Published online April 3, 2006
PEDIATRICS Vol. 117 No. 4 April 2006, pp. 1359-1371 (doi:10.1542/peds.2005-0994)
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REVIEW ARTICLE

Pediatric Sport-Related Concussion: A Review of the Clinical Management of an Oft-Neglected Population

Michael W. Kirkwood, PhDa,b, Keith Owen Yeates, PhDc,d and Pamela E. Wilson, MDa,b

a Department of Physical Medicine and Rehabilitation, Children's Hospital, Denver, Colorado
b University of Colorado Health Sciences Center, Denver, Colorado
c Department of Pediatrics, Ohio State University, Columbus, Ohio
d Center for Biobehavioral Health, Columbus Children's Research Institute, Columbus, Ohio

Athletic concussion is a growing focus of attention for pediatricians. Although numerous literature reviews and clinical guidelines are now available pertaining to athletic concussion, few have focused on the pediatric athlete in particular. Sport-related concussions occur relatively frequently in children and adolescents, and primary health care providers are often responsible for coordinating clinical management. Here we summarize the scientific literature pertinent to the care of young athletes. We examine how concussion affects younger and older athletes differently at biomechanical, pathophysiological, neurobehavioral, and contextual levels. We also discuss important issues in clinical management, including preparticipation assessment, concussion evaluation and recovery tracking, and when and how to return pediatric athletes to play sports. We also briefly cover non–sport-related interventions (eg, school support). With proper management, most children and adolescents sustaining a sport-related concussion can be expected to recover fully.

Key Words: concussion • mild traumatic brain injury • athletic injuries

Abbreviations: TBI—traumatic brain injury • mTBI—mild traumatic brain injury • PCS—postconcussive symptoms • CISG—Concussion in Sport Group • CSI—Concussion Symptom Inventory

Accepted Sep 6, 2005.




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