{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:11:13Z","timestamp":1792725073445,"version":"4.5.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>The aim of the study was to comprehensively describe the natural history of concussion in early childhood between 0 and 4 years.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Retrospective cohort study of 329 patients aged 0 to 4 years, with an <jats:italic toggle=\"yes\">International Classification of Diseases<\/jats:italic>, <jats:italic toggle=\"yes\">Ninth Revision<\/jats:italic>, concussion diagnosis in the Children's Hospital of Philadelphia healthcare network from October 1, 2013, to September 30, 2015. Clinical data were abstracted from the Children's Hospital of Philadelphia electronic health record, which captured all clinical care visits and injury characteristics.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Nearly 9 (86.6%) of 10 patients sought care in the emergency department or urgent care setting, most commonly on the day of injury (56.2%) and as a result of a fall (64.4%). More than two-thirds (64.4%) of patients or their parent\/caregiver reported somatic symptoms (ie, vomiting or headache), whereas close to half (49.2%) reported sleep issues. One of 5 patients identified emotional symptoms (21.9%) or visio-vestibular dysfunction (20.4%). Many patients also experienced symptoms not included in standard assessment tools including personality changes (34.0%) and change in appetite (12.8%).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>These results provide insight into the clinical characteristics of concussion in early childhood up to 4 years of age. Because assessment in this group relies heavily on parent\/caregiver symptom reporting, rather than patient self-report, these results will aid clinicians with the challenge of diagnosing concussions in this population. These findings highlight the need to develop additional tools to adequately and systematically assess common signs and symptoms of concussion in early childhood that may not be included in standard assessment scales routinely used in older adolescents and adults.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002148","type":"journal-article","created":{"date-parts":[[2020,6,16]],"date-time":"2020-06-16T13:56:58Z","timestamp":1592315818000},"page":"e1652-e1657","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":25,"title":["Characteristics of Diagnosed Concussions in Children Aged 0 to 4 Years Presenting to a Large Pediatric Healthcare Network"],"prefix":"10.1097","volume":"37","author":[{"given":"Olivia E.","family":"Podolak","sequence":"first","affiliation":[{"name":"Center for Injury Research and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Chaudhary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliet","family":"Haarbauer-Krupa","sequence":"additional","affiliation":[{"name":"National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina B.","family":"Metzger","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison E.","family":"Curry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronni S.","family":"Kessler","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa R.","family":"Pfeiffer","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Breiding","sequence":"additional","affiliation":[{"name":"National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina L.","family":"Master","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristy B.","family":"Arbogast","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,6,17]]},"reference":[{"key":"bib2-20250504","first-page":"1","article-title":"Traumatic brain injury-related emergency department visits, hospitalizations, and deaths - United States, 2007 and 2013","volume":"66","year":"2017","journal-title":"MMWR Surveill Summ"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1053\/spen.2002.35502","article-title":"Linguistic outcomes following traumatic brain injury in children","volume":"9","year":"2002","journal-title":"Semin Pediatr Neurol"},{"issue":"2\u20133","key":"bib4-20250504","first-page":"669","article-title":"Early brain injury in children: development and reorganization of cognitive function","volume":"24","year":"2003","journal-title":"Dev Neuropsychol"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1159\/000028956","article-title":"Recovery of intellectual ability following traumatic brain injury in childhood: impact of injury severity and age at injury","volume":"32","year":"2000","journal-title":"Pediatr Neurosurg"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1542\/peds.2004-1728","article-title":"Functional plasticity or vulnerability after early brain injury?","volume":"116","year":"2005","journal-title":"Pediatrics"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1093\/jpepsy\/jsp100","article-title":"Does early age at brain insult predict worse outcome? 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