Background Paediatric concussions are an important reason for children to seek care from their physician or in the Emergency Department (ED). Although studies are suggesting that paediatric concussions are increasing for sports-related diagnoses, there is a paucity of population-based information for all causes and including both office and emergency department visits. The objective of this study was to provide population-based estimates of paediatric concussions by age, sex, and external cause of injury.

Methods The National Ambulatory Care Reporting System (NACRS) was used to report on children in Ontario, Canada who attended an ED with a discharge diagnosis of concussion (S06) from 2003 to 2006. Children whose physician billed an office visit for a concussion based on the Ontario Health Insurance Program were also included.

Results There were over 80 000 children treated for concussions in Ontario over the seven study years. Fifty-two per cent were treated in physician's offices. Boys incurred 66% of all concussions, and the incidence was highest among 14-year-olds to 16-year-olds. The incidence of concussion is increasing, with an increase of 45% in physicians' offices, and an increase of 26% in EDs. Within the ED, 34% of all concussions were due to falls, and 18% were due to hockey or skating.

Conclusion Concussions are an important cause of morbidity within the paediatric population in Ontario, and the incidence is increasing. It is important to capture both physician visits and ED visits when calculating incidence. Evidence-based strategies can be used to reduce the burden, with particular emphasis on falls and sports-related concussions.