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How long does the brain rest after a concussion?


A concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, stretching and damaging the brain cells and creating chemical changes in the brain.

Concussions are common, particularly in certain sports like football, hockey, soccer, rugby, and boxing. But concussions can happen to anyone from a fall, car accident, assault, or other causes. When the brain gets injured from a concussion, it needs time to heal and recover. But how long does it take for the brain to fully rest and recuperate after a concussion?

Acute Recovery Time

The initial recovery time after a concussion is often referred to as the acute recovery phase. This covers the time from when the concussion first occurs to when the primary symptoms like headache, dizziness, confusion, and fatigue improve.

Studies show that for adults, the average length of acute concussion recovery is 10-14 days. However, each concussion and each person is unique. Around 80-90% of people will fully recover from concussion symptoms within 1-2 weeks, but a minority of patients can take over a month to feel back to normal.

Some factors affect the speed of acute concussion recovery:

Age

Younger patients like children and teens tend to take longer to recover than adults. One study found average acute symptom recovery was around 21 days in kids vs 11 days in adults. The developing brain may be more vulnerable to injury.

Number of Concussions

People who have had previous concussions often take longer to get over a new concussion. Each concussion causes more damage and makes the brain more sensitive to injury.

Severity

Patients with either prolonged loss of consciousness or amnesia at the time of injury tend to have more severe concussions. More serious concussions result in more acute symptoms and longer recovery.

Gender

Some research shows females can take longer than males to recover in the acute phase, but findings are mixed. Females may report more symptoms at baseline than males.

Individual Factors

Every person’s concussion is unique based on individual variations in brain structure, health status, genetics, and other factors. Recovery time can vary widely between different people with similar concussions.

Post-Concussion Syndrome

For some patients, concussion symptoms can persist for weeks or months beyond the normal acute recovery period. When symptoms like headache, dizziness, and foggy thinking last for over 1 month, this is diagnosed as post-concussion syndrome (PCS).

Studies show approximately 15-30% of concussion patients develop PCS. The average recovery time for PCS is around 3 months, but can range from 1 to 6 months recovery or even longer in rare cases.

Risk factors for developing post-concussion syndrome include:

Female Gender

Female patients have almost double the risk of PCS compared to males. The reason is unclear, but may involve differences in neck strength, neurophysiology, or how symptoms are reported.

Prior Concussions

A history of previous concussions is linked to increased risk of PCS. Each concussion may lower the threshold for developing persistent symptoms.

Mood Disorders

Pre-existing mental health problems like depression and anxiety are associated with greater odds of having symptoms beyond 1 month. Stress can compound symptoms.

Migraines

Patients with a history of migraines tend to have longer-lasting concussion symptoms. Migraines involve existing abnormalities in brain excitability.

Age

Younger patients who take longer to recover acutely are more prone to PCS. Children and teens with still-developing brains may have more vulnerability.

With proper rest and recovery, most patients fully return to normal function within a few months. But PCS can occasionally become chronic and last over a year, requiring more intensive rehabilitation.

Full Brain Recovery

The acute symptoms of concussion like headache and dizziness reflect temporary dysfunction in brain cells. These cells are stressed by the injury, but usually recover and start working properly again within days to weeks.

However, the metabolic changes and damage to connections between brain cells can persist longer than the acute symptoms. Full recovery likely takes much longer than the outward symptoms would indicate.

Studies using advanced neuroimaging show metabolic, blood flow, and structural abnormalities can last months after injury in some patients – even those who feel back to normal. Increased inflammation, reduced brain blood flow, altered neural networks, and microscopic bleeding can continue.

This means at a microscopic level, the concussion-injured brain may not be functioning fully normal for weeks to months after the accident. Complete rebalancing of chemicals, regenerating of connections, and healing of tiny bleeds takes time.

Full recovery likely overlaps with the normal aging process. The accumulating effects of repeated subconcussive impacts over a sports career, for example, may never fully heal. Ongoing subtle impacts from daily living also play a role.

While active concussion symptoms tell us the acute recovery timeline, we do not have metrics for definitively determining when the brain is 100% healed after concussion. Doctors clearance patients to return to activity once symptoms are gone, but that does not necessarily mean the brain has finished recovering at a deeper level.

Factors Affecting Overall Recovery

Many factors affect the overall timeline for the brain to fully heal and restore normal function after concussion:

Age

Younger brains recover more slowly but have more neuroplasticity. The aging brain takes longer to bounce back and may never fully recover due to poorer regenerative capacity.

Previous Concussions

The more prior concussions, the longer full recovery takes. Each concussion compounds damage and makes subsequent injuries worse.

Concussion Management

Proper rest, avoiding dangerous activities, following medical advice, and not returning to risky sports too soon all support optimal healing. Poorly managed concussions prolong recovery.

Overall Health

Good nutrition, fitness, hydration, sleep habits, and treating other medical conditions improve outcomes. Unhealthy lifestyles hamper the brain’s ability to fix itself.

Cognitive and Physical Activity

Light cognitive stimulation and physical activity during recovery help the brain rebalance and make new connections. Excessive training too soon or constant high cognitive load slow healing. Finding the right balance maximizes recovery.

Stress Level

Lower stress during recovery aids healing. High stress levels prolong concussion symptoms and full recovery. Using stress and anxiety reduction techniques improves outcomes.

Conclusion

Acute concussion symptoms typically resolve within 10-14 days for most patients. However, the concussed brain likely needs weeks to months for full metabolic recovery and structural restoration at a microscopic level. Factors like age, previous head injuries, health, and lifestyle all affect complete healing time. While full brain recovery cannot be measured precisely, optimizing rest, lifestyle, and recovery habits gives the brain its best chance to fix itself after concussion. With proper management, most patients make a full recovery. But some effects of brain injury can persist for the long term.