Office-Based Management of Pediatric and Adolescent Concussion

Abstract

CME Educational Objectives 1. Diagnose pediatric and adolescent concussion using directed clinical history and physical examination. 2. Identify specific associated pre-morbid conditions that increase risk of prolonged concussion recovery. 3. Implement timely prescription of physical and cognitive rest. During the past decade, there has been a tremendous amount of research that has provided an increased understanding of the underlying pathophysiology and far-reaching clinical implications of concussion as a form of traumatic brain injury. In addition, there has been a huge surge of interest in and awareness of concussions, in part due to high-profile cases involving professional athletes. These professional athletes, however, are merely the tip of the iceberg. An estimated 144,000 pediatric and adolescent patients are treated in emergency departments nationwide for concussion, 1 and this likely represents a significant underestimate of the actual incidence because many children do not seek emergency treatment for concussion. There are an estimated 3.8 million concussions due to sports annually 2 and the majority of these are in the pediatric and adolescent populations.