Skip to main content
SpringerLink
Log in

Definition and Classification of Concussion

  • Chapter
  • First Online:
Book cover Pediatric and Adolescent Concussion

Abstract

Traumatic brain injury (TBI) is a leading cause of hospitalization and death among children and adolescents and therefore represents a major public health problem. In the past decade, increased attention was given to milder forms of TBI, such as concussion. Despite this increased recognition, a substantial lack of agreement persists regarding the definition and classification of concussions. Numerous controversies exist with regard to methods of assessing severity of TBI and systems of grading concussion severity. The goal of this chapter is to provide a review of the definition and classification of concussions, with special attention to pediatric populations, as well as to review several nosological issues that arise during the course of both clinical and research work.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • (1966) Committee on Head Injury Nomenclature of the Congress of neurological surgeons: glossary of head injury, including some definitions of injury to the cervical spine. Clinical Neurosurgery, 12, 386–394.

    Google Scholar 

  • American Academy of Neurology. (1997). Practice parameter: The management of concussion in sports (summary statement). Report of the Quality Standards Subcommittee. Neurology, 48(3), 581–585.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, D.C.: American Psychiatric Association.

    Google Scholar 

  • Anderson, T., Heitger, M., & Macleod, A. D. (2006). Concussion and mild head injury. Practical Neurology, 6, 342–357.

    Article  Google Scholar 

  • Ashwal, S. (2010). Neuroimaging in pediatric traumatic brain injury. In V. A. Anderson & K. O. Yeates (Eds.), Pediatric traumatic brain injury: new directions in clinical and translational research. New York: Oxford University Press.

    Google Scholar 

  • Boake, C., McCauley, S. R., Levin, H. S., Contant, C. F., Song, J. X., Brown, S. A., et al. (2004). Limited agreement between criteria-based diagnoses of Postconcussional syndrome. The Journal of Neuropsychiatry and Clinical Neurosciences, 16, 493–499.

    Article  PubMed  Google Scholar 

  • Boake, C., McCauley, S. R., Levin, H. S., Pedroza, C., Contant, C. F., Song, J. X., et al. (2005). Diagnostic criteria for Postconcussional syndrome after mild to moderate traumatic brain injury. The Journal of Neuropsychiatry and Clinical Neurosciences, 17, 350–356.

    Article  PubMed  Google Scholar 

  • Bodin, D., & Yeates, K. O. (2010). Traumatic Brain Injury. In R. J. Shaw & D. DeMaso (Eds.), Textbook of pediatric psychosomatic medicine. Washington, DC: American Psychiatric Publishing.

    Google Scholar 

  • Brown, S. J., Fann, J. R., & Grant, I. (1994). Postconcussional disorder: time to acknowledge a common source of neurobehavioral morbidity. The Journal of Neuropsychiatry and Clinical Neurosciences, 6, 15–22.

    PubMed  Google Scholar 

  • Cantu, R. C. (2001). Posttraumatic retrograde and anterograde amnesia: Pathophysiology and implications in grading and safe return to play. Journal of Athletic Training, 36(3), 244–248.

    PubMed  Google Scholar 

  • Cantu, R. C. (2006). An overview of concussion consensus statements since 2000. Neurosurgical Focus, 21, 1–5.

    Article  Google Scholar 

  • Carroll, L. J., Cassidy, J. D., Holm, L., Kraus, J., & Coronado, V. G. (2004). Methodological issues and research recommendations for mild traumatic brain injury: the WHO collaborating centre task force on mild traumatic brain injury. Journal of Rehabilitation Medicine. Supplement, 43, 113–125.

    Article  Google Scholar 

  • Colorado Medical Society. (1991). Report of the Sports Medicine Committee: Guidelines for the Management of Concussion in Sports (revised). Denver: Colorado Medical Society.

    Google Scholar 

  • Committee on Quality Improvement, American Academy of Pediatrics (1999) The management of minor closed head injury in children. Pediatrics, 104, 1407–1415.

    Google Scholar 

  • DeMatteo, C. A., Hanna, S. E., Mahoney, W. J., Hollenber, W. J., Hollenberg, R. D., Scott, L. A., et al. (2010). My child doesn’t have a brain injury, he only has a concussion. Pediatrics, 125, 327–334.

    Article  PubMed  Google Scholar 

  • Durham, S. R., Clancy, R. R., Leuthardt, E., Sun, P., Kamerling, S., Dominguez, T., et al. (2000). CHOP infant coma scale (“Infant Face Scale”): A novel coma scale for children less than two years of age. Journal of Neurotrauma, 17, 729–737.

