Physical medicine and rehabilitation clinics of North America
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Most athletes who experience a sports-related concussion recover from the acute effects within a few weeks. However, some children and adolescents with concussion experience symptoms for many weeks, or even months after the injury. Subacute and chronic symptoms related to concussion are particularly concerning in children, because cognitive deficits, headache or neck pain, sleep dysfunction, and emotional dysregulation can affect school performance and social function at a critical period of development and maturation. This article reviews the epidemiology of subacute symptoms after pediatric concussion and the current recommendations for the assessment and management of these symptoms in children and adolescents.
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Mild traumatic brain injury, especially sport-related concussion, is common among young persons. Consequences of transient pathophysiologic dysfunction must be considered in the context of a developing or immature brain, as must the potential for an accumulation of damage with repeated exposure. This review summarizes the underlying neurometabolic cascade of concussion, with emphasis on the young brain in terms of acute pathophysiology, vulnerability, alterations in plasticity and activation, axonal injury, and cumulative risk from chronic, repetitive damage, and discusses their implications in the context of clinical care for the concussed youth, highlighting areas for future investigation.
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Phys Med Rehabil Clin N Am · Nov 2011
ReviewSport-related concussion: on-field and sideline assessment.
The careful and well-planned sideline assessment of concussion can be the difference between a good and bad outcome when managing sport-related concussion. In most cases, the sideline assessment serves as a triage for determining if an injury, such as a concussion, has actually occurred, and if so, establishes a benchmark for determining whether a more serious and potentially catastrophic condition could be developing. Concussions can evolve into something more serious if signs and symptoms go undetected or are ignored. Although these are very rare events, they must always be at the forefront of the clinician's mind.
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Phys Med Rehabil Clin N Am · Nov 2011
ReviewYouth sports and concussions: preventing preventable brain injuries. One client, one cause, and a new law.
Effective concussion prevention and management for youth athletes requires both education and legislation. Education alone effectively begins the awareness of an issue, but does not change behavior. Education and legislation are required to prevent preventable concussion and brain injuries in youth athletes.
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The overall prevalence of concussion is high school sports is unknown. In general, concussions in this age range occur much more frequently in games than in practice. ⋯ Recent data show that the time required for return to play and resolution of symptoms is similar for women and men. Very little is known about the epidemiology of concussions in middle school-aged athletes and younger children.