Pediatric assessment and management of concussions.

Concussions and mild traumatic brain injuries have become more widely recognized and understood during the past 5 to 10 years. Earlier and more active evaluation and management of this brain injury is necessary to reduce risk to the developing child and adolescent. Pediatricians play a central role in the evaluation and management of concussions and should develop a working understanding of the injury and its clinical manifestations. An individualized approach to evaluation and management by the pediatrician requires the development of a skillset to define the characteristics of the injury, conduct a full assessment of post-concussion symptoms, and define any risk history that may modify recovery. This evaluation forms the basis of concussion treatment, which involves the active management of the child’s daily routines at home, school learning and performance, and sports/recreational activities. The Acute Concussion Evaluation (ACE) and ACE Care Plan, published in the CDC’s “Heads Up: Concussion in Your Practice,” are presented as a set of tools that can assist the pediatrician in this endeavor.