If you're having mystery understanding what a brain concussion is, and how your son or daughter's head-injury affects their supplementary participation in sports, then you're in good company. The nature and effects of concussions are still poorly understood by many athletes, parents, coaches, news reporters and, to a positive extent, even the medical community. But because the brain is a treasured organ--one that athletes should want to keep in good working order for the rest of their lives--a good understanding of concussions is crucial.
Neurologists and neurosurgeons cringe when they hear sports-reporters make comments like, "Johnny had a Cat scan and it showed that he didn't have a concussion." The truth is that Cat scans don't show concussions. They do show other serious consequences of head injuries, like bleeding within the brain, or hemorrhages that compress the brain. But concussions--while no less real--are indiscernible to brain-imaging tests like Cat scans and Mris.
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So what is a concussion? If a blow to the head caused unconsciousness, a concussion occurred. Most people know this. But a concussion can occur even when there is no loss of consciousness. Other symptoms after a head-injury indicating a concussion include:
impaired attention, e.g. Vacant stare, slowness to respond, easy distractibility
slurred speech, or speech that doesn't make sense
clumsiness or unsteadiness
disorientation, e.g. Walking in the wrong direction, forgetting the day of the week
excessive emotional reaction, e.g. Easy tears, overly upset
memory impairment, e.g. Asking same demand repeatedly, can't memorize new facts
Other symptoms can found hours or even weeks after the injury, along with headache, dizziness, poor concentration, irritability, impaired memory, fatigue, disrupted sleep, anxiety, depression, and a lack of good judgment or insight.
You'll observation that all these symptoms share a common feature--an alteration in brain function. The general brain processes, which depend on allowable signaling among the brain's 20 billion brain cells, are out of whack.
There can also be bodily damage to the brain's cells. Because brain-cells are so tiny, brain scans don't detect them. Injuries causing more severe concussions can tear apart the cells' axons (the long filaments that carry coded messages over long distances within the brain). As you can imagine, these rips in the very fabric of the brain can cause persisting impairments in brain function or wish long periods of time for recovery.
One certainty about sports-related concussions is that they are very frequent. The Centers for Disease control estimates there are at least 300,000 of them in the U.S. Per year and they comprise about 20% of all head injuries. Explore also indicates that the brains of high school athletes are more vulnerable to concussion than those of older athletes, and wish longer periods of time to fully recover.
Individuals who have had one concussion are at greater risk for another. For example, in one study of high school and college football players, concussions occurred about six times more oftentimes in student-athletes who had experienced prior concussions than in those who had not. Moreover, repeated concussions can have more severe outcomes than first concussions.
A rare but particularly scary phenomenon has been called the "second impact syndrome" in which a second concussion occurring within days or weeks of an earlier concussion can yield catastrophic consequences--including death--way out of proportion to the apparent severity of the re-injury.
Because of the potentially serious consequences, athletes, coaching staffs and parents need to have a heightened awareness of head-injuries and their need for allowable evaluation, along with by medical personnel. Varied guidelines have been created for decisions about when it is safe to resume participation in touch sports. These guidelines, while based more on expert opinion than on medical evidence, are still the best benchmarks we have until more studies are done.
All guidelines agree that an athlete needs to come to be symptom-free in all areas--thinking, memory, emotions, coordination, balance, etc.--before resuming play. After a first concussion, the athlete should have been general for at least a week, and after a second concussion, for probably two weeks.
When should an athlete hang up his or her cleats and retire from the sport? How many concussions are too many? No one has a definite retort to whether question. As Clint Eastwood's "Dirty Harry" might ask, "Are you feeling lucky?" Three concussions in the same season--or even in an entire sports career--should as a matter of fact raise concern about long-term damage to the brain.
Of course, student-athletes often pressure their parents to allow them to return to play sooner than might be wise. In these circumstances it is beneficial to recall that many pro athletes in football, hockey, boxing and other sports have retired from their lucrative careers rather than suffer supplementary concussions. If these high-profile individuals were willing to give up their big paydays in order to safe their brains, then maybe your son or daughter will be able to succeed their examples when less money is at stake. However, if you are the parent and are being pressured to allow an early return to play, you just might have to stand tall, do the right thing, and say no.
For more information about traumatic brain injury see the websites of The Brain Matters and The Brain Injury connection of America.
(C) 2005 by Gary Cordingley
Brain Concussions in Sports: What's the Fuss?
