What elements of the history are most helpful for diagnosing a concussion?
An estimated 1.1 million to 1.9 million pediatric concussions occur annually in the US.
Additional Information
Does my child have a concussion?
OBJECTIVE: To determine the accuracy of clinical history for identifying concussion in children and adolescents.
While most children recover within 4 weeks, approximately 30% experience persistent symptoms beyond 28 days.
Early evaluation and timely management are associated with improved recovery—athletes who immediately reported their injury experienced almost five and half fewer days of symptoms compared to those who delayed reporting.
Key Diagnostic Findings
The review identified the most diagnostically useful symptoms (by likelihood ratio):
Finding
Likelihood Ratio (LR+)
Specificity
Mental fog
11.8–12.0
0.96
Noise sensitivity
6.9
0.94
Nausea
6.7
0.93
Light sensitivity
6.4
0.93
Headache
3.1
0.74
The ABSENCE of headache was the only finding that substantially reduced the likelihood of concussion (LR, 0.20; sensitivity, 0.86)
References
Shah SN, Chizuk HM, Fong H, Hannon M, Mannix RC. Does This Child Have a Concussion? The Rational Clinical Examination Systematic Review. JAMA.
