Concussions

Most everyone has heard about someone “getting their bell rung” in sports.

A concussion is not a simple matter and should not be taken lightly. A concussion is the result of a blow to the head or when the head strikes another object. Not every impact to the head requires immediate physician intervention, but every concussion needs to be taken seriously.

Physicians often grade concussions using various scales including the Cantu Scale or the American Academy of Neurology Concussion Grading Scale. These scales focus mainly on loss of consciousness and post traumatic amnesia. Another approach to a concussion is to focus attention on the symptoms of the athlete.

Symptoms of concussions can be mild to severe. Signs that someone needs to seek medical attention immediately are worsening headaches, numbness, weakness, decreased coordination, and repeated vomiting. A concussed individual should go to an emergency department immediately if they are becoming more confused, restless or disturbed, start slurring their words, have a seizure or convulsion or cannot be awakened. It is currently recommended that any athlete who loses consciousness (even brief) be evaluated in an emergency department.

Some other symptoms to monitor are recurrent headaches, difficulty concentrating, slowed responses, confusion, fatigue, dizziness, increased sensitivity, ringing in the ears and mood changes. Often times the athlete will just not seem “their self” or act “normal.” Signs and symptoms of a concussion vary between individuals.

How do you determine when to return to play? This is determined by the number and severity of concussion symptoms. As with the signs and symptoms, return to practice and play will vary with each individual. No athlete should be allowed to return to play while signs and symptoms persist.

An individual who returns to a sport too soon, before all their symptoms have cleared, places themselves at great risk for another concussion or a condition that could lead to permanent disability or even death.

A rare but potentially fatal brain injury that can occur is Second Impact Syndrome. This is defined as a second head injury that occurs before the first head injury has resolved. It is important to be aware of this syndrome as an individual with a mild concussion who receives another mild head trauma can develop symptoms of Second Impact Syndrome within seconds. In the case of Second Impact Syndrome, the individual’s condition deteriorates rapidly, as the brain is quickly compromised by bleeding and swelling.

We don’t need to live in a bubble and not do anything fun. Not every head injury leads to a concussion or Second Impact Syndrome. Not every concussion will be severe enough to drastically limit playing time. What we need to do though is take every head injury seriously.

Heads Up!
What is all the talk about concussions? Want more information? The Centers for Disease Control and Prevention (CDC) has a tool kit, Heads Up: Concussion in High School Sports. For this and other information go to: http://www.cdc.gov/ncipc/tbi/Coaches_Tool_Kit.

Concussion Management
The National Athletic Trainers’ Association issued a position statement concerning the management of sports-related concussions. The position statement provides key information that is broken down into easily followed sections. Take a few minutes to read the text found at www.nata.org/publicinformation/files/concussion .pdf or from a link at the Sports Advantage website.

Posted: 2008-08-01