Angela Lumba-Brown, MD; Keith Owen Yeates, PhD; Kelly Sarmiento, MPH; Matthew J. Breiding, PhD;
TamaraM. Haegerich, PhD; Gerard A. Gioia, PhD; Michael Turner, MD; Edward C. Benzel, MD;
Stacy J. Suskauer, MD; Christopher C. Giza, MD; Madeline Joseph, MD; Catherine Broomand, PhD;
BarbaraWeissman, MD;Wayne Gordon, PhD; DavidW.Wright, MD; Rosemarie Scolaro Moser, PhD;
Karen McAvoy, PhD; Linda Ewing-Cobbs, PhD; Ann-Christine Duhaime, MD; Margot Putukian, MD;
Barbara Holshouser, PhD; David Paulk, EdD; Shari L.Wade, PhD; Stanley A. Herring, MD; Mark Halstead, MD;
Heather T. Keenan, MD, PhD; Meeryo Choe, MD; CindyW. Christian, MD; Kevin Guskiewicz, PhD, ATC;
P. B. Raksin, MD; Andrew Gregory, MD; Anne Mucha, PT, DPT; H. Gerry Taylor, PhD; JamesM. Callahan, MD;
John DeWitt, PT, DPT, ATC; MichaelW. Collins, PhD; MichaelW. Kirkwood, PhD; John Ragheb, MD;
Richard G. Ellenbogen, MD; Theodore J. Spinks, MD; Theodore G. Ganiats, MD; Linda J. Sabelhaus, MLS;
Katrina Altenhofen, MPH; Rosanne Hoffman, MPH; TomGetchius, BA; Gary Gronseth, MD; Zoe Donnell, MA;
Robert E. O’Connor,MD, MPH; Shelly D. Timmons, MD, PhD
IMPORTANCE Mild traumatic brain injury (mTBI), or concussion, in children is a rapidly
growing public health concern because epidemiologic data indicate a marked increase in
the number of emergency department visits for mTBI over the past decade. However, no
evidence-based clinical guidelines have been developed to date for diagnosing and managing
pediatric mTBI in the United States.
OBJECTIVE To provide a guideline based on a previous systematic review of the literature to
obtain and assess evidence toward developing clinical recommendations for health care
professionals related to the diagnosis, prognosis, and management/treatment of pediatric
mTBI.
EVIDENCE REVIEW The Centers for Disease Control and Prevention (CDC) National Center for
Injury Prevention and Control Board of Scientific Counselors, a federal advisory committee,
established the Pediatric Mild Traumatic Brain Injury GuidelineWorkgroup. The workgroup
drafted recommendations based on the evidence that was obtained and assessed within the
systematic review, as well as related evidence, scientific principles, and expert inference. This
information includes selected studies published since the evidence review was conducted
that were deemed by the workgroup to be relevant to the recommendations. The dates of
the initial literature search were January 1, 1990, to November 30, 2012, and the dates of the
updated literature search were December 1, 2012, to July 31, 2015.