Does mechanism of injury play a role in recovery from concussion? 2015

Ashley Seiger, and Eva Goldwater, and Ellen Deibert
Brigham and Women's Hospital, Boston, Massachusetts (Ms Seiger); School of Public Health & Health Sciences, University of Massachusetts, Amherst (Ms Goldwater); and Wellspan Adult Neurology, York, Pennsylvania (Dr Deibert).

BACKGROUND High school football and soccer are 2 of the leading causes of concussion injuries. However, concussions also occur from mechanisms of injury such as motor vehicle accidents (MVAs), assault, and work-related accidents. OBJECTIVE Determine if recovery from concussion could be related to the mechanism of injury. METHODS Berkshire Medical Center Concussion Clinic. METHODS Patients aged 13 to 21 years suffering concussion from football (n = 31), soccer (n = 9), or MVAs (n = 20). METHODS ImPACT (Immediate Post Concussion Assessment Tool) test scores including symptom inventory; number of days sick; length of time to recovery. RESULTS Most commonly reported symptom at the time of injury was headache. Patients were seen in clinic an average of 16 (football), 14 (soccer), and 21 (MVA) days postinjury. Groups differed significantly on ImPACT Visual Memory and Visual Motor Speed scores (P < .05). MVA patients had a longer median number of days sick (97 days) than football players (32 days; P < .05). CONCLUSIONS This study suggests that concussion from an MVA may be a more serious injury than a typical concussion sustained during sports. Data suggest that MVA patients take longer to present to clinic, have lower Visual Memory and Visual Motor Speed scores on ImPACT, and take longer to recover. Further studies are needed to better understand how the mechanism of injury of concussion may relate to prognosis.

UI MeSH Term Description Entries
D008297 Male Males
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D001924 Brain Concussion A nonspecific term used to describe transient alterations or loss of consciousness following closed head injuries. The duration of UNCONSCIOUSNESS generally lasts a few seconds, but may persist for several hours. Concussions may be classified as mild, intermediate, and severe. Prolonged periods of unconsciousness (often defined as greater than 6 hours in duration) may be referred to as post-traumatic coma (COMA, POST-HEAD INJURY). (From Rowland, Merritt's Textbook of Neurology, 9th ed, p418) Cerebral Concussion,Commotio Cerebri,Concussion, Intermediate,Concussion, Mild,Concussion, Severe,Mild Traumatic Brain Injury,Brain Concussions,Cerebral Concussions,Concussion, Brain,Concussion, Cerebral,Intermediate Concussion,Intermediate Concussions,Mild Concussion,Mild Concussions,Severe Concussion,Severe Concussions
D005260 Female Females
D005538 Football A competitive team sport played on a rectangular field.This is the American version of the game. It does not include non-North American football ( American Football,Football, American
D006760 Hospitalization The confinement of a patient in a hospital. Hospitalizations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000063 Accidents, Traffic Accidents on streets, roads, and highways involving drivers, passengers, pedestrians, or vehicles. Traffic accidents refer to AUTOMOBILES (passenger cars, buses, and trucks), BICYCLING, and MOTORCYCLES but not OFF-ROAD MOTOR VEHICLES; RAILROADS nor snowmobiles. Traffic Collisions,Traffic Crashes,Traffic Accidents,Accident, Traffic,Collision, Traffic,Collisions, Traffic,Crashes, Traffic,Traffic Accident,Traffic Collision
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

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