Many Adolescents Report Symptoms Mimicking Concussions

Grant L. Iverson, PhD Director, Sports Concussion Program, MassGeneral Hospital for Children Director, Neuropsychology Outcome Assessment Laboratory, Department of Physical Medicine and Rehabilitation, Harvard Medical School Associate Director, Traumatic Brain Injury, Red Sox Foundation and Massachusetts General Hospital Home Base Program Boston, MassachusettsMedicalResearch.com Interview with:
Grant L. Iverson, PhD
Director, Sports Concussion Program
MassGeneral Hospital for Children
Director, Neuropsychology Outcome Assessment Laboratory, Department of Physical Medicine and Rehabilitation
Harvard Medical School
Associate Director, Traumatic Brain Injury
Red Sox Foundation and Massachusetts General Hospital Home Base Program
Boston, Massachusetts

Medical Research: What is the background for this study? What are the main findings?

Dr. Iverson: Health care providers rely heavily on symptom questionnaires to monitor recovery from concussion and make decisions about returning to sport after concussion.

Common symptoms of concussion include headache, fatigue, sleep problems, and difficulty concentrating.

However, many healthy adolescents, that is, with no prior concussions, report these same symptoms. It is fairly common for healthy adolescents have some symptoms in their daily life. Moreover, a subgroup of healthy high school students report multiple concussion-like symptoms, or a cluster of symptoms that look much like what we see after a concussion.

High school girls are more likely than boys to report multiple concussion-like symptoms.

High school athletes with mental health problems such as depression or anxiety, but no recent prior concussion, report a lot of concussion-like symptoms. Other prior health problems, including multiple past concussions and ADHD, had a similar but less strong association with current symptom reporting.

Girls with prior concussions might be more susceptible to the lingering effects of prior concussions. This requires further research.

Medical Research: What should clinicians and patients take away from your report?

Dr. Iverson: Be cautious about attributing symptoms that last many weeks or months following an injury to concussion, particularly in adolescents with pre-injury health problems.

When evaluating adolescents after a concussion, be sure to ask about any prior mental health problems and ADHD.

Appreciate that many factors separate from concussion can cause symptoms such as headaches, fatigue, and concentration problems in high school students.

Understand that it is difficult to know when an athlete becomes “asymptomatic” after concussion. That is, the longer a person has symptoms, the more difficult it can be to determine the extent to which those symptoms are due to the concussion or to other factors.

Citation:

Grant L. Iverson et al. Factors Associated With Concussion-like Symptom Reporting in High School Athletes. JAMA Pediatrics, 2015 DOI: 10.1001/jamapediatrics.2015.2374

Grant L. Iverson, PhD (2015). Many Adolescents Report Symptoms Mimicking Concussions 

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