Not all concussions are created equal

Children with histories of multiple or recent concussions are more likely to have prolonged symptoms than those without any history of traumatic brain injury. In fact, the former may have symptoms lasting twice as long as those who have never received a blow to the head.

Researchers from Boston Children’s Hospital and Harvard Medical School recently conducted a prospective cohort study involving 280 adolescents and young adults aged from 11 to 22 years presenting to the emergency department (ED) with an acute concussion.

The researchers found that those patients with a history of concussion had symptoms that lasted, on average, 24 days versus 12 days in those with no history. Those with a history of multiple concussions had symptoms that lasted for a median of 28 days, and those who had sustained a concussion within the past year had symptoms that persisted for a median of 35 days.

In addition to previous multiple and recent concussions, investigators found that other predictors of prolonged recovery include absence of loss of consciousness, being aged 13 years or older, and initial Rivermead Post-Concussion Symptoms Questionnaire (RPSQ) score greater than 18.

When determining follow-up care and treatment, particularly in those who are at high risk for repeat injuries, the aforementioned predictors should be considered.

According to the Centers for Disease Control and Prevention, each year EDs in the United States treat more than 173,000 sports- and recreation-related traumatic brain injuries, including concussions, among children and adolescents aged younger than 19 years. This does not include all those who are treated by athletic trainers, primary care physicians, and other outpatient health care practitioners.