Women are more prone to prolonged concussions

Amy Norton
HealthDay Reporter

THURSDAY, April 8, 2021 (HealthDay News) – After a concussion, women may have an increased risk of permanent physical and mental symptoms, new research reveals.

A study of 2,000 people with concussions found that women were more likely than men to still have some symptoms a year later. Problems included blurred memory and difficulty concentrating, as well as headaches, dizziness or fatigue.

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

The reasons are not clear, but the study is not the first to find gender differences in concussion recovery. Many have found that women on average improve more slowly after a concussion, regardless of what caused the injury.

But the new study also included a “control” group of people who suffered orthopedic injuries, to determine whether women are having a harder time recovering from injuries at all.

And that was not the case.

This is an important discovery, according to Martina Anto-Ocrah, assistant professor of emergency medicine and neurology at the University of Rochester Medical Center.

To be continued

She said that this intensifies the case that the slower recovery of women is especially connected with the concussion.

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

Although the findings may sound daunting, most women recover fairly quickly after a concussion.

“We expect most patients to recover within a few weeks,” Anto-Ocrah said, noting that about 90% returned to the right path within three months.

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

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

However, the researchers took depression and anxiety into account, and it seems that these diagnoses do not explain the more persistent female symptoms.

Whatever the cause, the findings offer confirmation. Some women, Anto-Ocrah noted, encounter skepticism when they tell their doctor they still have concussion symptoms many months after the injury.

To be continued

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

There is no repair for the brain injury. But there are ways to manage symptoms, Anto-Ocrah said. This can mean cognitive therapy for memory or thinking problems or medications for problems like persistent headaches.

If women feel their long-term symptoms are being rejected, she urged them to “be persistent” in providing the care they need.

“You could show your researcher this study,” Anto-Ocrah suggested.

The findings are based on 2,000 patients with concussions and 299 with orthopedic injuries treated in any of 18 U.S. hospitals.

Over the course of one year, they periodically completed standard questionnaires on physical, mental, and emotional symptoms, as signs of posttraumatic stress disorder (PTSD).

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

To be continued

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

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

The brain has estrogen receptors, and some research has suggested that women who have a concussion at certain times of the menstrual cycle have a slower recovery.

In this study, women between the ages of 35 and 49 usually had worse symptoms than younger and older women.

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

It is possible, she speculated, that this signals a hormonal effect, as women approach menopause in that age range.

Future studies, Anto-Ocrah said, should try to investigate more deeply the “hormonal assessment” of patients with concussions – such as whether they use hormonal birth control, have reached menopause or are on hormone therapy in menopause.

For now, Levin said that the age findings should be looked at “carefully” and that they need confirmation in further studies.

To be continued

More information

The U.S. Centers for Disease Control and Prevention has more questions about concussion recovery.

SOURCES: dr. Harvey Levin, Professor of Physical Medicine and Rehabilitation, Baylor School 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