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Women are more prone to the long-term harms of concussions

By Amy Norton
HealthDay reporter

THURSDAY April 8, 2021 (HealthDay News) – After a concussion, women may be at increased risk for lasting physical and mental symptoms, according to a new study.

The study of 2,000 concussion victims found that women were more likely than men to still have certain symptoms a year later. The problems included fuzzy memory and difficulty concentrating, as well as headaches, dizziness or fatigue.

In contrast, women and men showed similar recovery times after traumatic injuries in other areas of the body.

The reasons aren’t clear, but the study isn’t the first to find gender differences in concussion recovery. Many have found that, on average, women improve more slowly after a concussion, regardless of the cause of the injury.

But the new study also included a “control” group of people with orthopedic injuries, to see if women tended to recover from injuries more slowly in general.

And it was not.

It’s an important finding, according to Martina Anto-Ocrah, assistant professor of emergency medicine and neurology at the University of Rochester Medical Center.


She said it strengthens the argument that women’s slower recovery is linked to concussion, in particular.

Anto-Ocrah co-wrote an op-ed published with the study on April 6 in the journal JAMA network open.

Although the results may seem dire, most women bounce back fairly quickly after a concussion.

“We expect most patients to heal within a few weeks,” said Anto-Ocrah, noting that around 90% are back on track within three months.

But some people have persistent physical, mental or emotional symptoms, for reasons that are not entirely clear.

In this study, women had higher rates of pre-concussion depression and anxiety diagnoses, compared to men. And these are risk factors for prolonged concussion symptoms, Anto-Ocrah noted.

However, the researchers explained the depression and anxiety, and these diagnoses did not seem to explain the more persistent symptoms in women.

Whatever the cause, the results offer validation. Some women, Anto-Ocrah noted, experience skepticism when they tell their doctors that they still have concussion symptoms several months after the injury.


“This is further proof that it’s not all in your head,” she says.

There is no solution for brain damage. But there are ways to manage the symptoms, Anto-Ocrah said. It could mean cognitive therapy for memory or thinking problems, or medication for problems like persistent headaches.

If women feel their lingering symptoms are gone, she urges them to “be persistent” to get the care they need.

“You can show this study to your supplier,” Anto-Ocrah suggested.

The results are based on 2,000 concussion patients and 299 with orthopedic injuries who were treated at one of 18 US hospitals.

For a year, they periodically completed standard questionnaires on physical, mental, and emotional symptoms as signs of post-traumatic stress disorder (PTSD).

On average, women with concussions scored higher than their male counterparts on measures of physical and mental function (meaning they had more severe symptoms). The gender gap narrowed over time as most patients improved – but it was still present a year later.


The study cannot answer the question of why, said lead researcher Harvey Levin, professor of physical medicine and rehabilitation at Baylor College of Medicine in Houston.

It is possible, he said, that chronic inflammation of brain tissue or hormonal influences play a role.

The brain has receptors for estrogen, and some research has suggested that women who experience a concussion at certain points in the menstrual cycle tend to have slower recovery.

In this study, women aged 35 to 49 generally had worse symptoms than younger and older women.

Anto-Ocrah called the discovery “fascinating”, although there is no solid explanation.

It’s possible, she speculated, that this signals a hormonal effect, as women in this age range are nearing menopause.

Future studies, Anto-Ocrah said, should try to dig deeper by performing a “hormonal assessment” of women with concussion – for example if they were using hormonal birth control, had reached menopause, or were on hormone therapy. menopausal.

For now, Levin said the results on age should be viewed with “caution” and should be confirmed in other studies.


More information

The US Centers for Disease Control and Prevention has more on concussion recovery.

SOURCES: Harvey Levin, PhD, professor, physical medicine and rehabilitation, Baylor College of Medicine, Houston; Martina Anto-Ocrah, PhD, MPH, assistant professor, emergency medicine, neurology and obstetrics and gynecology, University of Rochester Medical Center, Rochester, NY; JAMA network open, April 6, 2021, online


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