AANS Neurosurgeon | Volume 26, Number 3, 2017

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Neuroimaging Findings Generally Nondiagnostic in Adolescents with Sports-related Concussion

In a study recently published in the Journal of Neurosurgery: Pediatrics researchers from the Canada North Concussion Network in Manitoba examined neuroimaging studies obtained from children and adolescents with sports-related concussions and found that the images appeared normal in 78 percent of cases. The authors of the study examined medical records and neuroimaging findings in 151 children and adolescents who had sustained sports-related concussions (SRCs) during competitive sports activities such as hockey, soccer and baseball. The SRCs were all diagnosed and followed up by a single neurosurgeon specializing in concussion spectrum disorders at a multidisciplinary concussion program in Canada. Abnormal findings were found on CT scans in five patients (skull fracture in two patients and suspected intracranial hemorrhage, arachnoid cyst, and suspected hemorrhage into an arachnoid cyst in one patient each) and on MRIs in four patients (intraparenchymal hemorrhage and sylvian fissure arachnoid hemorrhage; nonhemorrhagic contusion; demyelinating disease; and posterior fossa arachnoid cyst, cerebellar volume loss, and nonspecific changes in white matter). The authors discussed the common use of CT scans and the risks that excessive exposure to radiation may pose for children and adolescents. The fact that CT scans yielded no signs of traumatic injury to structures of the brain in most cases of SRC led the authors to suggest that use of CT should be limited to the emergency room setting when evaluating acutely injured patients in whom clinical signs or symptoms suggest the possibility of skull fracture or intracranial hemorrhage. To read more about this study, click here.

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