Symptoms upon postural change and orthostatic hypotension in adolescents with concussion

Objective: Concussion is associated with dysautonomia, altered blood pressure (BP) control, and may cause Orthostatic Hypotension (OH). We measured prevalence of OH using the 1-minute supine-to-standing OH Test in adolescents with concussion and controls. Participants: Adolescents within 10 days of injury (Concussion Group, n = 297, 15.0 +/- 1.7 years, 59% male) were compared with controls (Control Group, n = 214, 15.0 +/- 1.5 years, 58% male). Methods: BP, heart rate (HR), and complaints of lightheadedness/dizziness were measured after 2-minute supine and 1-minute standing. Control Group was assessed once. Concussion Group was assessed twice; (1) initial visit (mean 6.0 +/- 3 days-since-injury) and (2) after clinical recovery (mean 46.3 +/- 42 days-since-injury). Results: Initial visit; Concussion Group reported feeling lightheaded/dizzy on postural change more often than the Control Group (37% vs 4%, p < .001) but did not differ in meeting standard OH criteria (3% vs 5%, p = .32). Experiencing symptoms did not correlate with meeting OH criteria, but correlated with abnormal vestibulo-ocular reflex. After clinical recovery; Concussion Group did not differ in experiencing lightheaded/dizziness on postural change than controls (4%, p = .65). Conclusion: Adolescents commonly experience orthostatic intolerance after concussion without meeting the standard criteria for OH.

Automated summary

This study found that adolescents commonly experience orthostatic intolerance after concussion, even if they do not meet the standard criteria for Orthostatic Hypotension. Symptoms of lightheadedness/dizziness were reported more frequently in the Concussion Group compared to controls.