If It's Not Your First Concussion…

Repeat concussions take longer to recover from than a first concussion

(RxWiki News) When girls and boys play hard, they sometimes get hurt. But a bump on the head is nothing to shrug off, especially if it's not the first concussion.

A recent study found that a child's second or third concussion takes longer to recover from than the first concussion. Children may take two to three times longer to stop having concussion symptoms.

This study emphasizes the importance of personalized treatment for each child with a concussion, said dailyRx News expert Daniel Clearfield, DO.

Dr. Clearfield said recovery from concussion should be individualized for each person.

"Head injury?  See a doctor."

The study, led by Matthew Eisenberg, MD, of the Division of Emergency Medicine at Boston Children's Hospital, looked at the factors that influence how long it takes youth to recover from concussions.

The researchers followed 280 patients, aged 11 to 22, for up to three months after they went to the emergency room for a concussion.

About 64 percent of the concussions occurred while the kids or teens were playing sports.

The participants and/or their parents filled out questionnaires about the way they got their concussions, their symptoms and their medical history.

The researchers also collected data on any examinations and tests they had done in the hospital.

They found that participants who had a previous concussion took twice as long to recover from their new concussion.

The typical time to recover for the participants in the study without past concussions was 12 days.

Recovery for those who had a past concussion typically took about 24 days.

Patients who had more than one previous concussion typically took 28 days to recover.

If the patient's concussion had been within the past year, they typically took 35 days to recover from this one, about three times longer than those who were being treated for their first concussion.

According to dailyRx expert Daniel Clearfield, DO, a sports medicine and concussion specialist and an assistant professor of orthopedic surgery at the University of North Texas Health Science Center, this study validates what clinicians already knew but needed to be shown in research.

"We know if someone has had an ankle sprain before, you're more likely to have an ankle sprain. If you have a concussion, you're more likely to have another concussion," Dr. Clearfield said.

"If the last concussion has been within a year, you're definitely more sensitive to having another concussion and definitely more likely to have a longer recovery," he said.

The researchers also found that being younger was linked to a shorter recovery period, and those who lost consciousness actually recovered a little faster than those who did not lose consciousness.

Youth aged 13 and older took a typical 15 days to recover, compared to 11 days of recovery for kids under 13.

Dr. Clearfield said this finding might have resulted from the possibility that older kids play harder and hit harder, so more serious injury might be more likely among older kids versus younger kids.

He also said that clinicians have learned in recent years that losing consciousness does not necessarily mean the concussion is worse than one where a person does not lose consciousness.

"One thing we know is that any kind of initial dizziness or unsteadiness that occurs can be a leading indicator that it might take them longer to recover, as opposed to other symptoms that might occur," Dr. Clearfield said.

He said the symptoms to look for in a youth to see if they might have a concussion, besides losing consciousness and that dizziness or unsteadiness, include having a headache, nausea, having a sort of "glassed over" look to their eyes and being more sensitive to light or sounds

Another symptom is amnesia, where a person forgets what led up to the concussion or else they forget many of the events that occur shortly afterward.

Nausea or vomiting can also be a symptom of a concussion, and Dr. Clearfield said it can often happen an hour after the head injury. Some symptoms show up immediately and some take longer, he said.

The study was published June 10 in the journal Pediatrics. The research did not use external funding, and the authors declared no conflicts of interest.

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Review Date: 
June 7, 2013