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Follow-Up Visit a Must After a Concussion

by The Kid's Doctor Staff

A new study suggests that children admitted to a hospital with a concussion should have a follow-up assessment with a clinician before resuming normal play activities or sports.

Researchers at The Children’s Hospital of Philadelphia used a computer program to assess preteen and teenage concussion victims. They found that most scored poorly on tests of their attentionspan, memory, nonverbal problem solving and reaction time, and nearly all scored in the lowest test quartile on at least one of those four areas. The study looked at 116 children, aged 11 to 17, who were hospitalized for such head trauma over a two-year period.

“Head injuries that occur during regular activities, such as riding a bike or in a car crash, are more common than sports injuries and yet the same issues arise — the children want to go back to sports, or to school or outside to play,” study author Dr. Michael L. Nance, director of the hospital trauma program, said in a news release. “The old recommendation would be to go see your pediatrician if you are having trouble, but sometimes families don’t recognize there is trouble until six months later. We think they should be seen again by a qualified health-care provider before returning to play.”

The study appears in the May 2009 issue of Annals of Surgery.

A concussion is a mild traumatic brain injury. It may not always be obvious when it occurs because visible cuts or bruises may not appear, but symptoms like headache, vomiting, loss of consciousness or fatigue can appear after the event. Returning too soon to physical activity, such as sports or normal play, increases the likelihood of having another concussion, according to previous research, and could prolong symptoms or even result in death.

Follow-ups with some of those children in the study found their brain function improved overall, but the researchers noted difficulty in getting the patients to return. Despite repeated efforts, only slightly more than half came back to scheduled follow-ups.

“We suspect that the patients electing not to follow up were at risk as well, and would have benefited from a formal assessment before returning to physically exertive activity,” Nance said. “It is this misconception of not feeling injured that places the patient at additional risk.”

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