Skip to main content
SpringerLink
Log in
Book cover

Nursing Care of the Pediatric Neurosurgery Patient pp 317–334Cite as

Pediatric Athletic Concussion

  • Chapter
  • First Online:

  • 924 Accesses

Abstract

Pediatric concussions are frequently related to sports or playtime injuries, and the topic has generated considerable interest due to publicity about concussions in professional sports. Concussion is often referred to as a mild form of traumatic brain injury (mTBI). The term “mild” is misleading, as a concussion is still a brain injury that can have devastating consequences for a child if not diagnosed and managed properly. Even though a concussion may not necessarily involve a loss of consciousness, and radiographic imaging is typically negative, it must be treated as a potentially serious health problem for the pediatric patient. This chapter discusses the pathophysiology of concussion, particularly a child’s susceptibility, as well as the signs and symptoms, treatment, potential complications, nursing care, and current return to play/learn (RTP/RTL) guidelines for children who sustain concussions.

This is a preview of subscription content, 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   74.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   99.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   99.00
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

Learn about institutional subscriptions

References

  • Albright AL, Pollack IF, Adelson PD (2008) Principles and practice of pediatric neurosurgery. Thieme, New York

    Book  Google Scholar 

  • Alsalaheen BA, Mucha A, Morris LO, Whitney SL, Furman JM, Camiolo-Reddy CE et al (2010) Vestibular rehabilitation for dizziness and balance disorders after concussion. J Neurol Phys Ther 34(2):87–93

    Article  PubMed  Google Scholar 

  • American Association of Neurological Surgeons (2014) Patient information/sport-related head injury. aans.org

  • Andrasik F (2010) Biofeedback in headache: an overview of approaches and evidence. Cleve Clin J Med 77:S72–S76

    Article  PubMed  Google Scholar 

  • Anne Mucha D, Collins MW, Elbin R, Furman JM, Kontos AP (2014) A brief Vestibular/Ocular Motor Screening (VOMS) assessment to evaluate concussions. Am J Sports Med 42(10):2479–2486

    Article  PubMed  PubMed Central  Google Scholar 

  • Apps JN, Walter KD (eds) (2012) Pediatric and adolescent concussion diagnosis, management, and outcomes. Springer, New York. ISBN: 978-0-387-89544-4 (Print) 978-0-387-89545-1 (Online)

    Google Scholar 

  • Barkhoudarian G, Hovda DA, Giza CC (2016) The molecular pathophysiology of concussive brain injury – an update. Phys Med Rehabil Clin N Am 27(2):373–393

    Article  PubMed  Google Scholar 

  • Bergenstal J, Davis SM, Sikora R, Paulson D, Whiteman C (2012) Pediatric bicycle injury prevention and the effect of helmet use: the West Virginia experience. W V Med J 108(3):78–81

    PubMed  Google Scholar 

  • Broshek DK et al (2005) Sex differences in outcome following sports-related concussion. J Neurosurg 102(5):868–863

    Article  Google Scholar 

  • Bryan MA, Rowhani-Rahbar A, Comstock RD, Rivara F (2016) Sports-and recreation-related concussions in US youth. Pediatrics 138(1):e20154635

    Article  PubMed  Google Scholar 

  • Cantu RC (1986) Guidelines for return to contact sports after a cerebral concussion. Phys Sportsmed 14:75–83

    Article  CAS  PubMed  Google Scholar 

  • Cantu RC (1998) Second-impact syndrome. Clin Sports Med 17(1):37–44

    Article  CAS  PubMed  Google Scholar 

  • Chen JK, Johnston KM, Frey S, Petrides M, Worsley K, Ptito A (2004) Functional abnormalities in symptomatic concussed athletes: an fMRI study. NeuroImage 22(1):68–82. doi:10.1016/j.neuroimage.2003.12.032

    Article  PubMed  Google Scholar 

  • Control, Center for Disease, & Prevention (2011) Nonfatal traumatic brain injuries related to sports and recreation activities among persons aged ≤ 19 years – United States, 2001–2009. MMWR Morbidity Mortality Weekly Report 60(39):1337–1342.

