The more we think we understand concussions, the more we discover how much we have to learn. One of the most intriguing areas for exploration is how women and men experience concussions differently and what explains these differences.
While it’s still an emerging area of study, the closest thing to a consensus right now is that it’s unclear if women are at greater risk of suffering concussions, but that it’s clear the effects are more severe and long-lasting when they do.
Risk
How you assess the former issue depends somewhat on your point of reference. Overall men are more likely to suffer concussions and similar brain injuries, particularly at younger ages. However, this could largely be caused by men engaging in activities with a greater risk of head injury, particularly sports.
When you compare like for like, it’s a different picture, with women more likely to suffer head injuries when engaged in the same activity. For example, National High School Sports-Related Injury Surveillance data showed 8.4 out of every 10,000 girls playing soccer suffering a concussion, compared to 3.5 per 10,000 for boys. Such comparisons do come with a big caveat however: females may be more likely to report suffering a concussion with males culturally encouraged not to complain or to avoid the risk of being pulled from a game and “letting down” teammates or losing a spot.
Effects
The differences are more clear-cut with the effects of concussions. Several reports show women suffering considerably longer-lasting and more severe effects. For example, expert Tracey Covassin told Everyday Health that females could typically suffer effects for three to four weeks, twice as long as typical males. Other studies suggest that women are more likely to suffer specific symptoms such as nausea, headaches and drowsiness.
Causes: Medical
Isolating the biological reasons for these variations is also an ongoing task, though researchers have cited four main possibilities.
Women, particularly in adolescence, have weaker neck muscles. That can mean the head moves more after impact. Remember that the root cause of concussion is not so much the impact to the head itself, but rather than the resulting brain movement inside the skull.
Females may be more likely to have pre-existing head conditions such as migraine headaches. These may not make a concussion more likely but could certainly magnify the resulting symptoms.
The axons — the network of fibers that carry electrical signals around the brain — tend to be thinner in females. That increases the chances of them breaking as a result of head trauma. (In a related issue, nerve signals appear to be slower in females, meaning it takes longer to ‘heal’ from a concussion by rerouting neural pathways around the damaged section of the brain.)
Perhaps most intriguingly, sex hormones may play a role. Concussions can cause the brain to significantly slow its production of progesterone, a hormone that’s primarily designed to aid the early stages of pregnancy but has side benefits for memory and cognition. The natural levels of progesterone are highest in the later stages of the menstrual cycle and it appears women at these stages suffer worse symptoms when they have a concussion. The theory is that the sudden drop in progesterone caused by the concussion is more dramatic (simply because it has further to fall), resulting in disorientation and headaches.
Causes: Cultural
Cultural issues may also be at play, particularly in youth sport. Girls may be more likely to play sports not associated with the risk of head trauma and thus be less likely to benefit from immediate assessment and treatment from pitch-side medical staff.
Meanwhile, men are more likely to play sports such as football where contact is expected and thus bracing for impact and wearing protective headgear is the norm. Contrastingly women could be more likely to play sports where head trauma results from accidental and unexpected collisions.
One particularly grim factor to take into account regards the statistics for long term effects of severe head trauma. A woman who suffers a severe head injury, particularly from an intentional assault, is more likely to die from the impact than a man in the same position. By definition that means they won’t show up in figures measuring long-term or permanent damage.
The Future
Continuing to explore the differences in concussions between the genders will bring multiple benefits. It will teach us more about specific measures that could help women with prevention, diagnosis and treatment of severe head trauma. It may also help us learn more about the causes of concussions and how to effectively treat them.
Your Next Step
If you suffer a concussion or its related symptoms after head trauma, you should always seek expert medical guidance as a matter of priority. If your condition was caused or worsened by negligence, or if the effects were magnified by inadequate diagnosis or treatment, you may have a case for legal action. Contact Bennett Injury Law today to learn more and explore your options.
