Pediatric Sports-related Concussion

This article aims to examine pediatric concussion literature with respect to epidemiology, etiology, return to play, and recurrent concussions, and to provide recommendations for future research. We conducted a review of pediatric concussion literature regarding incidence, etiology, return to play, and recurrent concussive injury by using MEDLINE, CINAHL, Sport-Discus, and PsychInfo databases from 1995-2010. A review of reference lists in the aforementioned articles was also performed. We discovered that the research on sports-related concussion specific to children and adolescents is rather limited. Results of existing studies of concussion incidence in this population indicate that concussion is relatively rare compared with most musculoskeletal injuries; however, the potential consequences of mismanagement and of subsequent injury warrant significant attention regarding injury recognition and recovery, and the challenge of determining readiness to return to play. Evidence exists that children and adolescents take longer to recover than adults after a concussion, which underscores the need for a more conservative approach to management and return to physical and cognitive activities. Concussion in the young athlete is of specific concern because of the continuing cognitive maturation, therefore, the recovery may be more difficult to track when using the standard assessment tools currently available. Until future studies can better delineate the mechanisms of, response to, and recovery from concussion in the young athlete, it is prudent to act in a conservative manner when dealing with pediatric athletes with concussion. PM R 2011;3:353-364