    Google Scholar 

  • Dick RW (2009). Is there a gender difference in concussion incidence and outcomes?. British journal of sports medicine, 43(Suppl 1): i46–i50

    Google Scholar 

  • Ellis MJ, Cordingley D, Vis S, Reimer K, Leiter J, Russell K (2015) Vestibulo-ocular dysfunction in pediatric sports-related concussion. J Neurosurg Pediatr 16(3):248–255

    Article  PubMed  Google Scholar 

  • Evans V (2014) Recognizing and managing concussion in school sport. J Neurosurg Nurs 46(4):e25–e32

    Article  Google Scholar 

  • Fineman I, Giza CC, Nahed BV, Lee SM, Hovda DA (2000) Inhibition of neocortical plasticity during development by a moderate concussive brain injury. J Neurotrauma 17(9):739–749

    Article  CAS  PubMed  Google Scholar 

  • Furman GR, Lin C-C, Bellanca JL, Marchetti GF, Collins MW, Whitney SL (2013) Comparison of the balance accelerometer measure and balance error scoring system in adolescent concussions in sports. Am J Sports Med 41(6):1404–1410

    Article  PubMed  PubMed Central  Google Scholar 

  • Galetta K, Barrett J, Allen M, Madda F, Delicata D, Tennant A et al (2011) The King-Devick test as a determinant of head trauma and concussion in boxers and MMA fighters. Neurology 76(17):1456–1462

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Gessel L et al (2007) Concussions among United States high school and collegiate athletes. J Athl Train 42(4):495–503

    PubMed  PubMed Central  Google Scholar 

  • Giza CC, Kutcher JS, Ashwal S, Barth J, Getchius TS, Gioia GA et al (2013) Summary of evidence-based guideline update: Evaluation and management of concussion in sports report of the guideline development subcommittee of the American Academy of Neurology. Neurology 80(24):2250–2257

    Article  PubMed  PubMed Central  Google Scholar 

  • Guskiewicz K, Weaver N et al (2000) Epidemiology of concussion in collegiate and high school football players. Am J Sports Med 28:643–650

    Article  CAS  PubMed  Google Scholar 

  • Guskiewicz KM, Register-Mihalik J, McCrory P, McCrea M, Johnston K, Makdissi M et al (2013) Evidence-based approach to revising the SCAT2: introducing the SCAT3. Br J Sports Med 47(5):289–293

    Article  PubMed  Google Scholar 

  • Halstead ME, Walter KD (2010) Sport-related concussion in children and adolescents. Pediatrics 126(3):597–615

    Article  PubMed  Google Scholar 

  • Harmon KG, Drezner JA, Gammons M, Guskiewicz KM, Halstead M, Herring SA,Roberts WO (2013). American Medical Society for Sports Medicine position statement: concussion in sport. British journal of sports medicine, 47(1):15–26.

    Google Scholar 

  • Hildenbrand KJ, Vasavada AN (2013) Collegiate and high school athlete neck strength in neutral and rotated postures. J Strength Cond Res 27(11):3173–3182

    Article  PubMed  Google Scholar 

  • Hugentobler JA, Vegh M, Janiszewski B, Quatman-Yates C (2015) Physical therapy intervention strategies for patients with prolonged mild traumatic brain injury symptoms: a case series. Int J Sports Phys Ther 10(5):676

    PubMed  PubMed Central  Google Scholar 

  • Kelleher E, Taylor-Linzey E, Ferrigno L, Bryson J, Kaminski S (2014) A community return-to-play mTBI clinic: Results of a pilot program and survey of high school athletes. Journal of pediatric surgery, 49(2):341–344.

    Google Scholar 

  • King D, Brughelli M, Hume P, Gissane C (2013) Concussions in amateur rugby union identified with the use of a rapid visual screening tool. J Neurol Sci 326(1):59–63

    Article  PubMed  Google Scholar 

  • Konrad C, Geburek A, Rist F, Blumenroth H, Fischer B, Husstedt I et al (2011) Long-term cognitive and emotional consequences of mild traumatic brain injury. Psychol Med 41(6):1197–1211

    Article  CAS  PubMed  Google Scholar 

  • Kristjansson E, Treleaven J (2009) Sensorimotor function and dizziness in neck pain: implications for assessment and management. J Orthop Sports Phys Ther 39(5):364–377

    Article  PubMed  Google Scholar 

  • Langlois JA, Rutland-Brown W, Wald MM (2006) The epidemiology and impact of traumatic brain injury: a brief overview. J Head Trauma Rehabil 21(5):375–378

    Article  PubMed  Google Scholar 

  • Lovell MR, Solomon GS (2013) Neurocognitive test performance and symptom reporting in cheerleaders with concussions. J Pediatr 163:1192–1195

    Article  PubMed  Google Scholar 

  • Leddy JJ, Sandhu H, Sodhi V, Baker JG, Willer B (2012) Rehabilitation of concussion and post-concussion syndrome. Sports Health Multidiscip Approach 4(2):147–154

    Article  Google Scholar 

  • Lee H, Wintermark M, Gean AD, Ghajar J, Manley GT, Mukherjee P (2008) Focal lesions in acute mild traumatic brain injury and neurocognitive outcome: CT versus 3 T MRI. J Neurotrauma 25(9):1049–1056

