Objective To determine if gender plays a role in clinical presentation and recovery in concussion.

Design Retrospective

Setting one clinic

Participants 207 athletes (115 females, 92 males) presenting to clinic from September 2014 – January 2016. 79 athletes achieved clearance. Inclusion: sports or exercise, age 10–60 yrs.

Exclusion non-sports

Outcome measures Athletes completed computerised neurocognitive testing and physical assessments. A physician-led interdisciplinary team treated each athlete until resolution of signs and symptoms. Athletes were grouped by gender into recovery time groups (0–2 mo.; 3–5 mo.;≥ 6 mo.). An analysis by gender, age, symptoms, neurocognitive data, and concussion features was performed.

Main results Females report higher post-concussion symptom scores than males (p<0.0002).Females had a higher total number of features 4.5 to 3.6(p<0.00003). With respect to recovery, 34% of all males in our study were discharged within 0–2 mo. of injury date, compared to 12% of females. Females continued to experience symptoms at ≥ 6 months. Overall, females had a longer recovery period than males (p<0.002). Among discharged females, those requiring longer treatment (≥3 mo) were of a more mature age (23.8±13.2), presented later to clinic (t=3.3±3.6 mo.)and reported moresymptoms (PCSS=40.83±19.53).

Conclusions Female athletes present with higher post- concussion symptom scores and clinical features than their male counterparts. Mature females who later for treatment have a protracted recovery. Athletes of both genders who seek care earlier in the injury process have a shorter recovery.

Competing interests None.