    Article  PubMed  Google Scholar 

  • Esselman, P. C., & Uomoto, J. M. (1995). Classification of the spectrum of mild traumatic brain injury. Brain Injury, 9, 417–424.

    Article  PubMed  Google Scholar 

  • Ewing-Cobbs, L., Levin, H. S., Fletcher, J. M., Miner, M. E., & Eisenberg, H. M. (1990). The children’s orientation and amnesia test: relationship to severity of acute had injury and to recovery of memory. Neurosurgery, 27, 683–691.

    Article  PubMed  Google Scholar 

  • Falk, A. C., Cederfjäll, C., von Wendt, L., & Söderkvist, B. K. (2005). Management and classification of children with head injury. Child’s Nervous System, 21, 430–436. doi:10.1007/s00381-005-1142-4.

    Article  PubMed  Google Scholar 

  • Gordon, K. E., Dooley, J. M., & Wood, E. P. (2006). Descriptive epidemiology of concussion. Pediatric Neurology, 34, 376–378.

    Article  PubMed  Google Scholar 

  • Hunt, T., & Asplund, C. (2010). Concussion assessment and management. Clinical Journal of Sports Medicine, 29, 5–17.

    Article  Google Scholar 

  • Kirkwood, M. W., Yeates, K. O., & Wilson, P. E. (2006). Pediatric sport-related concussion: a review of the clinical management of an oft-neglected population. Pediatrics, 117, 1259–1371.

    Article  Google Scholar 

  • Langlois, J. A., Rutland-Brown, W., & Thomas, K. E. (2006). Traumatic Brain injury in the United States: Emergency department visits, hospitalizations, and deaths. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.

    Google Scholar 

  • Levin, H. S., Hanten, G., Roberson, G., Li, X., Ewing-Cobbs, L., Dennis, M., et al. (2008). Prediction of cognitive sequelae based on abnormal computed tomography findings in children following mild traumatic brain injury. Journal of Neurosurgery. Pediatrics, 1, 461–470.

    Article  PubMed  Google Scholar 

  • Levin, H. S., Zhang, L., Dennis, M., Ewing-Cobbs, L., Schachar, R., & Hunter, J. V. (2004). Psychosocial outcome of TBI in children with unilateral frontal lesions. Journal of International Neuropsychological Society, 10, 305–316.

    Article  Google Scholar 

  • Makdissi, M. (2009). Is the simple versus complex classification of concussion a valid and useful differentiation? British Journal of Sports Medicine, 43(Suppl 1), i23–i27. doi: 10.1136/bjsm.2009.058206.

  • Matz, P. G. (2003). Classification, diagnosis, and management of mild traumatic brain injury: a major problem presenting in a minor way. Seminars in Neurosurgery, 14(2), 125–130.

    Article  Google Scholar 

  • McCrory, P., Johnston, K., Meeuwisse, W., Aubry, M., Cantu, R., Dvorak, J., et al. (2005). Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004. British Journal of Sports Medicine, 39, 196–204.

    PubMed  Google Scholar 

  • McCrory, P., Meeuwisse, W., Johnston, K., Dvorak, J., Aubry, M., Molloy, M., et al. (2009). Consensus statement on concussion in sport 3rd International Conference on Concussion in Sport Held in Zurich, November 2008. Clinical Journal of Sports Medicine, 19, 185–195.

    Article  Google Scholar 

  • Mendez, C. V., Hurley, R. A., Lassonde, M., Zhang, L., & Taber, K. H. (2005). Mild traumatic brain injury: Neuroimaging of sports-related concussion. The Journal of Neuropsychiatry and Clinical Neurosciences, 17, 297–303.

    Article  PubMed  Google Scholar 

  • Mild Traumatic Brain Injury Committee, ACoRM., Head Injury Interdisciplinary Special Interest Group. (1993). Definition of mild traumatic brain injury. The Journal of Head Trauma Rehabilitation, 8(3), 86–87.

    Article  Google Scholar 

  • Mittenberg, W., & Strauman, S. (2000). Diagnosis of mild head injury and the Postconcussional syndrome. The Journal of Head Trauma Rehabilitation, 12(2), 783–791.

    Article  Google Scholar 

  • Mittenberg, W., Wittner, M. S., & Miller, L. J. (1997). Postconcussional syndrome occurs in children. Neuropsychology, 11, 447–452.

    Article  PubMed  Google Scholar 

  • Newsome, M. R., Steinberg, J. L., Scheibel, R. S., Troyanskaya, M., Chu, Z., Hanten, G., et al. (2008). Effects of traumatic brain injury on working memory-related brain activation in adolescents. Neuropsychology, 22, 419–425.