    Article  PubMed  Google Scholar 

  • Majerske CW, Mihalik JP, Ren D, Collins MW, Reddy CC, Lovell MR, Wagner AK (2008) Concussion in sports: postconcussive activity levels, symptoms, and neurocognitive performance. J Athl Train 43(3):265–274

    Article  PubMed  PubMed Central  Google Scholar 

  • Marar M et al (2012) Epidemiology of concussions among united states high school athletes in 20 sports. Am J Sports Med 40(4):747–755

    Article  PubMed  Google Scholar 

  • Mason C (2013) Mild traumatic brain injury in children. Pediatr Nurs 39(6):267–272

    PubMed  Google Scholar 

  • May KH et al (2014) Pediatric sports specific return to play guidelines following concussion. Int J Sports Phys Ther 9(2):242–255

    PubMed  PubMed Central  Google Scholar 

  • Mayer A, Ling J, Yang Z, Pena A, Yeo R, Klimaj F (2013) Diffusion abnormalities in pediatric mild traumatic brain injury. J Neurosci 32(50):17961–17969

    Article  Google Scholar 

  • McCrea, M., Hammeke, T., Olsen, G., Leo, P., & Guskiewicz, K. (2004). Unreported concussion in high school football players: implications for prevention. Clinical Journal of Sport Medicine, 14(1):13–17.

    Google Scholar 

  • McCrea M, Iverson GL, Echemendia RJ, Makdissi M, Raftery M (2013) Day of injury assessment of sport-related concussion. Br J Sports Med 47(5):272–284

    Article  PubMed  Google Scholar 

  • McCrory P, Davis G, Makdissi M (2012) Second impact syndrome or cerebral swelling after sporting head injury. Curr Sports Med Rep 11(1):21–23

    Article  PubMed  Google Scholar 

  • McCrory P, Meeuwisse W, Aubry M, Cantu B, Dvorak J, Echemendia R et al (2013) Consensus statement on Concussion in Sport – The 4th International Conference on Concussion in Sport held in Zurich, November 2012. Phys Ther Sport 14(2):e1–e13. doi:10.1016/j.ptsp.2013.03.002

    Article  PubMed  Google Scholar 

  • Meehan WP, Bachur RG (2009) Sport-related concussion. Pediatrics 123:114–123

    Article  PubMed  Google Scholar 

  • Meehan WP, d’Hemecourt P, Collins CL, Comstock RD (2011) Assessment and management of sport-related concussions in United States high schools. Am J Sports Med 39(11):2304–2310

    Article  PubMed  PubMed Central  Google Scholar 

  • Missouri State High School Activities Association (2015) Interscholastic Youth Sports Brain Injury Report, www.mshsaa.org/sportsmedicine.

  • Moser RS, Glatts C, Schatz P (2012) Efficacy of immediate and delayed cognitive and physical rest for treatment of sports-related concussion. The Journal of pediatrics, 161(5):922–926.

    Google Scholar 

  • National High School Sports-Related Surveillance Study (2015–2016) Summary report, school year, table 13.4. www.ucdenver.edu/piper

  • Noffke ex rel. Swenson v. Bakke, 2009 WI 10, 760 N.W.2d 156 (Wis. 2009)

    Google Scholar 

  • Norton C, Feltz S, Brocker A, Granitto M (2013) Tackling long-term consequences of concussion. Nursing 43(1):50–55

    Article  PubMed  Google Scholar 

  • Omalu BI, DeKosky ST, Minster RL, Kamboh MI, Hamilton RL, Wecht CH (2005) Chronic traumatic encephalopathy in a National Football League player. Neurosurgery 57(1):128–134

    Article  PubMed  Google Scholar 

  • Papa L, Lewis LM, Falk JL, Zhang Z, Silvestri S, Giordano P et al (2012) Elevated levels of serum glial fibrillary acidic protein breakdown products in mild and moderate traumatic brain injury are associated with intracranial lesions and neurosurgical intervention. Ann Emerg Med 59(6):471–483

    Article  PubMed  Google Scholar 

  • Papa L, Ramia MM, Edwards D, Johnson BD, Slobounov SM (2015) Systematic review of clinical studies examining biomarkers of brain injury in athletes after sports-related concussion. J Neurotrauma 32(10):661–673

    Article  PubMed  PubMed Central  Google Scholar 

  • Prins ML, Matsumoto J (2016) Metabolic response of pediatric traumatic brain injury. J Child Neurol 31(1):28–34

    Article  PubMed  Google Scholar 

  • Racicki S, Gerwin S, DiClaudio S, Reinmann S, Donaldson M (2013) Conservative physical therapy management for the treatment of cervicogenic headache: a systematic review. J Manip Ther 21(2):113–124

