Is MRI really necessary in children who have sustained concussions? Perhaps not, according to a review of more than five years' worth of records in a study published online July 19 in the Journal of Neurotrauma.
Lead author Dr. Robert Bonow and a team of researchers from the University of Washington and Seattle Children's Hospital found that structural brain injury is not common in sports concussion in children, although nearly 13% of the children in the study underwent an MRI scan.
Postconcussive effects, such as headaches, irritability, and cognitive difficulties, can linger in 25% to 30% of children for a month or more. But among a group of 427 kids with concussion who had MRI scans, only two (0.5%) had findings on the scans that were compatible with traumatic injury, both consisting of microhemorrhages.
The researchers found that 61 patients (14.3%) had abnormal findings on the MRI scans that were unrelated to trauma. But such abnormalities are usually benign.
John Povlishock, PhD, editor in chief of the Journal of Neurotrauma, said in a statement that the paper provides "important guidance for those clinicians caring for children with persistent symptoms of concussion."
The retrospective analyses also "strongly support the validity of the study's finding that only a small fraction of these children present with routine MRI-detectable intracranial lesions," he added. MRI should be "thoughtfully considered" in children who present with symptoms, the authors concluded.
