Teen girls who survive traumatic brain injuries are at higher risk of being involved in problematic behavior, new research shows. 

Researchers found 13 risky health behaviors such as suicidal thoughts, smoking marijuana, or binge drinking in girls who suffered some form of brain injury.

9,288 students in grades 7 through 12 from Ontario, Canada participated in the study. Traumatic brain injury was defined as any hit or blow to the head that caused the individual to knock out for at least five minutes or spend at least one night in hospital due to head injury symptoms.

Researchers found that both boys and girls were more likely to indulge in risky behaviors, but girls engaged in harmful behavior more than boys.

"Both boys and girls were more likely to engage in a variety of harmful behaviors if they reported a history of TBI, but girls engaged in all 13 harmful behaviors we looked for, whereas boys were at higher risk of engaging in only nine," said lead researcher Dr. Gabriela Ilie, a post-doctoral fellow at St. Michael's Hospital. "Sex matters when it comes to traumatic brain injuries."

The findings revealed that girls who survived traumatic brain injuries were more likely to smoke cigarettes, been victims of bullying, had suicidal thoughts or suffered significantly more psychological stress.

"Traumatic brain injuries are invisible but ignorance is not an excuse," added Ilie. "Parents, clinicians, teachers and coaches need to take all brain injuries, including concussions, seriously because their effects can affect students' formative years."

Dr Robert Mann, senior scientist at Center for Addiction and Mental Health and director of the Ontario Student Drug Use and Health Survey explained that the association between traumatic brain injury and mental health issues needs to have a greater focus on prevention.

"Many harmful behaviors in adolescence can be precursors to addiction and mental health issues later in life," he said.

The findings are published in the journal PLOS ONE.