Concussions: Know The Risks And Signs

If your children are active in sports, especially contact sports like football, hockey, lacrosse or soccer, you’re probably aware of the risk of concussions. Concussions have been a hot topic in the media lately.

A concussion is a type of traumatic brain injury caused by a bump, blow or jolt to the head that can change the way your brain normally works. Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth. A concussion can occur even without the loss of consciousness, and those injuries that may seem to be mild can result in serious injury.

Concussion can occur in any sport, and children and teens are more likely to get a concussion and take longer to recover than adults.

A repeat concussion that occurs before the brain recovers from the first concussion—usually within a short period of time (hours, days, or weeks)—can slow recovery or increase the likelihood of having long-term problems. In rare cases, repeat concussions can result in edema (brain swelling), permanent brain damage, and even death.

Recognition and proper response to concussion when they first occur can help prevent further injury or even death. So, all coaches, parents and athletes need to learn concussion signs and symptoms as well as what to do if a concussion occurs.

Common Signs Observed And Reported

• Appears dazed or stunned

• Headache or "pressure" in head

• Is confused about assignment or position

• Nausea or vomiting

• Forgets an instruction

• Balance problems or dizziness

• Is unsure of game, score, or opponent

• Double or blurry vision

• Moves clumsily

• Sensitivity to light

• Answers questions slowly

• Sensitivity to noise

• Loses consciousness (even briefly)

• Feeling sluggish, hazy, foggy, or groggy

• Shows mood, behavior, or personality changes

• Concentration or memory problems

• Can’t recall events prior to hit or fall

• Confusion

• Can’t recall events after hit or fall

• Does not "feel right" or is "feeling down"

If you suspect your child/athlete has a concussion:

• Remove the athlete from play. Look for signs and symptoms of a concussion if your athlete has experienced a bump or blow to the head or body. When in doubt, keep the athlete out of play.
• Ensure that the athlete is evaluated by a health care professional experience in evaluating for concussion. Do not try to judge the severity of the injury yourself. Health care professionals have a number of methods that they can use to assess the severity of concussions.
• As a coach, recording the following information can help health care professionals in assessing the athlete after the injury: Cause of the injury and force of the hit or blow to the head or body, any loss of consciousness (passed out/knocked out) and if so, for how long, any memory loss immediately following the injury and/or any seizures immediately following the injury as well as the number of previous concussions. Keep the athlete out of play the day of the injury and until a health care professional, experienced in evaluating for concussion, says they are symptom-free and it’s OK to return to play.

If your child/athlete is experiencing moderate to severe concussive symptoms refer the athlete to an emergency department for evaluation and treatment.

If your child/athlete is experiencing mild symptoms refer the athlete to The Urgent Care Center in McMurray for evaluation and an on-site ImPACT test (see below).

If your child has been assessed as having a concussion, follow up with a Sports Medicine Specialist to ensure proper care and an appropriate return to play plan.

What is ImPACT Testing?
Along with the signs and symptoms mentioned above, many athletes experience cognitive brain function deficits such as memory loss, difficulty concentration and decreased reaction time as a result of a concussion.

Immediate Post-Concussion Assessment and Cognitive Testing is the first, most-widely used, and most scientifically validated computerized concussion evaluation system. ImPACT helps to objectively evaluate the concussed athlete's post-injury condition and track recovery for safe return to play. In fact, neurocognitive testing has recently been called the "cornerstone" of proper concussion management by an international panel of sports medicine experts.

ImPACT takes approximately 20 minutes to complete. The program measures multiple aspects of cognitive functioning in athletes, including attention span, working memory, sustained and selective attention time, response variability, as well as Non-verbal problem solving and reaction time.

It is recommended that athletes playing collision sports do a baseline ImPACT test prior to the start of the season. In the event that the athlete sustains an injury during the following two years of their
baseline test, the athlete will repeat the test and the post-injury scores will be compared to baseline scores. If an athlete has already sustained an injury without getting baseline tested, the ImPACT testing can still be given and the scores compared with normal age-matched athletes.

ImPACT Testing is available at the following Washington Hospital locations:
Outpatient Rehabilitation Department at the Wilfred R. Cameron Wellness Center (724-250-6280)
The Urgent Care Center in McMurray (724-969-4321)

For more information, please visit www.washingtonhospital.org/orthoneuro.

Author:

Dr. Mary Parks Lamb
Medical Director, Urgent Care Center affiliated with The Washington Hospital
Medical Director, Lakeside Primary Care (opening Summer 2011)
724-969-4321