Graded Symptom Checklist IDs Pediatric Concussion

Checklist performs better than Standardized Assessment of Concussion score
By Lindsey Marcellin
HealthDay Reporter

WEDNESDAY, Sept. 8 (HealthDay News) -- A graded symptom checklist reliably identifies concussions (mild traumatic brain injuries [mTBIs]) in school-age children, and posttraumatic amnesia predicts greater symptom severity, according to a study published online Sept. 6 in Pediatrics.

Joseph A. Grubenhoff, M.D., of the University of Colorado School of Medicine in Denver, and colleagues conducted an observational study of children 6 to 18 years of age who presented to an emergency department with blunt head injury (case-patients) or minor extremity injury (controls). The primary measured outcome was comparison of Standardized Assessment of Concussion (SAC) scores and symptom severity in head-injured case-patients versus non-head-injured controls; secondary outcomes included comparison of SAC and graded-symptom-checklist scores to traditional indicators of mTBI severity, such as loss of consciousness, posttraumatic amnesia, and concussion grades, among case-patients.

The researchers found that SAC scores showed a nonsignificant trend toward lower scores among case-patients than controls, but did not correlate with other indicators of mTBI. Scores derived from a graded symptom checklist were significantly higher among case-patients, with altered mental status magnifying this effect. Graded-symptom-checklist scores positively correlated with posttraumatic amnesia and American Academy of Neurology concussion grade. The researchers concluded that the graded symptom checklist reliably identified mTBI symptoms in children aged 6 years and older.

"Future efforts should focus on creating a rapid, easily administered tool for detecting the cognitive effects of mTBI in children that accounts for developmental differences and provides an assessment of the likelihood for developing postconcussive syndrome," the authors write.

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