Cognitive and physical symptoms of concussive injury in children: a detailed longitudinal recovery study

• Published in: British journal of sports medicine 2016-03, Vol.50 (5), p.311-316
• Main Authors: Crowe, Louise, Collie, Alex, Hearps, Stephen, Dooley, Julian, Clausen, Helen, Maddocks, David, McCrory, Paul, Davis, Gavin, Anderson, Vicki
• Format: Article
• Language: English
• Subjects: Adolescent; Athletic Injuries - diagnosis; Brain Concussion - diagnosis; Child; Children & youth; Cognition; Cognition & reasoning; Concussion; Executive Function; Fatigue; Female; Headaches; Humans; Longitudinal Studies; Male; Memory; Nausea; Neuropsychological Tests; Parents; Post-Concussion Syndrome - diagnosis; Prospective Studies; Quality of Life; Reaction Time; Self Report; Sports injuries; Teenagers; Traumatic brain injury; Victoria
• ISSN: 0306-3674; 1473-0480
• DOI: 10.1136/bjsports-2015-094663

BackgroundRecovery from concussion sustained in childhood and adolescence is poorly understood. We explored patterns of recovery for neurocognition and postconcussive symptoms following concussion in children and adolescents.MethodsUsing a prospective, longitudinal design, we collected baseline data on 728 children and adolescents aged 10–17 years. 10 participants sustained a concussive injury (n=10) in the 12 months following baseline testing and they were reviewed at day 5, 10 and 30 postconcussion. Assessments included the CogSport for Kids computerised test battery to evaluate neurocognitive function and self-report, and parent measures of postconcussive symptoms. At day 30, parents also completed measures rating their child's quality of life and executive functions.ResultsChildren and adolescents displayed a gradual reduction in postconcussive symptoms over the 30 days following injury. At day 5, 87% of participants were reporting physical and cognitive symptoms, with a generalised reduction in all symptoms by day 10 (40% of participants). On the computerised measure, reaction time was slower after concussion, but returned to baseline levels by day 30. At day 30, 10% of participants demonstrated ongoing postconcussive symptoms. Number of previous concussions was related to speed of symptom resolution.ConclusionsAt 5 days postconcussion, the majority of children and adolescents experienced debilitating postconcussive symptoms. However, by 30 days postinjury, 90% demonstrated recovery to normal for both neurocognition and postconcussive symptoms.