Teenagers who suffer a concussion are more sensitive than adults or children to its aftereffects, Canadian researchers report.
Concussions can affect short-term memory in adolescents, which is essential for reading and calculating, and those effects can last for six months or longer, the study authors found.
"Contrary to the belief by some parents and coaches that children can play through a concussion because their brains are more resilient, we find that children are more vulnerable to the effects of a brain injury than adults," said lead researcher Dave Ellemberg, a neuropsychologist at the University of Montreal.
And, teenagers suffer greater symptoms than either children or adults, he added.
"It's not that surprising," Ellemberg noted. "We know the adolescent's brain, more specifically the areas affected by the concussion, the frontal lobe areas of the brain, are growing in spurts and when something is developing rapidly it is even more fragile to injury."
The report was published February 28 in the journal Brain Injury.
To come to its conclusions, Ellemberg's team worked with 96 male athletes who had suffered a concussion three to nine months before testing. The athletes were divided into three groups: adults (30), kids aged nine to 12 (32) and teens aged 13 to 16 (34). These athletes were then compared with similar people who had not had a concussion.
All of the study participants were given neuropsychological tests used by the U.S. National Hockey League. The researchers then compared the results of those tests with the results of electrophysical evaluations that measured working memory, attention and inhibition while participants worked on a computer. Electrophysical tests are considered more sensitive than neuropsychological screens, the study authors noted.
The researchers found all the athletes who suffered concussions had results on their electrophysical evaluations that indicated injurious effects, compared with similar people who had not had a concussion.
Among teens, there were also problems with short-term working memory that lasted six months to a year, they noted.
"We find that most concussions are similarly severe, whether or not there is loss of consciousness," Ellemberg said.
Immediate symptoms after an injury are not a way to know how a child is doing, he said. "You, typically, have to wait for a couple of days, or even weeks, after the injury to see the symptoms," Ellemberg explained. "Concussions are severe, and do have consequences. We need to have a systematic system to evaluate these children."
After a suspected concussion, the child or teen should be seen by a medical professional who can assess the patient and make a plan for when the child can go back to playing, he said.
"We can't be afraid to have our kids play sports. We know that it's good for the child's physical health and mental health," Ellemberg stressed. "So, we want to encourage sports, but we want to make sure that we do it in a safe way."
Teams need to have an adult trained in what to do if a child has a concussion. In addition, an effort should be made to eliminate violence and situations that can lead to concussions, Ellemberg added.
Commenting on the study, Gillian Hotz, director of the concussion program at the University of Miami Miller School of Medicine, said that "kids have developing brains, so issues may not show up until a year later when they are stressed to do more frontal lobe activities."
Concussions are preventable, she said, and there needs to be education about concussion directed to parents, coaches and children. "Of course, wearing helmets properly is important," Hotz noted, adding that more communities are taking a proactive approach to dealing with concussions.
For example, high school athletes in Miami are given tests of mental functioning before they can play. These give professionals a baseline with which to compare their symptoms after a concussion to see if there are changes, she explained.
These and other measure can make a difference in identifying and treating concussions, Hotz said.
For more on concussions, visit the U.S. Centers for Disease Control and Prevention.