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It is estimated that more than 630 000 children and adolescents present to emergency departments (EDs) each year in the United States after sustaining a traumatic brain injury (TBI), with the vast majority of these categorized as mild TBI, also commonly referred to as concussion.1,2 This is likely a significant underestimation of the true burden of mild TBI because many patients may seek care in nonemergency settings (such as physician offices) and are not routinely captured in systematic databases, whereas other patients with mild TBI may be evaluated on the sidelines of athletic events by nonphysicians or never seek care. In a consensus statement of the International Conference on Concussion in Sport,3 mild TBI or concussion was defined as “a complex pathophysiological process affecting the brain, induced by biomechanical forces caused either by a direct blow to the head, face, neck or elsewhere on the body with an ‘impulsive’ force transmitted to the head” resulting in a “rapid onset of short-lived impairment of neurological function” that largely reflects a “functional disturbance rather than a structural injury and, as such, no abnormality is seen on standard structural neuroimaging studies.”
Babcock L, Kurowski BG. Identifying Children and Adolescents at Risk for Persistent Postconcussion Symptoms. JAMA. 2016;315(10):987-988. doi:10.1001/jama.2016.1276