Nine Factors Could Predict How Long a Child’s Concussion Symptoms Last

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When a person experiences a concussion, especially at a young age, it can be incredibly difficult to gauge how severe their symptoms will be or how long they will last. Thankfully, a new test might change that. A new study from Canada shows an easy-to-perform test could pinpoint the children who are at the highest risk for experiencing more severe or longer-lasting brain injuries.


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According to the study, published in the Journal of the American Medical Association, this test can be performed within 48 hours of a child experiencing a brain injury and performs better than the current method – which requires a physician’s judgement to predict the children most likely to have ongoing symptoms one month after their brain injury.

Lead author of the study and director of the Clinical Research Unit at Children’s Hospital of Eastern Ontario in Ottawa, Roger Zemek, says the new tool makes it easier for doctors to accurately predict how long a child’s concussion symptoms will last.

“Prior to this study, doctors were unable to predict which children would continue to experience prolonged symptoms” after a concussion, Zemek said.

Past research suggests approximately 30 percent of children with concussions have symptoms that last at least one month, a condition which is referred to as persistent postconcussion symptoms (PPCS).

These symptoms can include ongoing physical symptoms, such as headaches and dizziness, as well as thinking problems including trouble concentrating and feeling as if in a fog. Children or teens with PPCS may also experience emotional issues, such as irritability or anxiety, which could affect their performance at school and prevent them from returning to sports or other activities.

For this latest study, the researchers gathered data from over 3,000 children between the ages of 5 and 18 who had gone to the emergency room at one of nine children’s hospitals in Canada within 48 hours of suffering a concussion. The group of children included those who experienced concussions while participating in sports, doing other activities, or as the result of a fall, assault, or car accident.

The participants completed online surveys or telephone interviews describing their symptoms at three points following injury: at 7, 14, and 28 days after the initial injury.

The results showed that the majority of children with concussions recover within a month of their initial injury, but approximately 30 percent still showed symptoms after a month. From the results, the researchers were able to identify nine key criteria that medical professionals could use to calculate a clinical risk score which would identify youth likely to experience prolonged symptoms.

The nine risk factors included gender (females were more likely to experience PPCS), being 13-years-old or older, having a history of migraines, and having a prior concussion with symptoms lasting longer than one week. The presence of four common symptoms of concussions – headache, sensitivity to noise, fatigue, and being slow to answer questions – were also listed among the nine factors for determining the clinical risk score. The last factor was having four or more errors on a balance test given by doctors.

The researchers say once a child’s clinical risk score is established, the number could be used to place children into low-, moderate-, or high-risk categories for PPCS. Low-risk children would be unlikely to require a follow-up assessment with a concussion specialist. Children at moderate-risk for PPCS may be advised to follow-up with a pediatrician within two to three weeks of their head injury while high-risk children would be referred to a hospital’s concussion clinic for close monitoring and further evaluation.

Since quick intervention is especially important for children who are likely to experience longer or more-severe symptoms, these new risk factors could prove highly useful to improve cognitive outcomes for children who experience persistent symptoms following their brain injury.

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