Sports Related Concussion in Paediatric Age: The Importance of Gradual Return to School and Sport Strategy

Background: Sports Related Concussion (SRC) is a traumatic brain injury that has been defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces with several common features that help define its nature. The diagnosis of concussion remains a clinical diagnosis despite the availability of auxiliary tests.

A 7 year’s old child, five hours later a history of head trauma when was playing football, started to experience in his football training dizziness, headache, nausea and vomiting and was referred for urgent assessment. A physical examination was performed and a CT was requested.

Serious intracranial injury was excluded by neuroimaging, the diagnosis of concussion has been established and the child was discharged, with surveillance of the alarm signals.

A brief period of physical and cognitive rest was advised followed by a gradual program, which included 10 steps with 3 medical evaluations. A return to play was achieved with no complications.

Objective: Encourage paediatric care providers to follow-up after an SRC to monitor recovery and help with return to school. Ensure the importance of spreading the SRC prevention and management for teachers, staff, students and parents.

Methods: The literature on paediatric concussion was reviewed. A case report of a 7 years old child was detailed. A graduated return to school and sport was designed.

Conclusion; Although most concussions solve without complications, they may occur, especially when concussions are not recognized or are sustained multiple times, which include post concussion symptoms, second impact syndrome, and chronic traumatic encephalopathy. The applicability of implemented tools like Child SCAT5 baseline testing can be a key for better interpreting post-injury test scores. Continued efforts to train and educate practicing and future physicians about concussion diagnosis and management should be promoted to better serve patients.