How Long Does it Really Take to Recover from a Concussion?

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How Long Does it Really Take to Recover from a Concussion?

Jim Windell

             If you are a movie hero, a head injury will not slow you down one bit.

             But most of us are not movie characters. And we know that you cannot just shake off a traumatic brain injury because we are aware it generally takes time to recover. If you look online to see how much time recovery requires, you will learn that it typically takes seven to 10 days.

           But is that accurate?

           A new study, just published in the online issue of Neurology, suggests the effects of a concussion might still be present several months after a brain injury.

           This study looked at 656 people who had been admitted to trauma center emergency rooms with concussions and also at 156 healthy people without head injuries. The average age of all participants was 40. Participants were given up to three neurological evaluations after their injury, at two weeks, six months and one year. Each of those evaluations provided five scores from three tests of recall, language skills and other cognitive domains.

           Poor cognitive outcome was defined as satisfying the criteria for cognitive impairment, cognitive decline or both. Cognitive impairment was defined as lower-than-expected performance on at least two cognitive tests such as one memory test and one processing speed test. Cognitive decline was defined as clinically meaningful decline on at least two cognitive tests.

           Researchers found that 86 out of 656 people with mild brain injuries, or 14%, had poor cognitive outcomes one year later. Of those, 10% had cognitive impairment only, 2% had cognitive decline only and 2% had both. That’s compared to eight out of 156 people without concussions, or 5%, who had poor cognitive outcomes one year later. Of those healthy people, 3% had cognitive impairment, none had cognitive decline only, and 1% had both.

           According to study author Raquel Gardner, MD, of the University of California San Francisco, “Our results suggest that clinically meaningful poor cognitive outcomes, which we defined as cognitive impairment, cognitive decline or both, one year after a concussion may be more common than previously thought. They also highlight the need to better understand the mechanisms underlying poor cognitive outcome, even after relatively mild brain injuries, to improve therapy for recovery.”

           Gardner and her colleagues also found that people who had good cognitive outcomes were more likely to have higher life satisfaction one year after their concussion. The life satisfaction test given to participants ranges in score from five to 35, with lower scores indicating lower life satisfaction. The people with good cognitive outcomes scored an average of 26 on the test, compared to people with poor cognitive outcomes, who scored an average of 21.

           Furthermore, the researchers found that people who had depression before their injury, had no health insurance, or had a high school education or less were more likely to have a poorer cognitive outcome as compared to those who were not depressed before the injury, or had insurance or had more than a high school education.

           It is important to note that the study does not prove that people with concussions will have worse cognitive outcomes one year later, but it shows an association.

           “Previous studies of people with moderate to severe brain injuries show that early, intensive rehabilitation can improve people’s cognitive outcomes over time, “ Gardner said. “More research is needed to find out the role of cognitive rehabilitation on people with more mild brain injuries who are also at risk for poor cognitive outcomes, and how to predict who falls into this risk category.”

      To read the original article, find it with this reference:

Andrea Lauren Christman Schneider, J. Russell Huie, W. John Boscardin, Lindsay Nelson, Jason K. Barber, Kristine Yaffe, Ramon Diaz-Arrastia, Adam R. Ferguson, Joel Kramer, Sonia Jain, Nancy Temkin, Esther Yuh, Geoffrey T. Manley, Raquel C. Gardner, TRACK-TBI Investigators. Cognitive Outcome 1 Year After Mild Traumatic Brain Injury: Results From the TRACK-TBI Study. Neurology, 2022 DOI: 10.1212/WNL.0000000000200041


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