Concussions tied to more school problems than other injuries

High school and college students who getconcussions may struggle more with academics than their peerswho get other types of sports injuries, a small U.S. studysuggests.

Researchers surveyed 70 students who received emergencytreatment for concussions and 108 teens and young adults treatedfor other injuries.

With a concussion, students took an average of 5.4 days toreturn to school, compared with 2.8 days for other injuries.

One week after getting hurt, 42 per cent of the students withconcussions received academic help such as tutoring or extratime for tests, compared with 25 per cent with other injuries.

After a concussion, there is an energy crisis in the brain;the brain needs more energy to heal than ithasavailable.-ErinWasserman

One month afterwards, 31 per cent of the concussion group gothelp, as did 24 per cent of the other students.

"After a concussion, there is an energy crisis in the brain;the brain needs more energy to heal than ithasavailable,"saidlead study author Erin Wasserman of the University of NorthCarolina at Chapel Hill.

"Because of this, individuals experience symptoms likeheadache and dizziness, they have trouble sleeping, they may
experience depression, and they often have trouble concentratingand remembering things," Wasserman, who completed the study atthe University of Rochester, said by email.

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"All of these symptoms are known to cause problems inschool," Wasserman added.

To assess how concussions impact schoolwork, Wasserman andcolleagues surveyed student athletes treated at three emergencydepartments in the Rochester, New York, area from September 2013to January 2015.

School performance, headaches and dizziness

They excluded students who went to the emergency departmentmore than 24 hours after the injury or who were hurt badlyenough to require a hospital admission.

For the comparison group without concussions, researchersonly included athletes with isolated injuries to theextremities, such as an arm broken in one place. Concussedstudents were excluded if brain scans showed what's known asacute intracranial lesions, or badly damaged tissue.

Researchers asked about symptoms and school performance oneweek and one month after injuries. Questions touched on thingslike their concentration skills, ability to do well on tests orquizzes, and symptoms like headaches and dizziness. Scoresranged from 0 to 174 with higher scores indicating worseacademic difficulties.

At one week, 83 per cent of the concussed students reportedimpairments in at least one area that they didn't experiencebefore the injury, as did 60 per cent of students with extremityinjuries, researchers report in theAmerican Journal of Public Health.

Also at one week, concussed students had academicdysfunction scores 15 points higher on average than their peers
with other injuries at 63 and 48, respectively. After one month,though, their scores were similar: 42 with concussions and 40with other injuries.

One limitation of the study is that 24 per cent of concussedstudents hadn't returned to school within a week of their injuryand were excluded from the analysis. That may mean only theless-impaired students were included and for others impairmentafter concussion could be worse than observed in the study.

Vision problems, difficulties with eye movements

With concussions, students may also have vision problems ordifficulties with eye movements that impact school performance,said Anthony Kontos, research director of the sports medicineconcussion program at the University of Pittsburgh MedicalCenter.

"Some students may experience difficulty shifting from nearto far like from a textbook to a chalkboard following
concussion," Kontos, who wasn't involved in the study, said byemail.

With the potential for vision and concentration issues aswell as symptoms like headaches and dizziness to complicateschoolwork, doctors advise students to take frequent breaks andtry to stop work before symptoms get bad, said Dr. John Leddymedical director of the concussion management clinic at theUniversity at Buffalo.

"We don't know for sure what the cause of difficulty withconcentration and memory in school is but a common report isthat of cognitive intolerance; that is, students cannot do theirwork for sustained periods of time before becoming very fatiguedand thus unable to process new information," Leddy, who wasn'tinvolved in the study, said by email.

"Academic problems likely reflect an issue of cognitiveintolerance due to an inefficient brain after concussion," Leddy
added.