PITTSBURGH (KDKA) – The CDC has released new guidelines regarding children suffering concussions.
The 19 recommendations focus on diagnosis, treatment, and prognosis.
A number of them address brain imaging. In fact, they advise against imaging, because the results are normal with concussion. Certain red flags, though, would push toward testing.
"Nausea, vomiting, severe headache, doing something neurologically that doesn't fit, emotional outbursts, can't smell, can't hear, can't taste, can't see," Dr. Ed Snell, of Allegheny Health Network Sports Medicine, said.
Similarly, no blood tests, for the same reason.
"We don't have an image, or a serum marker, or a biomarker to diagnose this injury," UPMC Concussion Specialist Dr. Mickey Collins said.
Diagnosis should be based on history, exam, and assessment with validated tools. Rating scales are commonly used for this, with questions about physical symptoms, thinking issues, and balance.
"Every concussion, because it affects different parts of your brain, it's hard to standardize it," Dr. Snell said.
After a period of rest, activity and academics should be gradually increased, with extra attention to good sleep.
"Getting kids active probably within a week or so is probably a good idea. Getting back into the swing of things, making that brain work a little bit, but not overwork," Dr. Snell said.
The most strident recommendation is education on concussions for parents, players, and coaches.
The experts behind the guidelines favor renaming concussions as a "mild traumatic brain injury."
"Using the word brain injury, it helps us understand this can be a very serious event that needs to be managed carefully," Dr. Collins said. "You have to individualize care. I believe concussion is a treatable injury. I believe we can get kids back to the sports they love."
The recommendations are based on studies published between 1990 and 2015. Taking care of traumatic brain injury in children is a rapidly changing field.
The CDC expects to update recommendations as more study and analysis come out.
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