Research Reports - Young age as a modifying factor in sports concussion management: what is the evidence?

Curr Sports Med Rep. 2014 Nov-Dec;13(6):390-4

Foley C(1), Gregory A, Solomon G

In 2008, the Concussion in Sport Group (CISG) published its third consensus
statement and introduced 10 'modifying' factors that were presumed clinically to
influence the investigation and management of concussions in sports. Young age
was listed as one of the modifying factors. In some cases, these modifiers were
thought to be predictive of prolonged or persistent symptoms. These same
modifying factors were retained in the fourth iteration of the CISG consensus
statement (2013), although mention was made of possible limitations of their
efficacy. The CISG statements provided several empirical references regarding
young age as a modifying factor. We reviewed the published sports concussion
literature with the purpose of determining empirical studies that support or
refute the inclusion of young age as a modifier of concussive injury in sports.
We performed a systematic review of the PubMed database utilizing the keywords
concussion, sports, mild traumatic brain injury, youth, adolescents, and
children. English language studies were extracted by the authors and summarized
for review. Multiple empirical studies were found indicating that younger
athletes may take longer to recover from a sports-related concussion (SRC) than
their older peers. However, studies did not indicate that younger athletes were
at more risk for prolonged recovery (>4 wk). Empirical evidence supports the
inclusion of young age as a modifying factor in sports concussion. However, the
difference in recovery time seems relatively small (a few days) and young age
does not predict prolonged recovery (>4 wk). The findings support the inclusion
of young age as a specific modifier in the treatment of SRC and have implications
for the clinical management of this common injury.

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