Children who suffer a concussion may have some symptoms like a headache that appear right after their injury, but they can also have longer-lasting effects well after the physical symptoms have subsided, according to a new study from the emergency medicine division at Boston Children’s Hospital.
The researchers saw that physical symptoms like headache, dizziness, and blurred vision can appear in the time immediately after a concussion, but emotional and mental symptoms like irritability and frustration show up much later and can last much longer.
“Patients and their families should expect the physical symptoms that they experience after a head injury to get better over the next few weeks, but that emotional symptoms may come on later, even as the physical symptoms subside,” said lead researcher Dr. Matthew Eisenberg.
“Only by knowing what symptoms can be expected after a concussion can we help reassure patients and families that what they experience is normal, know when to seek additional help, and make sure that children are taking appropriate precautions in regard to school and sports to achieve a full recovery,” Eisenberg added.
The study was published online May 12 and in the June print issue of Pediatrics.
The researchers used questionnaires to track 235 children and young adults aged 11 to 22, who suffered a concussion and went to a pediatric emergency department. The patients were followed for three months after the initial injury or until all symptoms were gone. They were also asked about symptoms as well as school and athletic performance.
The most common physical symptoms reported were headache, dizziness, and fatigue, all of which tended to start right after the injury and improved over time. Most patients also had mental symptoms, such as difficulty concentrating and taking longer to think.
Most children in the study recovered within two weeks of the injury, however 25 percent still had a headache a month after their injury. More than 20 percent and close to 20 percent reported taking longer to think for a month after their concussion, as well.
However, emotional symptoms were not as common right after the injury, but tended to develop later for many in the study. These symptoms were largely resolved by 90 days after the injury. Sleep disturbances also performed similarly to emotional symptoms, with more issues reported at a week after the injury, but fading away by the time of the three-month follow-up.
“Taken together, these findings show that although concussion symptoms often resolve quickly, they can be debilitating in the short term for many patients,” the authors write. “[C]hildren who have a concussion should be warned about the possibility of developing fatigue and sleep issues, and these symptoms should be specifically assessed during follow-up evaluation.” Parents and clinicians should also watch for emotional changes associated with these symptoms.