Getting care quickly improves concussion recovery
© 2020 Roy Benaroch, MD
Concussions are a mild traumatic brain injury. Mild means you can’t see any damage on a CT or MRI scan – but’s still an injury, and injured brains take time to recover. Symptoms like headache, brain fog, and trouble with mood, memory, and balance last on average 3 weeks in sports-injured teens. Three weeks is bad enough, but we know some teens have symptoms that linger far longer.
A new study from JAMA Neurology found an important predictor of a longer recovery: just how long did it take for a teenager with a concussion to get a medical evaluation and treatment? About 250 teens and young adults, aged 12-22, who had a sport-related concussion were tracked to see how long their symptoms lasted. The researchers looked back on many factors to see what best predicted longer symptoms. Many things you might think would be predictive were not, like measures of concussion severity or the findings of neurocognitive testing. These didn’t seem to matter.
The best predictor was a simple measure of how long it took to get in for an evaluation. If that first clinic visit took more than seven days, there was a six-fold increase in the chance of having symptoms lasting more than a month.
The treatment of concussion is actually pretty simple, but it is important. The first, most-important rule is to get people with suspected concussions off the field. They should absolutely not continue play. After the initial evaluation, they’ll need to reduce sports and academics, and slowly ramp back up to full activity as symptoms improve. Patients with concussions should not avoid all activity, though – some light exercise is ok, and can help recovery if done carefully. That’s why that initial medical evaluation is important, and should be done quickly. Patients and families need clear guidance on what to do, and what to expect from their recovery.
More about concussions:
What to do when your child has a concussion
Football helmets do not protect your child’s brain
The Pediatric Insider 
January 29, 2020 at 12:36 am
I’m left scratching my head, as there is precisely no treatment that i am aware of for a concussion.
Well, beyond “don’t get your bell rung again for a while”.
The “while” varying per decade and currently, I’ve lost track of recommendations to avoid another TBI.
Is there a novel treatment that I’m unaware of or is there a new methodology to address a TBI?
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January 29, 2020 at 7:15 pm
The only treatment is brief rest followed by a gradual increase in activity. But too much rest isn’t good, and too-quick return to play isn’t good either. The doc’s role is to guide through these recovery steps. I agree there’s nothing new or high-tech.
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January 29, 2020 at 11:39 pm
Thanks for the quick reply, that was what our military guidance was as well. Especially avoiding another chance to acquire another TBI for at least a month, due to cumulative effects in an already injured brain.
I’ll not even go into a certain politician who disparaged 50 service members with varying degrees of TBI…
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March 11, 2020 at 11:06 pm
Dr Roy, when you helped us with Emily’s concussion just over a year ago, you were so conscientious. The lights down in the exam room, making her feel as little stress as possible. Her recovery was terrifying, and I prayed for her to come back. You told us how long it could take for her to emerge from the far away place her brain went to heal, and you were spot on.
Thank you for everything you do. You navigate this parenting thing for us, and we are so grateful.
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