    Article  Google Scholar 

  • Raichle ME, Mintun MA (2006) Brain work and brain imaging. Annu Rev Neurosci 29:449–476

    Article  CAS  PubMed  Google Scholar 

  • Resch J, Driscoll A, McCaffrey N, Brown C, Ferrara MS, Macciocchi S et al (2013) ImPact test-retest reliability: reliably unreliable? J Athl Train 48(4):506–511

    Article  PubMed  PubMed Central  Google Scholar 

  • Schneider KJ, Meeuwisse WH, Nettel-Aguirre A, Barlow K, Boyd L, Kang J, Emery CA (2014) Cervicovestibular rehabilitation in sport-related concussion: a randomised controlled trial. Br J Sports Med 48:1294 .bjsports-2013-093267

    Article  PubMed  Google Scholar 

  • Selassie AW, Wilson DA, Pickelsimer EE, Voronca DC, Williams NR, Edwards JC (2013). Incidence of sport-related traumatic brain injury and risk factors of severity: a population-based epidemiologic study. Annals of epidemiology, 23(12): 750–756.

    Google Scholar 

  • Sone JY, Kondziolka D, Huang J, Smadani U (2016) Helmet efficacy against concussion and traumatic brain injury: a review. J Neurosurg 27:1. doi:10.3171/2016.2.JNS151972

    Google Scholar 

  • Stern RA, Riley DO, Daneshvar DH, Nowinski CJ, Cantu RC, McKee AC (2011) Long-term consequences of repetitive brain trauma: chronic traumatic encephalopathy. PM R 3(10 Suppl 2):S460–S467. doi:10.1016/j.pmrj.2011.08.008

    Article  PubMed  Google Scholar 

  • Sunami K, Nakamura T, Ozawa Y, Kubota M, Namba H, Yamaura A (1989). Hypermetabolic state following experimental head injury. Neurosurgical review, 12(1):400–411

    Google Scholar 

  • Thornton KE, Carmody DP (2009) Traumatic brain injury rehabilitation: QEEG biofeedback treatment protocols. Appl Psychophysiol Biofeedback 34(1):59–68

    Article  PubMed  Google Scholar 

  • Thunnan DJ, Branche CM, Sniezek JE (1998) The epidemiology of sports-related traumatic brain injuries in the United States: recent developments. J Head Trauma Rehabil 13(2):1–8

    Article  Google Scholar 

  • Tierney RT, Sitler MR, Swanik CB, Swanik KA, Higgins M, Torg J (2005) Gender differences in head-neck segment dynamic stabilization during head acceleration. Med Sci Sports Exerc 37(2):272–279

    Article  PubMed  Google Scholar 

  • Toledo E, Lebel A, Becerra L, Minster A, Linnman C, Maleki N et al (2012) The young brain and concussion: imaging as a biomarker for diagnosis and prognosis. Neurosci Biobehav Rev 36(6):1510–1531

    Article  PubMed  PubMed Central  Google Scholar 

  • Wetjen NM, Pichelmann MA, Atkinson JL (2010) Second impact syndrome: concussion and second injury brain complications. J Am Coll Surg 211(4):553–557

    Article  PubMed  Google Scholar 

  • Yoshino A, Hovda DA, Kawamata T, Katayama Y,Becker DP (1991). Dynamic changes in local cerebral glucose utilization following cerebral concussion in rats: evidence of a hyper-and subsequent hypometabolic state. Brain research, 561(1):106–119.

    Google Scholar 

Resources

Download references

Author information

Authors and Affiliations

  1. University of Kansas Medical Center, Kansas City, KS, USA

    Jill Kouts BSN, RN

  2. Department of Neurosurgery, University of Kansas Medical Center, Kansas City, KS, USA

    Tanya Filardi MD

Authors
  1. Jill Kouts BSN, RN
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tanya Filardi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jill Kouts BSN, RN .

Editor information

Editors and Affiliations

  1. Childrens Mercy Hospital, Kansas City, Missouri, USA

    Cathy C. Cartwright

  2. Division of Pediatric Neurosurgery, Banner Children Specialists at Cardon, Children’s Medical Center, Mesa, Arizona, USA

    Donna C. Wallace

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Kouts, J., Filardi, T. (2017). Pediatric Athletic Concussion. In: Cartwright, C., Wallace, D. (eds) Nursing Care of the Pediatric Neurosurgery Patient. Springer, Cham. https://doi.org/10.1007/978-3-319-49319-0_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-49319-0_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-49318-3

  • Online ISBN: 978-3-319-49319-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation