Severe Concussion Symptoms Offered Few Clues about Recovery

Severe concussion symptoms in children may be sign of increased risk for post concussive syndrome

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) A concussion can be unsettling, especially if the symptoms are severe. But severe symptoms do not necessarily mean a longer recovery.

A recent study found that the severity of a child's concussion symptoms did not necessarily explain how long it would take for them to go away.

However, severe symptoms might signal an increased risk of post-concussive syndrome, which involves persistent symptoms such as dizziness or headaches.

The researchers concluded that any child or teen who sustains a concussion should have a follow-up appointment to see how their recovery is going.

"Make your child rest to recover from a concussion."

This study, led by Joseph Grubenhoff, MD, of the Department of Pediatrics at the University of Colorado in Aurora, Colorado, aimed to find out whether the severity of concussion symptoms increased the likelihood that those symptoms would last longer.

The researchers began tracking 234 children and teens, aged 8 to 18, who were seen in the ER for concussion symptoms.

The severity of the children's symptoms were rated used a standardized tool. Then, a month later, the children's symptoms were assessed again to see if they had "delayed symptoms resolution," which means it is taking a longer time for the symptoms to go away.

The researchers were only able to follow-up with 179 of the children and teens, or 76 percent of the original participants.

Of these participants, one in five (21 percent, or 38 children and teens) still had some concussion symptoms.

However, there was no connection between those who still had symptoms and how severe the children's symptoms initially were at the time of the concussion.

Yet, somewhat paradoxically, there was a link between the severity of symptoms and a specific type of continuing symptoms problem, called post-concussive syndrome.

Post-concussive syndrome is a complex disorder in which a person continues to experience concussion symptoms, such as dizziness or headaches, several weeks after the original concussion.

Of the whole sample who were included in the follow-up, 22 participants (12 percent) had post-concussive syndrome.

The researchers found that children and teens with the most severe original symptoms — scoring over a 10 on a scale of 0 to 28 — were about three times more likely to have post-concussive syndrome.

Therefore, the findings showed that more severe concussion symptoms did predict a greater risk of developing post-concussive syndrome but did not otherwise predict how long standard symptoms would last as they gradually lessened.

The researchers noted that cognitive symptoms, such as confusion, memory problems and other issues with thinking clearly, may need closer attention than other symptoms.

"Follow-up is recommended for all patients after emergency department evaluation of concussion to monitor for delayed symptoms resolution," the researchers wrote.

The study was published June 23 in the journal Pediatrics. The research was funded by a Thrasher Research Fund Early Career Award and by the National Institutes of Health. The authors reported no conflicts of interest.

Review Date: 
June 23, 2014
Last Updated:
June 23, 2014