Concussive head injury in children and adolescents related to sports and other leisure physical activities

OBJECTIVE: To compare the characteristics of children and adolescents with concussive head injury (CHI) sustained during organised sports or other leisure physical activity. METHODS: This was a case series study reviewing the medical records retrospectively over a four year period of children 6-16 years presenting to the emergency department with a CHI after participating in sport and/or recreation activity. RESULTS: There were 592 cases of sport and recreation related concussion over the study period (2000-2003). Most of the patients (n = 424, 71.6%) were male, with half (n = 304, 51.4%) being older than 10 years of age. A total of 152 (25.7%) cases of CHI were related to playing sports. Most cases (71.2%) were mild concussion. The cause of injury was a fall (n = 322, 54.4%) or a collision. Nearly a quarter of the children (n = 143, 24.2%) were admitted to hospital, with imaging performed in 134 (22.7%). Most children were treated appropriately and no adverse events were reported. CONCLUSIONS: A severe CHI in a child is six times more likely to have resulted from organised sport than from other leisure physical activities. Outcomes for CHI in children is excellent, although their management places a considerable burden on emergency services. The need for activity restriction and the benefits of this in reducing long term cognitive effects of CHI are uncertain.