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The topic of concussions in sports gets a lot of attention in the media, and there's good reason for it. After all, it's the most common type of mild traumatic brain injury (TBI) sustained by Canadians, and the federal government has issued guidelines to help with decisions on diagnosis management and treatment.
But a less talked-about piece of the story is that it can also take females longer to recover from a concussion.
A team of researchers, led by Toronto Rehab Senior Scientist Dr. Angela Colantonio, have taken us closer to understanding why.
According to their study, females are more likely to sustain a neck injury at the time of a concussion.
Because symptoms, including headache, fatigue, and dizziness, can overlap, it's not clear to what extent these injuries may be missed during an initial screening.
"It's been hypothesized that weaker neck muscles in females may be one of the reasons they have an increased risk of sustaining a neck injury, along with a concussion," says Dr. Colantonio, whose team are leaders in sex- and gender-specific TBI research. "We set out to see if females did, in fact, have more neck injury with concussion."
By examining the health records of more than 90,000 female and male patients admitted to an Emergency Department in Ontario with a mild concussion, the researchers were able to support this hypothesis.
"Our findings show significantly higher neck comorbidity among females than males – whether the concussions were caused by sports, motor-vehicle collisions, or physical abuse," says Dr. Colantonio.
The case for increasing sex- and gender-specific knowledge
The team's work emphasizes a knowledge and practice gap in understanding concussions, and calls for more sex- and gender-informed guidelines and considerations for a broader range of people.
This could include increased consideration for screening for a neck injury, when females are admitted to the emergency room with a concussion, as well as improved protective equipment and road safety measures that support head and neck health.
Sex- and gender-specific concussion research is more relevant now than ever before. In fact, between 2002 and 2012, the 10-year period of health records reviewed by Dr. Colantonio's team, the number of concussions documented in emergency room visits in Ontario increased by more than 80 per cent for females, and less than 20 per cent for males.
"There is an appetite to learn more about sex and gender differences in concussion, and this study illustrates the importance of this growing field," says Dr. Colantonio.
"The ultimate, for me, is to ensure we give the best care in the area of concussion injury, and this study supports our journey."