@article{ref1,
title="Prevalence of abnormal magnetic resonance imaging findings in children with persistent symptoms after pediatric sports-related concussion",
journal="Journal of neurotrauma",
year="2017",
author="Bonow, Robert H. and Friedman, Seth D. and Perez, Francisco A. and Ellenbogen, Richard G. and Browd, Samuel R. and Macdonald, Christine L. and Vavilala, Monica S. and Rivara, Frederick P.",
volume="34",
number="19",
pages="2706-2712",
abstract="A subset of patients experience persistent symptoms after pediatric concussion, and magnetic resonance imaging (MRI) is commonly used to evaluate for pathology. The utility of this practice is unclear. We conducted a retrospective cohort study to describe the MRI findings in children with concussion. A registry of all patients seen at our institution from January 2010 through March 2016 with pediatric sports-related concussion was cross-referenced with a database of radiographic studies. Radiology reports were reviewed for abnormal findings. Patients with abnormal CTs or MRI scans ordered for reasons other than concussion were excluded. Among 3,338 children identified with concussion, 427 underwent MRI. Only two (0.5%) had findings compatible with traumatic injury, consisting in both of microhemorrhage. Sixty-one patients (14.3%) had abnormal findings unrelated to trauma, including 24 nonspecific T2 changes, 15 pineal cysts, eight Chiari I malformations, and five arachnoid cysts. One child underwent craniotomy for a cerebellar hemangioblastoma after presenting with ataxia; another had cortical dysplasia resected after seizure. The two patients with microhemorrhage each had three prior concussions, significantly more than patients whose scans were normal (median: 1) or abnormal without injury (median: 1.5; P = 0.048). MRI rarely revealed intracranial injuries in children after concussion, and the clinical relevance of these uncommon findings remains unclear. Abnormalities unrelated to trauma are usually benign. However, MRI should be thoughtfully considered in children who present with concerning or atypical symptoms.<p /> <p>Language: en</p>",
language="en",
issn="0897-7151",
doi="10.1089/neu.2017.4970",
url="http://dx.doi.org/10.1089/neu.2017.4970"
}