    Article  PubMed  Google Scholar 

  • Ruff, R. M., & Jurica, P. (1999). In search of a unified definition for mild traumatic brain injury. Brain Injury, 13(12), 943–952.

    Article  PubMed  Google Scholar 

  • Slobounov, S. (2008). Concussion classification: historical perspective and current trends. In Injuries in athletics: Causes and consequences (pp. 399–414). Boston, MA: Springer.

    Chapter  Google Scholar 

  • Tator, C. H. (2009). Let’s standardize the definition of concussion and get reliable incidence data. Canadian Journal of Neurological Sciences, 36, 405–406.

    PubMed  Google Scholar 

  • Taylor, H. G., Dietrich, A., Nuss, K., Wright, M., Rusin, J., Bangert, B., et al. (2010). Post-concussive symptoms in children with mild traumatic brain injury. Neuropsychology, 24, 148–159.

    Article  PubMed  Google Scholar 

  • Teasdale, G., & Jennett, B. (1974). Assessment of coma and impaired consciousness: A practical scale. Lancet, 2, 81–84.

    Article  PubMed  Google Scholar 

  • Thiessen, M. L., & Woolridge, D. P. (2006). Pediatric minor closed head injury. Pediatric Clinics of North America, 53, 1–26. doi:10.1016/j.pcl.2005.09.004.

    Article  PubMed  Google Scholar 

  • Willer, B., Dumas, J., Hutson, A., & Leddy, J. (2004). A population based investigation of head injuries and symptoms of concussion of children and adolescents in schools. Injury Prevention, 10, 144–148.

    Article  PubMed  Google Scholar 

  • Williams, D. H., Levin, H. S., & Eisenberg, H. M. (1990). Mild head injury classification. Neurosurgery, 27, 422–428.

    Article  PubMed  Google Scholar 

  • World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research. Geneva: World Health Organization.

    Google Scholar 

  • Yeates, K. O. (2010). Traumatic brain injury. In K. O. Yeates, M. D. Ris, H. G. Taylor, & B. F. Pennington (Eds.), Pediatric neuropsychology: research, theory, and practice (2nd ed., pp. 112–146). New York: Guilford.

    Google Scholar 

  • Yeates, K. O., Luria, J., Baertkowski, H., Rusin, J., Martin, L., & Bigler, E. D. (1999). Postconcussive symptoms in children with mild closed head injuries. The Journal of Head Trauma Rehabilitation, 14, 337–350.

    Article  PubMed  Google Scholar 

  • Yeates, K. O., & Taylor, H. G. (2005). Neurobehavioral outcomes of mild head injury in children and adolescents. Pediatric Rehabilitation, 8, 5–16.

    PubMed  Google Scholar 

  • Yeates, K. O., Taylor, H. G., Rusin, J., Bangert, B., Dietrich, A., Nuss, K., et al. (2009). Longitudinal trajectories of Postconcussive symptoms in children with mild traumatic brain injuries and their relationship to acute clinical status. Pediatrics, 123, 735–743.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Nationwide Children’s Hospital, The Ohio State University, Columbus, OH, USA

    Doug Bodin

  2. Department of Psychology, Professor Department of Pediatrics, Director Center for Biobehavioral Health, Nationwide Children’s Hospital, The Ohio State University, The Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA

    Keith Owen Yeates

  3. Pediatric Rehabilitation Medicine, Nationwide Children’s Hospital, Physical Medicine and Rehabilitation, Ohio State University Medical Center, Columbus, OH, USA

    Karl Klamar

Authors
  1. Doug Bodin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Keith Owen Yeates
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karl Klamar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Doug Bodin .

Editor information

Editors and Affiliations

  1. Dept. Psychiatry & Behavioral Medicine, Department of Psychiatry and Behavioral, Medical College of Wisconsin, N 118th Street 2544, Wauwatosa, 53226, Wisconsin, USA

    Jennifer Niskala Apps

  2. Children’s Hospital of Wisconsin, Departments of Orthopaedics & Pediatrics, Medical College of Wisconsin, 9000 W. Wisconsin Avenue Suite C360, Milwaukee, 53201, Wisconsin, USA

    Kevin D. Walter

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Bodin, D., Yeates, K.O., Klamar, K. (2012). Definition and Classification of Concussion. In: Apps, J., Walter, K. (eds) Pediatric and Adolescent Concussion. Springer, New York, NY. https://doi.org/10.1007/978-0-387-89545-1_2

Download citation

Publish with us

Policies and ethics

Search

Navigation