Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Dec 16;41(1):54.
doi: 10.1007/s00381-024-06706-z.

Does new research address persistent questions since the publication of the CDC's 2018 pediatric mTBI guideline

Rebecca Dann  1 , Ankita Das  1 , Alexandria Naftchi  1 , Brinda Raval  1 , Eris Spirollari  1 , OluwaToba Akinleye  2 , Sima Vazquez  1 , Allison Zhong  1 , Jose F Dominguez  3 , Jared Pisapia  1   3 , Carrie Muh  1   3 , Rachana Tyagi  1   3
Affiliations
Review

Does new research address persistent questions since the publication of the CDC's 2018 pediatric mTBI guideline

Rebecca Dann et al. Childs Nerv Syst. .

Abstract

Background and objective: Due to the potential debilitating sequelae following pediatric mTBI, the CDC published the Guideline on the Diagnosis and Management of mTBI Among Children in 2018. However, the guideline identified several key gaps in our clinical knowledge to support several clinical recommendations. The objective of this review is to evaluate if subsequent research has addressed these gaps in clinical practice recommendations.

Methods: A literature review was conducted in PubMed using keywords from the CDC guidelines for the years of July 2015-January 2021. Articles were screened by title and abstract so only studies with children < 18 years of age and those focusing on mTBI were included.

Results: A total of 531 articles were identified after screening. Forty-three percent was prospective; 24% were case reports, literature reviews, comments, or protocols; 19% were retrospective, 7% were cross-sectional, 4% were RCTs, and 4% were systematic reviews/meta-analyses. Forty-nine percent focused on diagnosis, 17% on prognosis, and 34% on treatment. The four most published topics were neuropsychological tools (28%), risk factors for intracranial injury and computed tomography (11%), cognitive/physical rest (11%), and return to school (10%).

Conclusion: Since the release of the 2018 CDC guidelines, the majority of publications addressing pediatric mTBI have been prospective studies evaluating the clinical application of neuropsychological tools in concussion management. While these studies do address several of the clinical gaps noted by the CDC regarding the diagnosis and prognosis of pediatric mTBI, there remains a lack of high-quality studies focused on improving pediatric concussion treatment and outcomes.

Keywords: Brain magnetic resonance imaging; Computerized cognitive testing; Including symptom scales; Neuropsychological tools; Reneral healthcare professional counseling of prognosis; Risk factors for intracranial injury (ICI) and computed tomography (CT); Serum markers; Single-photon emission CT; Skull radiograph; Standardized assessment of concussion.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Similar articles

See all similar articles

References

    1. Menon DK, Schwab K, Wright DW, Maas AI, & Demographics and Clinical Assessment Working Group of the International and Interagency Initiative toward Common Data Elements for Research on Traumatic Brain Injury and Psychological Health (2010) Position statement: definition of traumatic brain injury. Arch Phys Med Rehab 91(11):1637–1640. https://doi.org/10.1016/j.apmr.2010.05.017 - DOI
    1. Ruff RM, Iverson GL, Barth JT, Bush SS, Broshek DK, Policy NAN, Committee P (2009) Recommendations for diagnosing a mild traumatic brain injury: a National Academy of Neuropsychology education paper. Arch Clin Neuropsychol Off J Natl Acad Neuropsychol 24(1):3–10. https://doi.org/10.1093/arclin/acp006 - DOI
    1. Lumba-Brown A, Yeates KO, Sarmiento K, Breiding MJ, Haegerich TM, Gioia GA, Turner M, Benzel EC, Suskauer SJ, Giza CC, Joseph M, Broomand C, Weissman B, Gordon W, Wright DW, Moser RS, McAvoy K, Ewing-Cobbs L, Duhaime AC, Putukian M, … Timmons SD (2018) Diagnosis and management of mild traumatic brain injury in children: a systematic review. JAMA pediatrics, 172(11), e182847. https://doi.org/10.1001/jamapediatrics.2018.2847
    1. Veliz P, McCabe SE, Eckner JT, Schulenberg JE (2021) Trends in the prevalence of concussion reported by US adolescents, 2016–2020. JAMA 325(17):1789–1791. https://doi.org/10.1001/jama.2021.1538 - DOI - PubMed - PMC
    1. Black LI, Zablotsky B. Concussions and brain injuries in children: United States, 2020. NCHS Data Brief, no 423. Hyattsville, MD: National Center for Health Statistics. 2021. https://doi.org/10.15620/cdc:111174external

LinkOut - more resources