Post concussive symptoms in children

Concussion in kids

Concussion is divided loosely into two categories.
Mild concussion is a bang on the head where the patient was not knocked out.

Classic concussion is when a person was knocked out.

When assessing patients after a closed head injury, nurses and doctors often use a multitude of tools and questions about the event.  On average about 30% of adults who receive concussions, go on to have persistent symptoms of headache and concentration loss, memory disturbances and dizzyness for months.   This is called Persistent post concussion syndrome (PPCS).
Predicting who will have PPCS is difficult, but one team of researchers in Canada have just published a paper that summarises the process in children.

They state that  "clinician prediction is no better than a coin toss".

In assessing long term risk of PPCS in children the research team found some surprising things.

Where we as clinicians have long thought that loss of consciousness and vomiting post head injury were somewhat prognostic for post concussion symptoms, these researchers consider these as less predictive.

Using a 12 point scoring system the researchers looked at some 3000 five to 18 year olds,
Higher scoring data (2 points) Included
Gender=female
Age >13
Fatigue

Points are also allocated for
Headache
Previous concussion
Slow to answer questions
Sensitivity to noise
History of Migraine
Poor balance
For

A score of 9-12 correlated with a 93% incidence of prolonged post concussion symptoms.

Ref:
Zemek et. al  2016
Clinical Risk Score for Persistent Postconcussion Symptoms among children with acute concussion in ED
JAMA. 2016;315(10):1014-1025.
 doi:10.1001/jama.
http://jama.jamanetwork.com/mobile/article.aspx?articleid=2499274