July 26, 2011 / 4:45 PM / 6 years ago

Dizziness after concussion may mean longer recovery

NEW YORK (Reuters Health) - It might make sense to pay particular attention to dizziness in young football players who suffer a blow to the head, a new study suggests.

Researchers found that of 107 high school football players who'd suffered a concussion on the field, those whose injury had immediately triggered dizziness were at greater risk of a prolonged recovery.

Of the 87 who'd had dizziness, 34 -- or 39 percent -- needed three weeks or more to get the medical OK to return to the sport. And their odds of a long recovery were seven times higher versus players who had not suffered dizziness.

"We believe that dizziness is an important factor in length of recovery," lead researcher Dr. Brian C. Lau, of the University of Pittsburgh Medical Center, told Reuters Health by email.

He said that's largely because dizziness serves as a "proxy" for various problems that a head injury can cause -- such as difficulty with balance, spatial orientation and cognition (feeling like your brain is "foggy").

The study comes amid increased attention to concussions among high school athletes. One recent report found that such injuries have quadrupled in the past decade, with football players most likely to suffer them (see Reuters Health report, February 25, 2011).

If a person still recovering from a concussion suffers a repeat blow to the head, the effects can be serious -- including the so-called "second-impact syndrome," which can cause potentially fatal bleeding inside the skull and brain swelling.

Experts recommend that young athletes with a possible concussion be assessed right away on the field by an athletic trainer. And those later diagnosed with a concussion should wait for a doctor's OK before returning to play.

Yet athletes can feel pressure to return too quickly, Lau pointed out.

"If we can better predict which athletes will require a longer recovery time," he said, "we may be able to establish guidelines to mitigate the pressure to return quickly."

The current findings, published in the American Journal of Sports Medicine, are based on 107 Pennsylvania high school football players who sustained a concussion on the field. All had their immediate symptoms evaluated by an athletic trainer or team doctor.

Those symptoms ran the gamut from headache, dizziness and vision and balance problems, to fatigue, confusion, amnesia and personality changes.

But overall, dizziness was the only symptom linked to the odds of a prolonged recovery (three weeks or more).

In all, 36 players had a prolonged recovery, nearly all of whom had dizziness as an initial symptom. Another 62 had a "rapid" recovery of one week or less.

It was surprising that no symptom other than dizziness was related to the odds of a long recovery, according to the researchers.

And Lau said that finding should be interpreted cautiously. More studies are needed, he said, to rule out a link between other concussion symptoms and recovery time -- and to verify that dizziness is, in fact, a good predictor of recovery speed.

He also pointed out that this study was limited to male high school football players. So the findings may not necessarily apply to all athletes.

For now, Lau advised that young athletes and parents not "ignore" any of the signs and symptoms of a concussion, and instead see a doctor.

"You are doing yourself and your team better by taking the time to fully recover," he said.

SOURCE: bit.ly/okHat9 American Journal of Sports Medicine, online June 28, 2011.

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