Can we manage sport related concussion in children the same as in adults?

@article{McCrory2004CanWM,
  title={Can we manage sport related concussion in children the same as in adults?},
  author={Paul McCrory and Alex Collie and Vicki Anderson and Gavin A Davis},
  journal={British Journal of Sports Medicine},
  year={2004},
  volume={38},
  pages={516 - 519}
}
Evidence based guidelines are required for the management of concussive injury in children Consensus guidelines for managing sport related concussion in adults have been increasingly widely implemented.1 So far, there are no guidelines that enable clinicians to manage similar sporting concussive injuries in children. Furthermore, there are a number of important anatomical, physiological, and behavioural differences between adults and children that suggest that adult guidelines will need to be… 
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Clinical Report — Sport-Related Concussion in Children and Adolescents
TLDR
Recognition and education are paramount, because although proper equipment, sport technique, and adherence to rules of the sport may decrease the incidence or severity of concussions, nothing has been shown to prevent them.
Sport-Related Concussion in Children and Adolescents
TLDR
Recognition and education are paramount, because although proper equipment, sport technique, and adherence to rules of the sport may decrease the incidence or severity of concussions, nothing has been shown to prevent them.
Concussion in Young Athletes
TLDR
The key to management is physical and cognitive rest to allow symptoms to abate, followed by gradual return to cognitive activities, including school, then physical activity via a medically supervised stepwise exertion protocol.
Sport-Related Concussion in Children and Adolescents
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Education is provided on the current state of sport-related concussion knowledge, diagnosis, and management in children and adolescents.
Comparing the Acute Presentation of Sport-Related Concussion in the Pediatric and Adult Populations
TLDR
The initial presentation of concussion within 7 days of injury will likely not differ by age, specifically 18 and older versus 17 and younger, and there were no significant differences between pediatric and adult patients in any score of the Sport Concussion Assessment Tool–3rd Edition symptom scale, neurologic examination category, pertinent elements of past medical history, or characteristics of the concussion.
The evaluation and management of acute concussion differs in young children
TLDR
Age-specific, validated diagnostic tools are required, and management of concussion in children should focus attention on return to learn before considering return to play.
Minor traumatic brain injuries have been the topic of an extensive body of literature in recent years.
TLDR
It was thought that guidelines formulated for adults could be extended to children, but evidence is emerging that children may react differently when sustaining a TBI, although recovery times in children 'may be longer'.
Assessment and Treatment of Concussion in the Pediatric Population.
TLDR
Specific issues related to TBI in children that might be useful to adult neurologists are focused on.
Neuropsychological evaluation and management of sport-related concussion
TLDR
There is good evidence to support the use of neuropsychological assessment to inform treatments and return-to-play decision making in children and adolescents diagnosed with sport-related concussion.
Pediatric Sports‐related Concussion
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References

SHOWING 1-10 OF 160 REFERENCES
Paediatric sport related concussion pilot study
TLDR
A study was undertaken to determine the degree to which paediatric neurosurgeons agreed on the optimum management of sport related concussion in children, and to establish current consensus neurosurgical practice for management of children with sportrelated concussion.
Concussion incidences and severity in secondary school varsity football players.
TLDR
Contin use of illegal techniques of butt-blocking and face-tackling by as many as 40 per cent of the players was associated with apparent increased risks of concussions and concussion symptoms.
Management of minor closed head injury in children.
TLDR
A recommendation in “The Management of Minor Closed Head Injury in Children” practice parameter by the AAP's Committee on Quality Improvement is questioned, with the author saying that the performance of fundoscopy in acute head trauma is not warranted.
Summary and agreement statement of the first International Conference on Concussion in Sport, Vienna 2001*
TLDR
A persuasive argument was made that a comprehensive systematic approach to concussion would be of potential benefit to aid the injured athlete and direct management decisions.
Mild head injury in New Zealand: incidence of injury and persisting symptoms.
TLDR
Mild head injuries are economically important and deserve efficient management and were marginally more likely to be referred and the probability was significantly greater in women injured in sport and in minor RTA not needing admission to hospital.
Risk factors in the outcome of children with minor head injury.
TLDR
Risk factors such as length of unconsciousness, presence of skull fractures, computed tomography findings, posttraumatic seizure, and Glasgow or Children's Coma scores were evaluated for their impact on the patient's outcome.
The assessment of orientation following concussion in athletes.
  • D. Maddocks, G. Dicker, M. Saling
  • Medicine, Psychology
    Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine
  • 1995
TLDR
Investigation of the sensitivity of orientation and recent memory questions in the diagnosis of concussion showed that items evaluating recently acquired information were more in the assessment of concussion than standard orientation items.
Summary and Agreement Statement of the First International Conference on Concussion in Sport, Vienna 2001
TLDR
A small group of experts was given a mandate by the conference delegates and organizing bodies to draft a document describing the agreement position reached by those in attendance at that meeting, and this group will be called the Concussion in Sport Group.
Psychological Impact of Injuries in Athletes
TLDR
Interventions such as positive self-talk, relaxation, goal setting and healing imagery, all used by a faster healing group of athletes, and although not well researched, seem appropriate to assist athletes in coping with injury.
Does age play a role in recovery from sports-related concussion? A comparison of high school and collegiate athletes.
TLDR
Preliminary data may suggest a more protracted recovery from concussion in high school athletes, and self-report of postconcussion symptoms by student athletes was not predictive of poor performance on neuropsychologic testing.
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