title: Detailed concussion symptom analysis in a paediatric ED population.
abstract: OBJECTIVE
  To examine the frequency of acute mild traumatic brain injury (mTBI) symptoms in children using a concussion symptom inventory and to identify which symptoms are most useful in identifying mTBI. It was hypothesized that symptoms associated with mTBI are more common in children with head injury than orthopaedic injury and certain symptoms are more useful than others in identifying mTBI.
  
  
  METHODS
  Prospective case-control study conducted in a paediatric trauma centre emergency department.
  
  
  METHODS
  Children of 6-18 years old with head injury or a minor extremity injury were enrolled. Symptoms were assessed using a graded symptom checklist. Symptom frequency was compared using a chi-square test. The association between individual symptoms with AMS was evaluated with logistic regression analysis.
  
  
  RESULTS
  Children with head injury displayed more frequent symptoms than controls. Head-injured cases with altered mental status (AMS) demonstrated the most frequent and severe symptoms (median symptom scores: control = 1, cases without AMS = 5, cases with AMS = 10; p < 0.001). Headache, nausea, dizziness, blurred/double vision and not feeling 'sharp' were associated with AMS.
  
  
  CONCLUSIONS
  Symptoms associated with mTBI are more frequent in children with head injury. AMS magnifies this effect. A symptom inventory is integral to the evaluation of mTBI in children; a smaller set of dichotomized symptoms may be as useful as and more easily administered than lengthier symptom scales.
authors.affiliation: University of Colorado School of Medicine, Department of Pediatrics, Section of Emergency Medicine, Aurora, CO, USA. grubenhoff.joe@tchden.org
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Grubenhoff
authors.forename: Michael W
authors.initials: MW
authors.lastname: Kirkwood
authors.forename: Sara
authors.initials: S
authors.lastname: Deakyne
authors.forename: Joe
authors.initials: J
authors.lastname: Wathen
mesh_terms: D000293:Adolescent; D001924:Brain Concussion / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D006259:Craniocerebral Trauma / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D038223:Post-Concussion Syndrome / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D015995:Prevalence; D011446:Prospective Studies; D013997:Time Factors; D014193:Trauma Centers