Government issues new guidelines on concussions in children

CHICAGO — New children’s concussion guidelines from the U.S. government recommend against routine X-rays and blood tests for diagnosis and reassure parents that most kids’ symptoms clear up within one to three months.

Signs of potentially more serious injuries that may warrant CT imaging scans include nausea, unconsciousness and severe, worsening headaches, according to the guidelines released Tuesday.

The guidelines from the U.S. Centers for Disease Control and Prevention are the first broad evidence-based recommendations for diagnosing and treating children’s concussions, the researchers say. They evaluated 25 years of scientific research on managing concussions in children and chose procedures with the strongest evidence of benefit.

The American Academy of Neurology has similar evidence-based guidelines, but strictly for sports concussions in child and adult athletes and focused on restricting return to play. The American Academy of Pediatrics also has guidance for managing sports concussions, and for returning to school after a concussion.

The CDC’s guidelines are for concussions from all causes, including falls, sports and car accidents. They recommend rest from physical and mental activity including school and sports immediately after a concussion, gradually resuming normal routines.

CDC brain-injury specialist Matthew Breiding, a co-author of the guidelines, said parents should tell their kids to report any concussion symptoms right away — whether they occur at home or during sports activities.

“Some children and teens think concussions aren’t serious or worry that if they report a concussion they will lose their position on the team or look weak. Remind them that it’s better to miss one game than the whole season,” he said.

By some estimates, at least 1 million U.S. children get concussions each year although the true frequency is unknown because there is no national effort to track them and many go untreated. The CDC has proposed developing a surveillance system to fill that gap and the new guidelines, published in JAMA Pediatrics, aim to improve detection and treatment.