Sex Specific Post-concussion Symptom Reporting in Adolescents: A Systematic Review and Meta-analysis

Previous research indicates that concussion symptom presentation is population specific, with differences based upon patients' sex and age. Awareness of signs and symptoms of concussion in youth and high school sports has improved in recent years. However, it is still widely unknown if sex specific differences emerge in adolescent populations, as the majority of research been performed on collegiate athletes or has combined adolescent and adult concussion patient populations. Identification of sex specific differences in adolescent concussion symptoms, or lack thereof, would aid in concussion diagnosis and management. Therefore, the objective of the current meta-analysis and systematic review was to evaluate the literature and determine if a relationship exists in post-concussion symptom reporting between male and female adolescent athletes. An extensive search of PubMed, SPORT Discs, Web of Knowledge, Cochrane Library, ProQuest and Google Scholar was undertaken. Search terms were based on the individual database. Studies meeting inclusionary criteria underwent quality assessment. A total of three articles met inclusionary criteria and were deemed of high methodological quality. The meta-analysis examined differences in symptoms reported between sexes in 1421 adolescent athletes (770 males, 669 females). A significantly higher percentage of females reported concentration difficulty, drowsiness, visual disturbance, and sensitivity to noise compared to males. Males reported more amnesia and irritability than females. The results of the current meta-analysis indicate differences in the presentation of commonly reported post-concussion symptoms between the male and female adolescents.