A CT scan of the head should not be routinely done for diagnostic purposes in children with mild traumatic brain injury (TBI), often referred to as concussion, says the Centers for Disease Control and Prevention (CDC) in its recently published guidelines on the “Diagnosis and Management of Mild Traumatic Brain Injury Among Children” published online September 4, 2018 in JAMA Pediatrics.
The 19 sets of clinical recommendations cover various aspects of mild TBI including diagnosis, prognosis, and management of mild TBI, which are applicable to healthcare providers in all practice settings. It also outlines specific actions that they can take to help the patients and their parents.
The guideline includes five key practice changing recommendations:
- Do not routinely
use imaging to diagnose mild TBI in children.
- Use validated,
age-appropriate symptom scales to identify children with mild TBI at low risk
for intracranial injury in whom head CT is not indicated, as well as
children who may be at higher risk for clinically important ICI and thus
may warrant head CT scan.
- Assess for risk
factors for prolonged recovery, including history of mild TBI or other
brain injury, severe symptom presentation immediately after the injury,
and personal characteristics and family history (such as learning
difficulties and family and social stressors).
- Provide patients
and their parents/caregivers with instructions on returning to activity
customized to their symptoms.
- Counsel patients
and their parents/caregivers to return gradually to non-sports activities
after no more than a 2-3 days of rest.
(Source: CDC, JAMA Pediatrics)
Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Immediate Past National President IMA