Post-concussive symptoms not overly common in children

March 9, 2009

Although the majority of children with mild traumatic brain injury will not face any long-lasting adverse effects, there is a "substantial minority" -approximately 25%- who will experience a significant sharp rise in post-concussive symptoms, according to new research.

Although the majority of children with mild traumatic brain injury will not face any long-lasting adverse effects, there is a "substantial minority" -approximately 25%- who will experience a significant sharp rise in post-concussive symptoms. In some instances, the symptoms will continue for months. This is according to research, led by Keith Yeates, PhD, in the March issue of Pediatrics.

The symptoms, which may include dizziness, vomiting, amnesia, and headache, appear to occur more frequently in children who had mild concussions, as opposed to a reference group of children who had orthopedic injuries.

In a statement, Yeates reported that the study "provides reassurance" for parents of children who experience concussions for the first time, because it is evident that more than likely they will recover rather quickly. However, he cautions that the study, which was supported by NIH, also indicated that children with more severe concussions may need to be watched closely for longer periods, as their symptoms may persist.

This prospective study of 186 consecutive patients (ages 8 to 15) at the Nationwide Children's Hospital emergency department treated for blunt head trauma or orthopedic injuries was designed to determine the causes of postconcussive symptoms following mild traumatic brain injury.

Blunt head trauma was defined by

Recreational sports and activities were responsible for 57% of concussions and 62% of orthopedic injuries. Falls caused another 20% of concussions and 21% of orthopedic injuries.

Parents evaluated children within three weeks following injury, based on the Postconcussive Symptom Interview. The interview enables parents to indicate whether 15 symptoms were present or not during the previous week. Similar follow-ups were conducted at three-, six- and 12-month post-initial assessments.

Results showed 67% of those who experienced concussions had zero postconcussive symptoms, while 76% of children with orthopedic injuries had no symptoms. Approximately 15% of children with concussion had a significant number of symptoms shortly after injury; however, symptoms diminished by 100 days post-injury, compared with 5% of reference children. Another 9% of children with concussion had many symptoms immediately following injury that lasted for the study's duration, compared with 1% of the reference group.