Persisting Concussion Symptoms: Vulnerability of Females from Motor Vehicle Crashes
By Kira Kunzman. This article was initially published in the 10/9/25 edition of our Concussion Update newsletter; please consider subscribing.
A retrospective study by Tator et al., published in the Journal of Neurotrauma, examined patients from the Canadian Concussion Centre who sustained concussions with persisting symptoms (C+PCS) following motor vehicle crashes (MVCs). The study consisted of data collected from 2000 to 2020 of 136 patients who experienced at least one C+PCS symptom lasting at least one month. Notably, 69% of the patients identified as female, despite the fact that male drivers are statistically more likely than female drivers to be involved in MVCs in Ontario. This finding suggests that female drivers may be at a higher risk of developing persisting symptoms after a concussion, despite being involved in fewer collisions overall. The authors note that "Complete recovery from C+PCS was rare, and most patients with known follow-up continued to suffer from persisting symptoms for months to years."
The study collected detailed information regarding demographics, crash dynamics, injury characteristics, recovery patterns, and persistent symptom profiles. Within the data, the typical C+PCS patient was described as a "belted female driver, often completely stopped in traffic, and then struck from behind by another vehicle." The "bobble-head effect" (the rapid back-and-forth movement of the head during vehicular impact, with the possibility of the head striking other parts of the automobile, such as the steering wheel or window) was often reported as the reason for injury. Given previous findings from sport-related concussion research, the authors propose that females' reduced neck muscle strength and lower effective head mass (which would increase the "bobble-head effect") could be a potential cause for the discrepancy between male drivers and female drivers' C+PCS vulnerability.
The study concludes that existing vehicle safety mechanisms are inadequate for preventing concussions, particularly in rear-end collisions. It recommends rethinking occupant protection systems to better prevent head injuries, especially in female passengers. Enhanced strategies might include additional airbags, improved cabin padding, and advanced head restraint systems. As the study concludes, "automobile engineers, automobile manufacturers, and governments should be encouraged to improve vehicle occupant safety systems to prevent concussions with a focus on female occupants in rear-end collisions who are at high risk of concussion."
