Association of Concussion History and Prolonged Recovery in Youth

Abstract

To determine the number of prior concussions associated with increased incidence of persistent postconcussive symptoms (PPCS) in a cohort of acutely concussed pediatric patients. Design: Prospective observational cohort study. Setting: Three university-affiliated concussion clinics. Participants: Two hundred seventy participants (14.9 6 1.9 years, 62% male, 54% with prior concussion) were assessed within 14 days of concussion and followed to clinical recovery. Participants with a second head injury before clinical recovery were excluded. Measures: and Main Outcome: Concussion history, current injury characteristics, recovery time, and risk for prolonged recovery from current concussion. Results: There was no statistically significant change in PPCS risk for participants with 0, 1 or 2 prior concussions; however, participants with 3 or more prior concussions had a significantly greater risk of PPCS. Twelve participants sustained a subsequent concussion after clinical recovery from their first injury and were treated as a separate cohort. Our secondary analysis found that these participants took longer to recover and had a greater incidence of PPCS during recovery from their latest concussion. Conclusion: Pediatric patients with a history of 3 or more concussions are at greater risk of PPCS than those with fewer than 3 prior concussions.

Contemporary diagnosis and management of mild TBI (concussions): What you need to know

“…), history of migraines, attention-deficit/hyperactivity disorder (ADHD), learning disabilities, anxiety and depression. [10][11][12][13] Once obtained, the clinician should proceed with a symptom assessment and physical examination. Validated tools commonly utilized for symptom assessment are the Post-Concussion Symptom Scale (PCSS), validated in children 11 years and older, or the SCAT Symptom Inventory, or Post-Concussion Symptom Inventory (PSCI) self-report, both with a Child version for children 5 years to 12 years of age and another for adolescents 13 years or older.…”

“…Risk factors for prolonged recovery after concussion in the pediatric population include concussion history, female sex, adolescent age and certain comorbidities including, certain visual conditions (i.e., amblyopia, strabismus, convergence insufficiency, etc. ), history of migraines, attention-deficit/hyperactivity disorder (ADHD), learning disabilities, anxiety and depression 10–13 …”

Chronic Traumatic Encephalopathy in Soccer Players: Review of 14 Cases

“…In childhood and adolescence, the brain probably is more vulnerable to heading, because of its relative large size and immaturity/developmental phase. 124,125 Although the number of headers in youth soccer is very low, 126,127 the US Soccer Federation eliminated heading for youth players younger than 10 years and limited the practice of heading for children ages 11 to 13 years, see Table 3. 128 After this age, young players should be taught proper heading technique.…”

Factors Associated with Symptom Resolution after Aerobic Exercise Intervention in Adolescent and Young Adults with Concussion

“…However, additional patient-specific factors, such as age, sex, concussion history, preintervention symptom severity, or time since injury, have not been investigated within the context of aerobic exercise treatment efficacy. Each of these factors may influence recovery (10)(11)(12)(13)(14)(15)(16)(17) and interact with postconcussion exercise behavior (18,19).…”