Girls More Likely To Develop Post-Concussive Symptoms After Head Injury Interview with:

Dr. Ewing-Cobbs PhD Professor in the Department of Pediatrics McGovern Medical School University of Texas Health Science Center at Houston Harriet and Joe Foster Chair in Cognitive Neuroscience

Dr. Ewing-Cobbs

Dr. Linda Ewing-Cobbs PhD
Professor in the Department of Pediatrics
McGovern Medical School
University of Texas Health Science Center at Houston
Harriet and Joe Foster Chair in Cognitive Neuroscience What is the background for this study? What are the main findings?

Response: Children may have long-lasting psychological and physical symptoms after an injury. Post-concussive symptoms (PCS) are nonspecific cognitive, physical, and mood symptoms such as difficulty concentrating, headache, and irritability. These symptoms occur in approximately 15 to 30% children after mild traumatic brain injury (TBI). Although PCS often resolve within one month, some children experience symptoms for longer periods of time. What should readers take away from your report?

Response: My colleague, Dr. Heather Keenan, and I performed this study to learn more about how injured children recover from post-concussive symptoms and to identify factors that increase the risk of persisting symptoms.

We followed children ages 4 to 15 for a year after they were treated for a mild traumatic brain injury or orthopedic injury at the McGovern Medical School at the University of Texas Health Science Center or the University of Utah Medical School.  Compared to symptoms before the injury, parent ratings after the injury showed that new PCS persisted one year after injury in 25-31% of children with mild TBI and 18% of children with orthopedic injuries. PCS were related to children’s age and sex. Even though girls and boys had similar symptoms before their injuries, girls had significantly more symptoms than boys and had twice the odds of having PCS lasting one year after injury.

Several risk factors predicted persistent PCS. Children with mood or anxiety problems before the injury, girls, young children, and teens had higher risk of persistent PCS.  The family was also an important factor in children’s recovery. Children from families with lower stress, greater connection with their community, and Hispanic ethnicity recovered better. What recommendations do you have for future research as a result of this work?

Response: Children with all types of injuries may show “post-concussion” symptoms.  Girls are especially likely to develop symptoms. Physical symptoms usually are seen soon after the injury. Emotional and cognitive symptoms may become more noticeable several weeks later when children return to school and sports.

Children with symptoms that persist beyond a month should be monitored by their pediatrician so that they can be referred for any needed physical or psychological health services. Is there anything else you would like to add?

Response: Recent research suggests that progressive return to physical activity beginning within a week or so after an injury may reduce PCS. Future research should identify best practices for returning children to learning, sports, and other activities to minimize the burden of PCS on children and their families.


Persistent Postconcussion Symptoms After Injury

Linda Ewing-Cobbs, Charles S. Cox Jr, Amy E. Clark, RichardHolubkov, Heather T. Keenan

Pediatrics Published Online October 15, 2018
doi: 10.1542/peds.2018-0939

Oct 18, 2018 @ 11:41 pm




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