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Q. When will the cognitive function get back to normal after sports concussion?

Answered by
Dr. Rahul Rathee
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Feb 29, 2020 and last reviewed on: Mar 03, 2020

Hello doctor,

My daughter suffered a concussion 16 weeks ago. She is still struggling with several symptoms like constant headache, fatigue, trouble falling asleep, feeling weird and occasional dizziness. She does feel a little better compared to a couple of weeks after it happened, but unfortunately, she still feels pretty bad. She has taken the impact test with her doctors twice since it happened, just to track her progress. The first one she failed, but she just took another one this week and passed. Her score was back to baseline. How can her cognitive function be back to normal when she still feels so bad? Does she need to continue to rest as she has been for four months? Does she still have a concussion? She has special accommodations at school right now. Should those continue? Her case is being referred and sent to a neurologist as the pediatric concussion specialist does not specialize in post-concussion syndrome or symptoms and he wants her to get the best treatment possible. We are awaiting that appointment so I do not currently have a doctor who can answer these questions.

The only medication she has been taking is Naproxen (Aleve). The doctors have not allowed anything else, but we are hoping the neurologist will prescribe something. She is also taking a lot of vitamins to try and help her energy level. I have attached a file.

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Hi,

Welcome to icliniq.com.

I can completely understand your concern for your daughter's illness. I have seen the attachment. (attachment removed to protect patient identity).

Sports concussion injury is a new concept in medical sciences. Concussion is basically a very mild injury to the brain which impairs the basic mechanism in which a brain functions under normal circumstances. Concussion can be caused by a direct blow to the head or by indirect blow, for example, when an athlete is sprinting very fast and suddenly stops or changes direction leading to the sudden change in movement of the brain tissue leading to a friction between the brain tissue and inner surface of the bones of the skull.

Let us discuss the queries asked by you one by one.

Regarding how can her cognitive function be back to normal when she still feels so bad?

Well, at present her problem is not concussion brain injury because concussion brain injuries usually heals within a few days. Various scientific studies shows that 90-95 % of concussion injuries heals as fast as within eight to nine days after the injury and only 5-10 %,injuries take more than 10 days. So medically and technically it is post concussion syndrome which she is presently dealing with. Post concussion syndrome can develop in a person with a very mild concussion and on the contrary, do not develop in some patients who suffered a major injury which in turn means that development of post concussion syndrome does not depend on the severity of brain injury, it happens in some and do not happen in others. But the good thing is that in sooner or later the person gets cured with time. 90% cases of post concussion syndrome resolves in two to three months and 10% resolves six to eight months after the initial injury and very rarely it may take maximum upto one year but the point is that almost 100% cases get resolved maximally within one year after the injury.

Regarding does she need to continue to rest as she has been for four months?

Yes, as she is still having symptoms of post-concussion syndrome i.e headache, fatigue, dizziness, sleeping disturbances, etc., she needs to continue both physical and mental rest till all the symptoms go away. The medical reason behind recommending both mental and physical reasons is that doing physical activity the heart starts beating fast and more forcefully leading to increased blood flow in the brain which inturn can exacerbate the symptoms of post-concussion syndrome and can cause the symptoms to reoccur. Similarly performing cognitive activity and even mental activities like thinking use energy in the brain and can slow the recovery process of post-concussion syndrome

Regarding does she still have a concussion?

No, she does not have concussion now. As I have already explained that in almost all cases, concussion injury heals within 10 days. Her primary concussion injury has healed and presently she only has the symptoms of post-concussion syndrome. Regarding her special accommodations at school right now.

Yes, she should continue and follow those special accommodations till all her symptoms of post-concussion syndrome subside and go away, otherwise as I explained above, any physical or mental stress can delay the recovery and can re-trigger the symptoms repeatedly.

I hope this helps.


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