Haider et al reported a score for predicting delayed recovery following concussion in pediatric athletes. The authors are from the University of Buffalo.
Patient selection: pediatric patient from 8 to 18 years old without loss of consciousness >= 30 minutes, post-traumatic amnesia >= 24 hours, and GCS <=12
Exclusion: new concussion in period
Criteria for delayed recovery: >= 30 days
Parameters:
(1) number of days since injury, <= 14 days
(2) high velocity and/or multiple impact
(3) number of previous concussions
(4) orthostatic intolerance
(5) tandem gait
(6) vestibulo-ocular reflex
|
Parameter
|
Finding
|
Points
|
|
number of days since injury
|
|
|
|
high velocity and/or multiple
|
no
|
0
|
|
|
yes
|
2
|
|
number of previous concussions
|
0 to 2
|
0
|
|
|
3 or more
|
4
|
|
orthostatic hypotension
|
no
|
0
|
|
|
yes
|
5
|
|
tandem gait
|
normal
|
0
|
|
|
abnormal
|
1
|
|
vestibulo-ocular reflex
|
normal
|
0
|
|
|
abnormal
|
5
|
(7) combination of orthostatic intolerance and vestibulo-ocular reflex
(8) combination of high velocity/multiple and tandem gait
|
Parameter
|
Finding
|
Points
|
|
orthostatic intolerance and vestibular-ocular reflex
|
both abnormal
|
-4
|
|
|
other
|
0
|
|
high velocity/multiple and tandem gait
|
both abnormal
|
5
|
|
|
other
|
0
|
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 32
|
Total Score
|
Risk Delayed Recovery
|
Rate
|
|
0 to 10
|
low
|
< 30%
|
|
11 to 14
|
medium
|
30 to 70%
|
|
>= 15
|
high
|
> 70%
|
