On 12/29/08, U.S. News and World Report published an entry on the “On Parenting” blog by Nancy Shute entitled, Concussions Pose a Long-Term Health Threat to Young Athletes. The article discusses a recently published article in the medical journal, Pediatrics, entitled “Sport-Related Concussion” by Drs. Meehan and Bachur (2009).

The article contains excellent educational information that informs parents about the risk of returning a child to play before he/she has fully recovered from a mild traumatic brain injury (concussion). This view is consistent with national return-to-play guidelines and is fully supported at MTBIFacts.com.

Drs. Meehan and Bachur (2009) correctly point out that there are several studies documenting no cumulative effect of multiple concussions, although some studies do show an increased risk. The differing results may be related to whether the patients studied mostly consisted of those who suffered another concussion before fully recovering from the preceding concussion or not. The number of prior concussions likely also plays a role (e.g., 2 vs 10), especially over a long sports career. However, the need for long-term prospective studies is needed to make more firm conclusions on the risk of multiple concussions.

One concern about the blog entry is that it contains a discussion of the “…long-term deficits in thinking and memory that can come as a result of concussion…” While there is a need for proper safety awareness, this must also be balanced with a need to reduce anxiety regarding the long-term effects of a single concussion, since psychological factors (including expecting certain symptoms to occur; Mittenberg, 1992) are widely known to worsen outcome. The article by Meehan and Bachur does not contain any references documenting long-term cognitive deficits from a single concussion. As McCrea (2008) discusses in his recent book (see below), longitudinal prospective studies of children and adults who have suffered a sports-related concussion do not show evidence of long-term cognitive deficits. In fact, the vast majority of such patients return to their baseline level of cognitive functioning by seven days post-injury.

The author of the story was contacted on 12/29/08 and she responded the same day saying she would write a reply soon on the same blog. On 1/2/09, a follow-up blog entry was posted entitled, Had a concussion? Don’t panic but be cautious. This is a perfectly appropriate title to the article and the message that MTBIFacts.com is promoting.

REFERENCES

McCrea, M. (2008). Mild traumatic brain injury and postconcussion syndrome. The new evidence base for diagnosis and treatment. New York: Oxford University Press.

Meehan, W.P., & Bachur, R.G. (2009). Sport-related concussion. Pediatrics, 123, 114-23.

Mittenberg, W. et al. (1992). Symptoms following mild traumatic brain injury: expectation as aetiology. Journal of Neurology, Neurosurgery, and Psychiatry, 55, 200-04.