Pediatric and Adolescent Concussion: Diagnosis, Management, and Outcomes

229 Pages·2012·1.89 MB·English

by  Mark E. Halstead (auth.)

Pediatric and Adolescent Concussion

Jennifer Niskala Apps Kevin D. Walter
●
Editors
Pediatric and Adolescent
Concussion
Diagnosis, Management and Outcomes
Editors
Jennifer Niskala Apps Kevin D. Walter
Department of Psychiatry Departments of Orthopaedics
and Behavioral Medicine and Pediatrics
Medical College of Wisconsin Medical College of Wisconsin
Children’s Hospital of Wisconsin Children’s Hospital of Wisconsin
Milwaukee, WI, USA Milwaukee, WI, USA
[email protected] [email protected]
ISBN 978-0-387-89544-4 e-ISBN 978-0-387-89545-1
DOI 10.1007/978-0-387-89545-1
Springer New York Dordrecht Heidelberg London
Library of Congress Control Number: 2011941868
© Springer Science+Business Media, LLC 2012
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Preface
As health care providers for children, we are dedicated to giving kids of all ages the
best care possible. During training, we each developed a strong interest in concus-
sion-related concerns which peaked while treating the increasing number of chil-
dren presenting in our individual practices. Upon collaborating to develop a formal
clinic to attempt to best treat these children, the focus on concussion diagnosis and
treatment became a passion. As with many aspects of pediatric care, not enough
focused information is available to help the child and adolescent practitioner best
serve this population. Through interaction with a number of other professionals,
from teachers and athletic trainers to parents to pediatricians, we felt limited in our
ability to provide resources and education. Thus, the idea for this book was born.
It is diffi cult to be both comprehensive and all-inclusive in a rapidly expanding
fi eld. This is refl ected even in the title of our book, which focuses on “concussion.”
Use of this term is debated, with some of the authors in this book (see Chap. 2 for
example) pointing out that mild traumatic brain injury (mTBI) could be considered
a more appropriate term. However, we have chosen to include a wide number of
opinions in this book, focusing on the use of more common terms to allow for a
wide readership base. We would like this book to be useful for caregivers with sig-
nifi cantly different backgrounds. As a result, the reader will likely note a variation
in opinions and perspectives, but we felt it was important for all to be represented.
As editors, we purposely chose our contributing authors in an attempt to provide the
most up-to-date and expansive views across the myriad of professional fi elds. We
have allowed these authors to use their own voices to communicate important
aspects of this topic. We hope that in doing so, we have represented the complexity
of this rapidly developing and expanding fi eld, while also giving the reader a strong
foundation in fact and knowledge about the assessment, diagnosis, management,
recovery, and prevention of these injuries.
Each chapter is intended to stand alone and work in coordination with the book
as a whole. As a reader, you may wish to read the work from beginning to end, in
which case we hope you will fi nd the experience vastly educational. However, by
contrast and particularly depending on your own level of expertise with this injury,
v
vi Preface
you may fi nd it just as useful to read chapters individually. For enjoyment, you
could start your journey with the case story presented at the end of Chapter 12.
Most of all, we intend to help bring a voice to this massively important injury in
childhood and adolescence. Too many children are suffering needlessly during their
recovery process because too many adults who care for them are not adequately
educated about concussion and how to recognize and treat it. We hope that this work
will improve the knowledge base available for all those who care for kids.
Milwaukee, WI, USA Jennifer Niskala Apps
Milwaukee, WI, USA Kevin D. Walter
Acknowledgements
Our deepest thanks to Robert Newby, PhD, ABPP. The quality of this work improved
exponentially by your involvement. For all your guidance, mentorship and honesty,
we are truly thankful.
I dedicate this work to my family – my husband for all of his never-ending sup-
port and belief in me, not to mention his ability to pique my competitive, sports-
driven nature; and my children. Being a parent, I have learned the true value and
motivation of life.
Jennifer Niskala Apps PhD
We would like to thank all of our authors for their hard work. It is a pleasure to be
involved in a project with people we hold in such high regard.
I dedicate this work to my wife Katie, without her support and love I could not
accomplish my goals. I also dedicate this to Abby, Claire and Ryan, you are all of
my future hopes and dreams.
Kevin D. Walter, MD
vii

Contents
Part I Defi nitions and Causes of Concussion
1 Historical Perspectives on Concussion .................................................. 3
Mark E. Halstead
2 Defi nition and Classifi cation of Concussion ......................................... 9
Doug Bodin, Keith Owen Yeates, and Karl Klamar
3 Sports-Related Concussion .................................................................... 21
Amy E. Valasek and Teri Metcalf McCambridge
4 Biomechanics and Pathophysiology of Concussion.............................. 29
Michael McCrea and Mathew R. Powell
Part II Assessment and Treatment of Concussion
5 Immediate “On-the-Field” Assessment of Concussion ........................ 57
Susannah M. Briskin and Amanda K. Weiss Kelly
6 Acute Treatment of Concussion ............................................................. 73
Danny G. Thomas
7 Utilization of Imaging Technology in Concussion Assessment ........... 81
Katherine S. Dahab and David T. Bernhardt
8 Long-Term Assessment of Concussion .................................................. 93
Jonathan E. Romain
9 Long-Term Treatment of Concussion ................................................... 107
Monique S. Burton
10 Methods of Formal Neurocognitive Assessment of Concussion ......... 117
Nathan E. Kegel and Mark R. Lovell
ix