What are likely postconcussive symptoms and how long do they last?

After a concussion, youngsters have primarily physical symptoms, such as headache and dizziness, but symptoms with a substantial emotional component, such as sleep disturbance, frustration, and forgetfulness, often develop during the course of recovery.

These were the primary findings in a study of 235 11- to 22-year-olds who visited the emergency department of a children’s hospital with an acute concussion. Participants completed the Rivermead Post-Concussion Symptoms Questionnaire after the initial injury and again periodically for up to 3 months postconcussion until all symptoms resolved.

At presentation, headache, fatigue, dizziness, and taking longer to think were the most common symptoms, with sleep disturbance, frustration, forgetfulness, and fatigue most likely to develop after the injury. Irritability, sleep disturbance, frustration, and poor concentration persisted the longest (median, 14 to 16 days). Nausea, depression, dizziness, and double vision abated most quickly. One month after sustaining a concussion, 25% of children still complained of headache and 20% of fatigue. Only 8% of patients had returned to full athletic activity at 1 week postconcussion, with most reporting no athletic activity except for walking (Eisenberg MA, et al. Pediatrics. 2014;133[6]:999-1006).

Centers for Disease Control and Prevention. Heads Up: Brain Injury in Your Practice. Available at: www.cdc.gov/concussion/HeadsUp/physicians_tool_kit.html.

MS FREEDMAN is a freelance medical editor and writer in New Jersey. DR BURKE, section editor for Journal Club, is chairman of the Department of Pediatrics at Saint Agnes Hospital, Baltimore, Maryland.The editors have nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.