Abstract

Closed head injury (CHI) resulting in concussion accounts for half a million emergency department (ED) visits annually. Children aged 0 to 4 years and adolescents aged 15 to 19 years are most likely to sustain a traumatic brain injury. There is a 2:1 male-to-female preponderance of mild traumatic brain injury (MTBI) across all ages. Mild traumatic brain injury often presents with symptoms of concussion such as loss of consciousness (LOC), amnesia, confusion, headache, nausea, and vomiting; these symptoms should be evaluated for other potential etiologies. A pediatric Glasgow Coma Scale (GCS) score of 14 or below is concerning for clinically important traumatic brain injury (TBI), and CT scan is recommended. The American Academy of Pediatrics has recommended observation periods of 24 hours in children with CHI; however, with reliable families in close proximity to a hospital and with a well-appearing child, observation may occur at home.

Keywords: mild traumatic brain injury, traumatic brain injury, concussion, postconcussive syndrome, second impact syndrome, and closed head injury.