Study recommends against brain scans for kids with concussion
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.