How Long Will Concussion Symptoms Last?

37EEG_mit_32_ElectrodenThose of us on the front line in the concussion world and certainly all injured people would like to know if it will take a few hours, or days, or if the debilitating symptoms of concussion are likely to persist. For some recovery can take many months. For some life is never quite the same. Ever.

A fascinating if somewhat disheartening study was published online this week showing us just how much we really don’t know about concussions.

In the revamped JAMA Pediatrics journal online, Drs. Zemek and others from Canada published their ambitious review of the literature to see if they could define the predictors (or “prognosticators”) of prolonged recovery from concussion in pediatric (ages 2-18) patients. The murkiness starts with the fact that there is not a consistent definition of concussion, post-concussion syndrome (PCS) or full recovery. So with these limitations in mind, the researchers did their best to determine what we know about predicting.

They culled fifteen studies that met strict criteria after a review of over 500 published papers in the world literature. In sum their findings show that in large studies the risk of PCS (defined as more than a month of symptoms following injury) was increased in older children who had sustained loss of consciousness, headache and/or nausea/vomiting. In smaller studies there appeared to be some correlation between initial dizziness after the injury and prolonged recovery (PCS).

Another soft finding from the review that many “feel” is true is that certain conditions predispose to prolonged recovery. Those include children and teens who have had a previous head injury, learning difficulties, or behavioral problems. However, none of these associations with prolonged recovery were strong predictors.

The authors conclude that “because there is no method to predict which children will experience prolonged symptoms vs which will have a rapid recovery, clinicians must continue to recommend conservative management including both cognitive and physical rest, followed by a stepwise return to activities for all children.”

We remain without a good “test” or means to determine whether a concussion is mild, moderate or severe until we see how long the process of recovery will take. No estimation of severity can be made at the time of the injury. We still do not have a clue about who will recover when.

But we have a fantastic opportunity to do some good research to try to find out. Now that the majority of the states in the US have mandated some sort of concussion protocol and management program at the middle and high school levels, there is a tremendous opportunity to collect solid data. And we also need to keep looking for and tracking markers (biological or behavioral tests) that might help predict who will play the next season and who cannot.

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3 thoughts on “How Long Will Concussion Symptoms Last?

  1. I wish there was more information about adult concussion. It seems as if almost every online source is focused on children and pediatric medicine. I know this is valuable, but I’m 51, and just had a grade 3 concussion due to a ski crash into an unmarked hazard. I am looking for information for my situation so that I can make the best decisions for recovery.

    • I understand your frustration. That is why I wrote my book It’s All in Your Head:Everyone’s Guide to Managing Concussions….for EVERYONE. Please download or buy it from the website. It will help you figure out how to move forward and explain much of what you may have been experiencing. By the way, that grading system you cite is a thing of the past. In any case, I hope you are doing better. Dr E

  2. Karen, I was 58 years old when I had a concussion. You are right, there is very little information around that is helpful when it comes to adults who have suffered from concussions. I was diagnosed by my family doctor right away but told that the symptoms would last from 3 days to one month. I was not sent to any specialists, I had to do all of the investigating myself, while I was struggling with the symptoms of headache, confusion, etc. I am not a doctor but I have had a number of years to deal with my injury and to reflect back on it. And so with that in mind, this is my advice:
    Get a full medical assessment from your family doctor. Make sure to request a ct scan or mri. No its not just for Hilary Clinton it is for anyone who has had a concussion as the impact could have caused a bleed. Ask your doctor if you require a neurologist, a neuropsychologist, and/or a physiotherapist, occupational therapist etc. You will have a better idea of the extent of your injury and your own issues/needs as time passes. The most important thing you can do once you are sure that you are in the right hands medically, is to try to rest….DO NOT push yourself. Understand that your cognitive abilities may not be just what they were before the accident, at least, not for a period of time and rest is the best medicine. Also, and I hate to mention this to you, women of ‘a certain age’ heal from concussions more slowly than men in a similar age category.
    Take heart, you will get there, but keep asking questions if you do not think you are benefiting from the treatments etc. that are recommended. All the best! Ellen

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