CDC Releases Guidelines for Pediatric Mild Traumatic Brain Injury

The CDC has released a set of 19 recommendations for the assessment and treatment of children with mild traumatic brain injury (mTBI).

The guideline specifically uses the term mild traumatic brain injury, rather than “concussion” or “minor head injury” which, although often used interchangeably, “have different connotations for families, researchers, and health care professionals, allowing for misinterpretation.”

Although mTBI is a growing public health concern, no evidence=based clinical guidelines have previously been developed for the diagnosis and management of pediatric mTBI in the US, according to the researchers.

They conducted an initial literature review comprising data from January 1, 1990, to November 30, 2012, and an updated literature search from December 1, 2012, to July 31, 2015.

Among the guidelines:

• Clinicians should not routinely obtain computed tomography (CT) for diagnostic purposes in children with mTBI (moderate, level B).
• Single-photon emission CT should not be used in the acute evaluation of suspected or diagnosed mTBI (moderate, level B).
• Skull radiographs should not be used in the diagnosis of pediatric mTBI (high, level B).
• Health care professionals should screen for known risk factors for persistent symptoms in children with mTBI (moderate, level B).

“The science of managing mTBI in children is rapidly evolving and expanding. This guideline identifies the best practices based on the current evidence for health care professionals in primary care, outpatient specialty, inpatient, and emergency care settings; updates may be made as the body of evidence grows,” they concluded.

—Michael Potts

Reference:

Lumba-Brown A, Yeates KO, Sarmiento K, et al.

Centers for disease control and prevention guideline on the diagnosis and management of mild traumatic brain injury among children [published online September 4, 2018]. JAMA Pediatr. doi:10.1001/jamapediatrics.2018.2853