Girls Have Longer Recovery Time From Concussions

Editor's note:  one of the most frustrating illnesses to treat his concussion. Parents and patients are always  surprised by the  duration of time until recovery  and the extent of cognitive disability. J Rotenberg MD

Girls take longer to recover from sports related concussions than boys do, according to new research.

High school athletes, both boys and girls, also have longer recovery times than do college athletes, says researcher Tracey Covassin, PhD, associate professor of kinesiology and a certified athletic trainer at Michigan State University.

"We have known that high school kids will take longer," Covassin tells WebMD. "We are starting to show there are differences between female and male athletes."

Covassin's study evaluated 222 high school and college athletes who had sustained a concussion.

After a concussion, females also did worse than males on visual memory tests. They had more symptoms, Covassin found.

The study is published in The American Journal of Sports Medicine.

Concussion: The Problem

A concussion, a type of traumatic brain injury, results from an impact to the head. Those affected can have headaches, concentration problems, memory and balance problems, blurry vision, and nausea.

A concussion changes the way your brain functions, according to the CDC. It can occur even with a helmet on. Most do not involve loss of consciousness.

The injuries can lead to memory and communication problems, depression, and early dementia, the CDC says.

From 2001 through 2005, more than 150,000 sports-related concussions occurred in young people 14 to 19, Covassin says. However, the actual number is probably much higher, she says. The statistics only reflect concussions treated at an emergency department.

Awareness of the problem has grown in the wake of hundreds of lawsuits from former National Football League players. They are suing the NFL for what they claim are concussion-related dementia and other brain problems.

Concussion, Gender, and Age: Study Details

After the concussions, Covassin gave standard tests to measure thinking skills such as verbal and visual memory. She evaluated symptoms. She repeated the tests two, seven, and 14 days later.

She also tested the athletes' balance at one, two, and three days after the concussion.

The athletes played football, soccer, volleyball, basketball, wrestling, ice hockey, softball, rugby, crew, baseball, cheerleading, and lacrosse.

Among the findings:

• High school athletes did worse than college athletes on tests of verbal and visual memory (such as recalling a group of words just read).
• Girls and young women did worse than boys and young men on visual memory.
• Girls and young women had more symptoms than boys and young men.

"Our high school athletes took longer to recover than college athletes," Covassin says. "The college athletes had recovered by seven days. All [high school and college athletes] went back to normal within 14 days." She cannot pinpoint exactly when the high school athletes recovered.

Exactly why girls have more symptoms is not certain, Covassin says. Some researchers suggest that women's greater rate of blood flow in the brain compared to men's may somehow make the symptoms worse and last longer.

Based on her new findings, teachers and coaches may need to make some accommodations for the athletes whose symptoms are worse and recovery slower, Covassin says.

Some athletes may need to be excused from classes for a few days after concussion, she says.

The study was funded by the National Operating Committee on Standards for Athletic Equipment.

Concussions in High School, College Athletes: Perspective

The new research confirms earlier findings and adds to growing research about gender differences, says Gillian Hotz, PhD, director of the concussion program and professor of neurological surgery at the University of Miami Miller School of Medicine.

She reviewed the findings for WebMD.

Educating parents, coaches, and youth is key, she says. A crucial message? "If you get a headache [after a hit], pull yourself out," she tells young athletes.

Too often, she says, kids, encouraged by parents and coaches, will play through the pain. "I get parents in my clinic who say, 'They have to play, they have to play,' and they are still recovering from a concussion," Hotz says.

Concussion Education

Parents can be on the lookout for symptoms in their young athletes, Covassin says. Symptoms may come on later, not right after the hit, she says.

As for young athletes, "they need to understand that they need to tell someone [about the hit]." Boys are more likely to play through than are girls, she says.

About 35 states, the District of Columbia, and the city of Chicago have passed youth concussion laws, according to a tally by the National Football League, which supports the effort.

The laws require:

• Young athletes, parents, and guardians to sign an information form about concussions.
• Removal of young athletes from play or practice if a concussion is suspected.
• Clearance from a health care professional trained in concussions before an athlete can resume play or practice.

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