Kids' Concussion Recovery Varies by Symptom Severity: Study

Identifying which factors lead to longer recoveries may improve treatment

By Robert Preidt

HealthDay Reporter

THURSDAY, April 25 (HealthDay News) -- Children with more severe concussion symptoms take longer to recover from their head injury than those with milder symptoms, a new study finds.

Most children recover from sports-related concussions within a few days, but some continue to have symptoms for a month or longer. The reasons for this have been unclear. The authors of this study sought to identify risk factors that might be associated with longer recovery times.

The researchers analyzed data from 182 children who were seen at a sports concussion clinic within three weeks of their injury. The patients completed the Post-Concussion Symptom Scale (PCSS), which uses a 0-6 scale to assess the severity of 22 symptoms. The higher the number, the more severe the symptoms.

The investigators found that the total score on the PCSS was independently associated with the length of time that patients had concussion symptoms. The higher the score, the more likely a child would have symptoms for longer than 28 days, according to the study published April 25 in The Journal of Pediatrics.

Identifying risk factors for prolonged recovery from concussion will enable doctors to provide the best treatment for patients, said the researchers from Boston Children's Hospital and the University of Pittsburgh Medical Center.

Some of the symptoms included on the PCSS questionnaire include headache, vomiting, balance problems, sleeping more or less than usual, sensitivity to light or noise, fatigue, numbness, problems with memory or concentration, and visual problems.

"Parents, physicians and caregivers of athletes who suffer from a high-degree of symptoms after a sports-related concussion should start preparing for the possibility of a prolonged recovery," study author Dr. William Meehan said in a journal news release.

Some previous studies found that younger patients and those with memory loss had longer recovery times after suffering a concussion. But this study did not find that age or amnesia are risk factors for prolonged recovery time, the investigators pointed out in the news release.

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Concussion Damage Looks Much Like Early Alzheimer's: Study

Preliminary finding suggests mild brain injury triggers long-lasting abnormalities in white matter

By Dennis Thompson

HealthDay Reporter

TUESDAY, June 18 (HealthDay News) -- Concussion can lead to damage in the white matter of the brain that resembles abnormalities found in people in the early stages of Alzheimer's disease, a new study suggests.

Researchers at the University of Pittsburgh School of Medicine said their findings should prompt a re-evaluation of the long-term effects of concussion, which affects more than 1.7 million people in the United States annually. About 15 percent of concussion patients suffer persistent neurological symptoms.

"The previous thinking before was you get a concussion, and that causes a certain damage from bopping your head and you get these symptoms," said study author Dr. Saeed Fakhran, an assistant professor of radiology at the University of Pittsburgh School of Medicine. "We found it acts as a kind of trigger, and lights a fuse that causes a neurodegenerative cascade that causes all these symptoms down the line. Once you've hit your head, the injury isn't done."

The findings are published online June 18 in the journal Radiology.

The study drew some criticism from concussion and Alzheimer's disease experts who said the findings, while provocative, should not be interpreted as drawing a clear link between a concussion suffered early in life with the development of Alzheimer's.

"I don't want a mom to pick this up and say, 'Oh my god, my 10-year-old is going to get Alzheimer's now,' because that is not the case," said Dr. Ken Podell, a neuropsychologist and co-director of the Methodist Concussion Center in Houston. "It's very inconclusive at this time, and there's no clinical application of this at this point of time."

White matter serves as the tissue through which messages pass between different areas of gray matter within the brain and spinal cord. Think of gray matter as the individual computers in a network, and white matter as the cables that connect the computer.

The researchers reviewed past brain scans of 64 people who had suffered a concussion, focusing on scans that used an advanced MRI technique called diffusion-tensor imaging, which spots microscopic changes in the brain's white matter.

The investigators then compared these brain scans to symptoms reported by concussed patients in a post-concussion questionnaire. They focused on symptoms shared with Alzheimer's patients, including memory problems, disturbances in sleep cycles and hearing problems.

The results showed a significant correlation between high concussion symptom scores and reduced water movement in the parts of the brain's white matter related to auditory processing and sleep-wake disturbances. Further, the researchers said, the distribution of white matter abnormalities in mildly concussed patients resembled the distribution of abnormalities in people with Alzheimer's disease.

"Basically, it looks a lot like Alzheimer's," said study co-author Dr. Lea Alhilali, an assistant professor of radiology at the University of Pittsburgh School of Medicine. "You get the same distribution of damage in the way that Alzheimer's disease affects the brain."

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