Up to one third of children with concussions still have symptoms a year later
Conventional wisdom suggests that the symptoms from a concussion should disappear within a week or two. However, a new study suggests that up to one-third of children who have experienced a concussion still experience some symptoms up to a year later. Additionally, the symptoms (such as headache, fatigue, and irritability) may be significant enough to affect school performance.
“Children with all types of injuries may show post-concussion symptoms,” said lead researcher Linda Ewing-Cobbs, a professor of pediatrics at the University of Texas Health Science Center Medical School in Houston.
According to the report published in the latest issue of the journal Pediatrics, children from poor or troubled household and girls with mood disorders were the most vulnerable to these long-lasting symptoms.
“This study is valuable because it demonstrates that our approach to post-concussive management should take into consideration prior psychological issues, gender, familial harmony, as well as income disparity,” Dr. Robert Glatter told WebMD.
Glatter is an emergency physician at Lenox Hill Hospital in New York City, and who was not involved in the study.
Based on the findings, Ewing-Cobbs says that while physical symptoms are likely to appear in the time soon after a brain injury, emotional and mental symptoms appear to be delayed. These types of symptoms may not be noticeable until weeks after a brain injury, once a child has returned to school and sports.
She notes that symptoms fade away within a month in the majority of cases, but a considerable number of children experience lasting symptoms that could affect their performance in school.
“Children with symptoms that persist beyond a month should be monitored by their pediatrician so that they can be referred for any needed physical or psychological health services,” Ewing-Cobbs added.
In the study, the team evaluated nearly 350 children between the ages of 4 and 15 and who had experienced a concussion or orthopedic injury. The children’s parents also completed surveys assessing their child’s health before the injury and collecting general information about their home lives.
With this information, the researchers then rated each child’s post-concussion recovery.
While the girls and boys in the study showed similar pre-concussion characteristics, the team found that girls were much more than twice as likely to have symptoms a year later.
Gender wasn’t the only factor that predicted long-lasting symptoms though. A child’s home environment also played a strong role in a child’s recovery.
“Children from families that are supportive, communicative, and have access to a community network of supports tend to do better in a variety of areas, including recovering from a concussion, than children who do not have these assets,” Ewing-Cobbs said.
Because of this wide variance in the length of symptoms, Ewing-Cobbs believes medical professionals need to better tailor treatment and recovery plans for each child.
There is no one-size-fits-all answer to the question of return-to-play in high-impact sports,” she said.
She also recommends involving both school personnel and family in the recovery of the child.