{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:37:26Z","timestamp":1777927046375,"version":"3.51.4"},"reference-count":39,"publisher":"SAGE Publications","issue":"20","license":[{"start":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T00:00:00Z","timestamp":1569196800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:p>Given the lack of evidence regarding effective pharmacological and non-pharmacological interventions for pediatric mild traumatic brain injury (mTBI) and the resultant lack of treatment recommendations reflected in consensus guidelines, variation in the management of pediatric mTBI is to be expected. We therefore surveyed practitioners across 15 centers in the United States and Canada who care for children with pediatric mTBI to evaluate common-practice variation in the management of pediatric mTBI. The survey, developed by a panel of pediatric mTBI experts, consisted of a 10-item survey instrument regarding providers' perception of common pediatric mTBI symptoms and mTBI interventions. Surveys were distributed electronically to a convenience sample of local experts at each center. Frequencies and percentages (with confidence intervals [CI]) were determined for survey responses. One hundred and seven respondents (71% response rate) included specialists in pediatric Emergency Medicine, Sports Medicine, Neurology, Neurosurgery, Neuropsychology, Neuropsychiatry, Physical and Occupational Therapy, Physiatry\/Rehabilitation, and General Pediatrics. Respondents rated headache as the most prevalently reported symptom after pediatric mTBI, followed by cognitive problems, dizziness, and irritability. Of the 65 (61%; [95% CI: 51,70]) respondents able to prescribe medications, non-steroidal anti-inflammatory medications (55%; [95% CI: 42,68]) and acetaminophen (59%; [95% CI: 46,71]) were most commonly recommended. One in five respondents reported prescribing amitriptyline for headache management after pediatric mTBI, whereas topiramate (8%; [95% CI: 3,17]) was less commonly reported. For cognitive problems, methylphenidate (11%; [95% CI: 4,21]) was used more commonly than amantadine (2%; [95% CI: 0,8]). The most common non-pharmacological interventions were rest (\u201calways\u201d or \u201coften\u201d recommended by 83% [95% CI: 63,92] of the 107 respondents), exercise (59%; [95%CI: 49,69]), vestibular therapy (42% [95%CI: 33,53]) and cervical spine exercises (29% [95%CI: 21,39]). Self-reported utilization for common pediatric mTBI interventions varied widely across our Canadian and United States consortium. Future effectiveness studies for pediatric mTBI are urgently needed to advance the evidence-based care.<\/jats:p>","DOI":"10.1089\/neu.2018.6290","type":"journal-article","created":{"date-parts":[[2019,4,26]],"date-time":"2019-04-26T05:58:27Z","timestamp":1556258307000},"page":"2886-2894","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Practice Patterns in Pharmacological and Non-Pharmacological Therapies for Children with Mild Traumatic Brain Injury: A Survey of 15 Canadian and United States Centers"],"prefix":"10.1177","volume":"36","author":[{"given":"Rebekah","family":"Mannix","sequence":"first","affiliation":[{"name":"Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Zemek","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith Owen","family":"Yeates","sequence":"additional","affiliation":[{"name":"Department of Psychology, Faculty of Kinesiology, Alberta Children's Hospital Research Institute, and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristy","family":"Arbogast","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Sports Medicine and Performance Center, Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shireen","family":"Atabaki","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Children's National Health System, Washington, District of Columbia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Badawy","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Texas Southwestern Medical School, Dallas, Texas."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam H.","family":"Beauchamp","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Montr\u00e9al and Ste-Justine Research Center, Montr\u00e9al, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darcy","family":"Beer","sequence":"additional","affiliation":[{"name":"Section of Pediatric Emergency Medicine, University of Manitoba, Children's Hospital of Winnipeg, Winnipeg, Manitoba, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Bin","sequence":"additional","affiliation":[{"name":"UCSF School of Medicine, Division of Pediatric Emergency Medicine, San Francisco, California."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett","family":"Burstein","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Department of Pediatrics, Montr\u00e9al Children's Hospital, McGill University Health Centre, Montr\u00e9al, Quebec, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Craig","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Alberta and Stollery Children's Hospital, Edmonton, Alberta, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Corwin","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Sports Medicine and Performance Center, Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quynh","family":"Doan","sequence":"additional","affiliation":[{"name":"Children's Research Institute, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Ellis","sequence":"additional","affiliation":[{"name":"Department of Surgery and Pediatrics, Section of Neurosurgery, University of Manitoba, Pan Am Concussion Program, Winnipeg, Manitoba, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen B.","family":"Freedman","sequence":"additional","affiliation":[{"name":"Stephen B. Freedman Sections of Pediatric Emergency Medicine and Gastroenterology, Department of Pediatrics, Alberta Children's Hospital, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabelle","family":"Gagnon","sequence":"additional","affiliation":[{"name":"School of Physical and Occupational Therapy, McGill University; Trauma Programs, Montr\u00e9al Children's Hospital, McGill University Health Center, Montr\u00e9al, Quebec, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jocelyn","family":"Gravel","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, University of Montr\u00e9al and Ste-Justine Research Center, Montr\u00e9al, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Leddy","sequence":"additional","affiliation":[{"name":"UBMD Department of Orthopaedics and Sports Medicine, State University of New York at Buffalo, Buffalo, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Lumba-Brown","sequence":"additional","affiliation":[{"name":"Departments of Emergency Medicine and Pediatrics, Concussion and Brain Performance Center, Stanford University, Stanford, California."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Master","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics, Sports Medicine and Performance Center, Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew R.","family":"Mayer","sequence":"additional","affiliation":[{"name":"The Mind Research Network\/LBERI and Departments of Psychology, Neurology, and Psychiatry, University of New Mexico, Albuquerque, New Mexico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of New Mexico Hospital, Albuquerque, New Mexico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Penque","sequence":"additional","affiliation":[{"name":"Pediatrics Division of Emergency Medicine, and Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara","family":"Rhine","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Russell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, University of Manitoba, Children's Hospital of Winnipeg, Winnipeg, Manitoba, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Schneider","sequence":"additional","affiliation":[{"name":"Sport Injury Prevention Research Centre, Faculty of Kinesiology, Alberta Children's Hospital Research Institute, and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Critical Care Medicine, Children's National Medical Center, Washington, District of Columbia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Wisniewski","sequence":"additional","affiliation":[{"name":"Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,9,23]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1227\/01.neu.0000429846.14579.41"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.1203"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.1327"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.2900"},{"key":"e_1_3_3_6_2","first-page":"139","article-title":"Utilization of mental health services after mild pediatric traumatic brain injury","author":"Jimenez N.","year":"2017","unstructured":"Jimenez N., , Quistberg A., , Vavilala M.S., , Jaffe K.M., , and Rivara F.P. 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