Pediatric concussion: boys and girls differ in symptom evolution

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Takeaway

  • Among children with concussion, symptom improvement occurs at 2 weeks on average. 
  • Adolescent girls have the longest recovery period, and less than half fully recover by 12 weeks.

Why this matters

  • Clinicians may want to consider sex differences in managing concussion recovery among adolescents.
  • Recovery curves provided in this paper might serve as an evidence base for managing expectations.

Key results

  • Children ages 5-7 years saw symptom improvement in a week.
  • At 2 weeks, 75.6% of this age group had improved.
  • Children ages 8-18 years saw symptom change by 2 weeks, followed by 2-week plateau.
  • 83.6% of those ages 8-12 years and 86.2% ages 13-18 years had symptom resolution by 4 weeks.
  • Most adolescent girls did not have full recovery at 12 weeks despite showing faster symptom improvement vs boys between 1 and 2 weeks.

Study design

  • Secondary analysis, Predicting Persistent Postconcussive Problems in Pediatrics study, 9 Canadian pediatric emergency departments.
  • 3063 children ages 5-18 years with acute concussion (Postconcussion Symptom Inventory) included.
  • Outcomes: symptom change at 1, 2, 4, 8, and 12 weeks.
  • Funding: Canadian Institutes of Health Research.

Limitations

  • Limited comparison of age groups.
  • Clinically significant differences in scale scores not clear.
  • Possibly not generalizable to, e.g., delayed symptoms.