Do Multiple Concussions Lead to Cumulative Cognitive Deficits? A Literature Review.

A concussion is an important health concern for children and adolescents, particularly in the context of sporting injuries. Some research suggests a cumulative effect from multiple concussions (also referred to as mild traumatic brain injury), which creates a dilemma when considering how to manage children and young persons who may experience multiple concussive events within a sporting season. However, there is very little research regarding the outcomes of multiple concussions and their optimal management. The purpose of this review is to evaluate the evidence regarding the cognitive outcomes of multiple concussions. After assessing the eligibility of the articles from the literature search, 7 studies were identified and included in the review. In most of the available literature, the cognitive outcomes related to multiple concussions are measured during the same developmental age as when the injuries happened. Moreover, most studies that investigated multiple concussions are focused on sports-related injuries, and only some are conducted in children and adolescents in the general population. The current evidence is inconclusive; whereas some studies reported adverse outcomes, others reported null findings. The studies that reported adverse or cumulative effects based their findings on worse cognitive outcomes, more subjective symptoms, and prolonged recovery postinjury.

LEVEL OF EVIDENCE: II.