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:

1. Do not routinely use imaging to diagnose mild TBI in children.
2. 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.
3. 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).
4. Provide patients and their parents/caregivers with instructions on returning to activity customized to their symptoms.
5. 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