Abstract
Background:
Concussion is a growing area of concern, with 3.9% of all children having been diagnosed with concussion. As much as 1% of the population is affected by a bleeding disorder. While there has been extensive research on intracranial hemorrhage in those living with bleeding disorders, there is a large knowledge gap regarding mild TBI and concussion in this patient population. There are no studies to date exploring demographics, injury patterns, symptom profiles, or recovery rates.
Hypothesis:
For this descriptive study, we hypothesized similar characteristics to a generalized youth concussion cohort.
Methods:
Data were collected from a prospective registry at a tertiary care pediatric hospital sports medicine program between 2017 and 2025. The presence of underlying bleeding disorder was identified using ICD 10 codes (D65-D69, Z14.02).
Results:
A total of 67 patients with an age range from 6-18 with bleeding disorders were treated for concussion during the study period. 55% were male and 86.6% held private medical insurance. Almost half were sport related (48.3%). A majority of patients were Non-Hispanic white (73.1%). 70.1% of patients remained under the care of a sports medicine provider for longer than 28 days from their injury.
Conclusion:
This is the first study exploring the relationship of concussion with bleeding disorders. Patients living with bleeding disorders do remain active, as half of our cohort had a sport-related injury. Recovery times may be longer in those with bleeding disorders, as 70% of this cohort was still under our care >28 days from their injury. This is higher than has previously been observed in this registry with 38-50% experiencing prolonged recovery. It is not clear whether this prolonged time in care is related to physiological factors within the neurovascular system or to more sociological factors, as parents and clinicians may be monitoring longer in this population. Further research is needed to explore this prolonged recovery as well as to determine if there are any differences among the various bleeding disorder diagnoses or if there is any effect to the severity of hemophilia, use of factor prophylaxis, presence of inhibitors or other factors of disease control.