Why head injuries affect girls differently than boys

Young female soccer athlete is dazed while ER doctor asks her questions. The girl has an icepack on her head. The girl's mom is in the background.

Bumps and bruises are a normal part of childhood, especially if your young one is a fan of playground activities, like capture the flag or jump rope, or is involved in organized sports. Team sports help kids and adolescents form friendships, boost self-esteem and get physically active, but they also increase the risk of injury – the most frightening of which tend to be injuries to the head and brain.

Some 45 million children and adolescents in the U.S. are involved in organized sports. In 2013, team and group sports were the leading cause of injury-related hospital visits among older children, young adults and males, and research suggests, certain sports, like football, field hockey, soccer and basketball, pose a greater risk for head injury.

“The number of athletic head injuries has been going up significantly over the last 10 years and I think that’s more a function of awareness than anything else,” says Robert Abramson, MD, a neurosurgeon with Doctors Hospital of Augusta in Augusta, Georgia. “These things are being reported a whole lot more.”

Here’s what else Dr. Abramson had to say about cranial contusions, from detection to recovery and more.

Girls are at a greater risk

Teenage girls involved in team sports are more likely to sustain head injuries, according to a 2017 study that analyzed 27 sports in 147 U.S. high schools.

This is true even for boys and girls playing the same sports. Results from a review of 15 college sports suggests female softball players were two times more likely to experience concussions than male ball players. Another study of high school athletes suggests female soccer and basketball players endure head injuries more frequently than male classmates.

The exact reason for these disparities is somewhat unclear, but experts have a few theories. For one, girls may be more apt to report a bump on the head.

There’s more. “I think one thing that is apparent is that musculature in the shoulders and neck, especially in younger girls, is not as strong,” Dr. Abramson says.

The strength of your neck muscles may indicate the likelihood of a head injury, especially during sports like soccer, where athletes often make contact with the ball using their heads. Boys and men typically have stronger necks than girls and women, which may explain the lower rate of concussions.

Gender and recovery – the shocking difference

Research seems to suggest the post-concussion recovery period is longer for girls than boys.

A 2017 study of 212 male and female athletes between the ages of 11 and 18 suggests young women may exhibit symptoms of a head injury, like headache, nausea, fatigue and irritability, for a longer period of time. On average, girls reported symptoms up to 17 days longer than boys.

“Girls tend to be more responsible in reporting symptoms, but that doesn’t explain all of it,” Abramson says. “There are probably some hormonal factors that go along with it, too.”

Results from one study of 144 women between the ages of 16 and 60 suggest women who endured a head injury in the two weeks before their period – when progesterone levels are low – took longer to heal than those with an injury sustained in the two weeks following a period. Women taking birth control pills were also slower to heal.

Signs you shouldn’t ignore

Head injuries shouldn’t be ignored, and there are some serious indicators your young one should be seen by a medical professional. This type of head injury often presents with physical, cognitive and emotional symptoms.

“The things to look for in children are headache, dizziness, nausea, vomiting and irritability,” Abramson says.

Other common signs include:

  • Difficulty thinking and concentrating
  • Inability to remember new information
  • Blurred vision
  • Problems with balance
  • Sadness or anxiety
  • Changes in sleep, including snoozing more or less or having trouble dozing off

Onset of these symptoms may occur immediately after the injury, or appear hours, days or even months later. Adults caring for children should keep a close watch for worrisome symptoms and seek care when necessary. If signs worsen or will not go away, it’s a good idea to see a doctor.

Rest, including a break in physical and mental activity, is the key to a healthy recovery. Jumping back into daily activities before full recovery can make symptoms even worse and lengthen the recovery period.

Another reason to report injuries to your doctor? For some, the effects of traumatic brain injuries last long beyond the initial impact. Issues with memory, reasoning, balance, communication and depression can persist for years. Head injuries can also lead to conditions like Alzheimer’s disease and epilepsy.

Prevention strategies that really work

“Studies have been done on kids that have had concussions, and they are more prone to progress to undisciplined behavior, like drinking and taking drugs,” Abramson says. So, preventing head injuries, whenever possible, is important.

It’s not always possible to prevent head injuries, but there are some proven techniques to reduce your child’s risk of traumatic brain injuries. These precautions won’t eliminate a child’s risk for a bump on the head altogether, but they will likely reduce the severity of an injury.

Seeking out parks and playgrounds with shock-absorbing surfaces is one way to protect your children from serious fall-related head injuries. Wearing the proper helmet during activities like contact sports, bike riding, skateboarding, snowboarding, horseback riding, snowmobiling or riding a motorcycle can help prevent traumatic brain injuries.

Motor vehicle accidents can also cause serious head trauma. To protect your passengers, ensure older children and adults fasten their seatbelts, and small children are secured in the proper car seat.

For more tips to prevent head injuries, speak with your healthcare provider.

About HCA Healthcare

HCA Healthcare, one of the nation's leading providers of healthcare services, is comprised of 183 hospitals and more than 2,300 sites of care, in 20 states and the United Kingdom. Our more than 283,000 colleagues are connected by a single purpose — to give patients healthier tomorrows.

As an enterprise, we recognize the significant responsibility we have as a leading healthcare provider within each of the communities we serve, as well as the opportunity we have to improve the lives of the patients for whom we are entrusted to care. Through the compassion, knowledge and skill of our caregivers, and our ability to leverage our scale and innovative capabilities, HCA Healthcare is in a unique position to play a leading role in the transformation of care.

Recent articles