc. All Rights Reserved This material may not be published, disseminated, rewritten or redistributed.)
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