Study rec­om­mends against brain scans for kids with con­cus­sion

Fort McMurray Today - - ALBERTA NEWS - SHAWN LO­GAN

Kids suf­fer­ing from con­cus­sions needn’t un­dergo brain scans and should re­turn to non-sport­ing ac­tiv­i­ties fol­low­ing a few days of rest, says a Univer­sity of Cal­gary re­searcher whose find­ings could help shape clin­i­cal prac­tice around the world.

Keith Yeates, who heads the U of C’s In­te­grated Con­cus­sion Re­search Pro­gram, was the lead author on a new re­port ini­ti­ated by the U.S. Cen­ters for Disease Con­trol based on the find­ings of a quar­ter-cen­tury of data on the di­ag­no­sis and man­age­ment of chil­dren’s con­cus­sions.

The re­view and the en­su­ing guide­line adopted by the CDC was pub­lished on­line by the pe­di­atric health jour­nal JAMA Pe­di­atrics.

“The goal in de­vel­op­ing the guide­line was to help im­prove and stan­dard­ize care for kids with these in­juries, not just in the United States but hope­fully world­wide,” said Yeates, the head of the depart­ment of psy­chol­ogy and mem­ber of the Al­berta Chil­dren’s Hospi­tal Re­search In­sti­tute and the Hotchkiss Brain In­sti­tute at the Cum­ming School of Medicine.

The team de­ter­mined that chil­dren are more vul­ner­a­ble to changes in brain func­tion re­sult­ing from a con­cus­sion be­cause their brains are still grow­ing.

A re­cent study by the CDC found that some 2.5 mil­lion high school kids in the U.S. re­ported suf­fer­ing a sport­sre­lated con­cus­sion within the past year, while more than 800,000 chil­dren an­nu­ally seek care for con­cus­sions in emer­gency rooms south of the bor­der.

Key among the 19 rec­om­men­da­tions re­sult­ing from the work of Yeates and his team was es­chew­ing the rou­tine imag­ing of pa­tients through MRIS, CT scans and other meth­ods.

“In the vast ma­jor­ity of cases, kids with con­cus­sions don’t show vis­i­ble le­sions on stan­dard imag­ing,” Yeates said.

“There is no data to sug­gest that stan­dard imag­ing dif­fer­en­ti­ates kids with con­cus­sions from kids with other types of in­juries, or even healthy kids.”

As well, the CDC guide­line urges young pa­tients to grad­u­ally re­turn to non-sports ac­tiv­i­ties af­ter no more than two or three days of rest, with Yeates not­ing ex­er­cise fa­cil­i­tates re­cov­ery from brain in­jury.

“We’ve dis­cov­ered that the old ad­vice, that kids should rest un­til they’re asymp­to­matic, is ac­tu­ally counter-pro­duc­tive,” he said.

“Yes, two or three days of rest makes sense, but pretty quickly we should start en­cour­ag­ing kids to be­gin en­gag­ing in light ac­tiv­ity, and then, as they tol­er­ate it, aer­o­bic ac­tiv­ity.”

Yeates noted that not all cases are the same, and the newly adopted guide­line sug­gests med­i­cal pro­fes­sion­als screen pa­tients for other risk fac­tors that could af­fect their re­cov­ery from a con­cus­sion.

He said in 70 to 80 per cent of cases, chil­dren suf­fer­ing from con­cus­sions don’t have sig­nif­i­cant dif­fi­cul­ties beyond one to three months af­ter the in­jury.

“What some­times gets lost in the me­dia mes­sage is that, yes, we have to be con­cerned about con­cus­sions,” he said.

“We have to take them very se­ri­ously. But the ma­jor­ity of chil­dren are go­ing to get bet­ter. Let’s try to re­as­sure fam­i­lies of that.”


Al­berta Chil­dren’s Hospi­tal in Cal­gary.

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