Most children who suffer from sports-related concussions recover within a few days. However, in a small number of children, symptoms can last for a month or more. Although there have been numerous theories as to what might predict a longer recovery time, there is no definitive answer as to why it takes some children longer to recover. In a new study scheduled for publication in The Journal of Pediatrics, researchers attempted to identify risk factors that might predispose some children with concussions to longer recovery times.
Dr. William P. Meehan, III and colleagues from Boston Children's Hospital and the University of Pittsburgh Medical Center analyzed data from 182 patients who were seen at a sports concussion clinic within 3 weeks of injury. Patients completed the Post-Concussion Symptom Scale (PCSS), which contains 22 different symptoms that they ranked from 0-6 (0 = not experiencing a given symptom; 6 = describing the symptom as "severe"). Patients were separated into 2 groups: those who were symptom-free within 28 days and those who had symptoms for longer than 28 days. After analyzing data for numerous variables, including total score of the PCSS at initial visit, age, and amnesia symptoms, only the total score on the PCSS was independently associated with symptoms lasting longer than 28 days; the higher the score, the greater chance of a prolonged recovery time.
Although it is important for patients who suffer from prolonged symptoms of concussion to receive medical management, along with academic and occupational accommodations, most patients recover without needing these. Identifying risk factors for potentially prolonged recoveries will allow clinicians to coordinate the best treatment for patients. According to Dr. Meehan, "Parents, physicians, and caregivers of athletes who suffer from a high-degree of symptoms after a sports-related concussion should start preparing for the possibility of a prolonged recovery." Although some studies have shown longer recovery times in younger patients and patients who suffered from amnesia, results from this study do not suggest that age or amnesia are risk factors for prolonged recovery time. Instead, efforts to develop clinical tools for predicting which athletes will suffer prolonged recoveries after concussion should focus on initial symptom score.
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"Symptom Severity Predicts Prolonged Recovery after Sport-Related Concussion, but Age and Amnesia Do Not," by William P. Meehan, III, MD, Rebekah C. Mannix, MD, Andrea Stracciolini, MD, R.J. Elbin, PhD, and Michael W. Collins, PhD, appears in The Journal of Pediatrics, DOI 10.1016/j.jpeds.2013.03.012