What is the prevalence of postconcussion syndrome (PCS)?

Updated: Sep 24, 2018
  • Author: Eric L Legome, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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More than 1 million instances of minor head injury occur in the United States each year. The overall incidence rate of minor head injury for persons not hospitalized, with data compiled by the National Hospital Ambulatory Medical Care Survey, was 503 per 100,000 population or 1,367,101 visits per year to hospital EDs in the United States. [10]  Depending on the definitions used and population examined, approximately 50% of patients with minor head injury have symptoms of postconcussion syndrome at 1 month and 15% have symptoms at 1 year. The number of patients who sustain minor head injury and do not present for medical care is unknown; therefore, the number of patients with PCS is likely significantly underdiagnosed.

Morbidity is mainly due to the persistence of symptoms, which make it difficult for patients to resume premorbid functions. Between 14 and 29% of children with mild traumatic brain injury will continue to have postconcussion symptoms at 3 months. [11, 12]

Fifty percent of those who experience minor head injury are aged 15-34 years. However, postconcussion syndrome has no predilection for any specific age group. [1, 13]

Approximately 500,000 children a year visit the ED for traumatic brain injuries (TBIs). TBIs are largest cause of ED visits for adolescents. Eighty to ninety percent of these are mild (mTBIs), or concussions, and are not life-threatening, but even a mild TBI can have ongoing effects. Young children are more susceptible to concussion than adults not only because they are more likely to be active and involved in sports but also because their brains are not yet fully developed and therefore are more vulnerable to injury. [14]

According to the University of Pittsburgh's Brain Trauma Research Center more than 300,000 sports-related concussions occur annually in the United States, and the likelihood of suffering a concussion while playing a contact sport is estimated to be as high as 19% per year of play. More than 62,000 concussions are sustained each year in high school contact sports, and among college football players, 34% have had one concussion and 20% have had multiple concussions. Estimates show that between 4 and 20% of college and high school football players will sustain a brain injury over the course of one season. The risk of concussion in football players is 3 to 6 times higher in players who have had a previous concussion. [15]

A study conducted by McGill University found that 60% of college soccer players reported symptoms of a concussion at least once during the season and that concussion rates in soccer players were comparable to those of football players. Athletes who suffered a concussion were found to be 4 to 6 times more likely to suffer a second concussion. [16]

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