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Pathophysiology and Diagnosis of Concussion

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Common Neurosurgical Conditions in the Pediatric Practice

Abstract

Concussion is one of the most common neurological conditions to occur during childhood. Since 1997, the incidence of concussion has doubled, likely due to increased reporting of events by parents, schools, and team officials. Concussion occurs after an impact to the body or head causes a rotational force on the brain sufficient to disturb consciousness. A complex neurochemical cascade ensues, sometimes accompanied by physical damage to neuronal structures. Patients can suffer from a multitude of somatic and cognitive complaints, although they resolve in the majority of cases after 7–10 days. There is no proven treatment, and the most commonly prescribed remedy is a combination of physical and cognitive rest. Children should only return to playing sports when symptoms have resolved, and this return should occur in a stepwise manner from light exercise, to sports-specific exercise, to noncontact drills, and finally to full-contact practice and return to play after clearance by a licensed medical professional. The management of chronic symptoms and likely temporary cognitive deficits should be dealt with on a case-by-case basis, and academic accommodation should be utilized when necessary.

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Abbreviations

CDC :

Centers for Disease Control and Prevention

CT:

Computed tomography

DTI :

Diffusion tensor imaging

ER:

Emergency room

GCS :

Glasgow Coma Scale

LTP :

Long-term potentiation

MRI :

Magnetic resonance imaging

PET :

Positron emission tomography

SPECT :

Single-photon emission computed tomography

TBI :

Traumatic brain injury

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  1. New York Presbyterian Hospital – Weill Cornell Medical Center, 525 East 68th Street, New York, NY, 10065, USA

    Baxter B. Allen M.D.

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  1. Associate Professor of Neurological Surgery, Weill Cornell Medical College, New York, New York, USA

    Jeffrey P. Greenfield

  2. Manhattan Pediatrics, New York, New York, USA

    Caroline B. Long

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Allen, B.B. (2017). Pathophysiology and Diagnosis of Concussion. In: Greenfield, J., Long, C. (eds) Common Neurosurgical Conditions in the Pediatric Practice. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3807-0_29

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