Children who have suffered a concussion regularly visit emergency rooms (EDs). The changes in concussion signs, symptoms, and epidemiology dependent on patient age are little understood. The authors wanted to see a link between age and acute concussion symptoms. In Australia and New Zealand, the authors conducted a multicenter prospective observational analysis of head injuries in ten emergency departments. They looked for children aged 5 to <18 who had a Glasgow Coma Scale score of 13–15, presenting <24 hours after an event, had no abnormalities on CT if one was done, and had one or more concussion symptoms. They gathered data on demographics, injuries, symptoms, then stratified it by age group.
About 4709 patients out of 8857 children aged 5 to <18 years satisfied the concussion criteria (5–8 years, n = 1546; 9–12 years, n = 1617; 13 to < 18 years, n = 1546). The cohort’s average age was 10.9 years, and nearly 70% of the patients were men. Sport-related concussions accounted for 43.7% of all concussions, rising from 19.1% to 48.9% to 63.0% in 5–8, 9–12, and 13–18 years. Headache (64.6%), dizziness (36.2%), amnesia (30.0%), and vomiting were the most prevalent acute symptoms following an injury (27.2%). Vomiting decreased with age, with 41.7% in the 5–8 years group, 24.7 % in the 9–12 years group, and 15.4% in the 13–18 years group, whereas reported loss of consciousness (LOC) increased with age, with 9.6% in the 5–8 years group, 21.0% in the 9–12 years group, 36.7% in the 13–18 years group, and 22.4% in the entire study cohort experiencing it. The latter path led to headaches, amnesia, and disorientation. Male and female symptom profiles were remarkably similar.
With increasing age, concussions presenting to EDs become more sports-related. The signs and symptoms changed dramatically with advancing age, with vomiting reducing and headache, LOC, amnesia, and disorientation rising.
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