Mild Traumatic Brain Injury in Children: A 5-Question Quiz

Discussion: The CDC advises against routine imaging for pediatric patients to diagnose acute mTBI. Clinical decision rules are more accurate for identifying patients and should be used instead. In addition, skull radiographs cannot detect intracranial injuries, such as hemorrhage, and they expose children to radiation.¹

Discussion: Nonfrontal scalp hematoma is listed in the guidelines as a risk factor for serious injury. Other risk factors are patient age <2 years, vomiting, loss of consciousness, severe mechanism of injury, severe/worsening headache, amnesia, a Glasgow Coma Scale score of <15, and clinical suspicion of skull fracture.¹

Discussion: Lower socioeconomic status is a risk factor for prolonged recovery from mTBI, as are older age/adolescence, Hispanic ethnicity, history of mTBI or other brain injury, more severe presentation, more acute postconcussion symptoms, personal characteristics (eg, learning difficulties, psychiatric disorders), and family history (social stressors). Validated prediction rules may be used to provide prognostic counseling to patients and family.¹

Discussion: Research suggests that early rest for 3 days after the injury may be beneficial. However, rest beyond 3 days may worsen symptoms.¹