Concussion Symptoms May Differ in Girls and Boys

Expert: Parents, Coaches Should Be Aware of Gender Differences

Medically Reviewed by Laura J. Martin, MD on December 07, 2010

Dec. 7, 2010 -- A new study looking at concussions in high school athletes suggests that girls may describe those head injuries differently than boys do, and experts fear that may cause parents and coaches to miss telltale signs that the brain has been badly jolted.

"Because male and female athletes may have different types of symptoms, they may present differently to health care professionals," says R. Dawn Comstock, PhD, an associate professor at Ohio State University, who co-authored the study. "So what that means is that not just health care professionals, but also clinicians, athletic trainers, and parents and coaches all need to be aware of higher rates of nontraditional symptoms of concussions and 'when in doubt, sit them out,'" she says.

The study, which was published in the Journal of Athletic Training, found that while headaches were the most frequently reported symptom of concussions in both girls and boys ­-- more than 95% of athletes of both sexes reported having headaches after bad head blows ­-- secondary symptoms tended to differ quite a bit between the sexes.

About half of boys, for example, reported being confused or disoriented after a head injury, while slightly more than a third of girls reported being confused under the same circumstances. And more than twice as many boys as girls reported having amnesia as part of a concussion.

Girls, on the other hand, were three times more likely to report being sensitive to noise after being hit in the head. And almost 1 in 3 girls reported feeling drowsy, compared to 1 in 5 boys.

Previous studies have noted that female athletes experience higher rates of concussions in sports than males do, and some research has suggested that women may fare worse after traumatic brain injuries than men do, experiencing brain swelling more frequently and facing longer hospitalizations and longer recovery times.

The study, which included reports of 821 sport-related concussions from hundreds of U.S. high schools over two years, from 2005 through 2007, found no differences in recovery times in boys or girls. Both sexes usually felt better within about three days or less and many returned to play within six days of their injury.

Loss of consciousness, once thought to be necessary before a concussion could be diagnosed, was one of the least reported symptoms.

“It’s kind of an old wives’ tale now, but once it was thought that you didn’t have a concussion unless you had a loss of consciousness. That used to be a widespread belief, but we know that’s just not true. It’s exactly the opposite,” Comstock says. “Of all the data we’ve collected over the last five years on thousands and thousands of concussions we know that less than 5% present with loss of consciousness. So since we cannot use loss of consciousness as a means of diagnosing concussion or as a way to judge the severity of a head injury, these gender differences become all the more important.”

Show Sources


Frommer, L. Journal of Athletic Training, February 2011.

R. Dawn Comstock, PhD, associate professor, Ohio State University.

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