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Journal Article

Citation

Ellis M, Krisko C, Selci E, Russell K. J. Neurosurg. Pediatr. 2018; 21(4): 401-408.

Affiliation

Canada North Concussion Network, Winnipeg, Manitoba, Canada.

Copyright

(Copyright © 2018, American Association of Neurological Surgeons)

DOI

10.3171/2017.9.PEDS17392

PMID

29393810

Abstract

OBJECTIVE The aim of this study was to examine differences in symptom burden and duration until physician-documented clinical recovery among pediatric patients with sports-related concussion (SRC) with and without a history of concussion.

METHODS A retrospective chart review was performed for all pediatric patients (7-19 years old) referred to the Pan Am Concussion Program in Winnipeg, Canada, with an SRC and evaluated < 30 days postinjury between September 1, 2013, and August 1, 2015.

RESULTS A total of 322 patients with SRC (64.91% male, mean age 13.96 years) who were evaluated a median of 7 days (interquartile range [IQR] 5-11 days) postinjury were included. Patients without a history of concussion endorsed significantly fewer concussion symptoms at initial assessment (median 5.5 symptoms, IQR 1-10 symptoms) than those with a previous concussion (median 7 symptoms, IQR 2-13.25 symptoms; p = 0.036). The median Post-Concussion Symptom Scale scores were 9 (IQR 1-23) for patients with no concussion history and 13 (IQR 3-33) for those with a history of concussion (p = 0.032). For patients with no previous concussion, the median number of days until physician-documented clinical recovery was 23 (IQR 15-44 days) compared with 25 days (IQR 18-43 days) for those with a history of concussion (p = 0.281). There was no significant difference in the proportion of patients who experienced delayed time until physician-documented clinical recovery (> 1 month postinjury) between the groups (p = 0.584).

CONCLUSIONS Although a history of concussion may be associated with increased symptom burden following pediatric SRC, there was no difference in the time until physician-documented clinical recovery. Pediatric patients with SRC who have a history of concussion should be managed on an individualized basis. Future work is needed to examine the short- and long-term effects of multiple concussions in children and adolescents.


Language: en

Keywords

IQR = interquartile range; PCSS = Post-Concussion Symptom Scale; SRC = sports-related concussion; TBI = traumatic brain injury; concussion history; outcomes; pediatric; predictors; recovery; sports-related concussion; symptoms; trauma

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