Unusual presentation of more common disease/injury

Paediatric sports-related mild traumatic brain injury

Michelle Keightley^1,2,3,4,5, Catrin Theresa Duggan¹, Nick Reed^1,2, Jim McAuliffe⁶, Tim Taha⁷, Brent Faught⁸, Moira McPherson⁹, Joseph Baker¹⁰, William Montelpare⁹

¹ University of Toronto, Occupational Science and Occupational Therapy, Faculty of Medicine, 920, 160-500 University Avenue, Toronto, Ontario, M5G 1V7, Canada
² University of Toronto, Graduate Department of Rehabilitation Science, 160-500 University Avenue, Toronto, Ontario, M5G 1V7, Canada
³ University of Toronto, Psychology, 100 St George Street, Toronto, Ontario, M5S 3G3, Canada
⁴ Toronto Rehabilitation Institute, 550 University Avenue, Toronto, Ontario, M5G 2A2, Canada
⁵ Bloorview Kids Rehab, 150 Kilgour Road, Toronto, Ontario, M4G 1R8, Canada
⁶ Nipissing University, Physical and Health Education, 100 College Drive, North Bay, Ontario, P1B 8L7, Canada
⁷ University of Toronto, Faculty of Physical Education and Health, 55 Harbord Street, Toronto, Ontario, M5S 2W6, Canada
⁸ Brock University, Community and Health Sciences, 500 Glenridge Avenue, St Catherines, Ontario, L2S 3A1, Canada
⁹ Lakehead University, School of Kinesiology, 955 Oliver Road, Thunder Bay, Ontario, P7B 5E1, Canada
¹⁰ York University, School of Kinesiology and Health Science, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada

Correspondence to:
Michelle Keightley, michelle.keightley{at}utoronto.ca

Mild traumatic brain injury (mTBI) is a common but relatively understudied childhood injury that can impact cognitive functioning and development. The present report describes a case study of a 14-year-old boy who sustained two consecutive sports-related mTBIs within a 24 h period. Neurocognitive functioning at 2, 6, 8, 55 and 225 days after injury is compared to baseline prior to injury assessment on the same measures. Results from Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), Conner Continuous Performance Test 2 (CPT-II) and the Attention Network Test (ANT) revealed decreased performance in attention, visual memory functioning and impulsivity, with some measures still not returning to baseline at 225 days post injury. The results are discussed with respect to return to normal activities at 4 days post injury. This case study highlights the need for increased research regarding the clinical management of mTBI in the paediatric population, particularly the potential deleterious effects of cumulative injuries.

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