Concussions
This experience was shared with me by an athletic trainer I used to work with. It occured on the week of April 21, 2008 at a school in southern PA. I share this with you to stress the severity of even the slightest symptoms of a concussion, and the importance of monitoring the symptoms at home (especially at night while the injured athlete is sleeping). It also demonstrates that concussions can occur in sports other than football. The name of the athletic trainer and email address have been deleted to protect the privacy of the school and athletes.
"I arrived at work on Monday to be told that one of my athletes was in the hospital b/c they 'needed brain surgery for a concussion'. Of course my initial response was that these students were pulling my leg. But, as more and more students started asking about this athlete I became curious and asked my AD if he knew anything. And sure enough I had an athlete recovering from surgery to stop a bleed that occurred after receiving a head injury during a game on Sat. So, I contacted the ATC at the school where they played and the athlete's parents to get all of the information. And of course followed up with my coach as to why we didnt get a phone call.
Now, fast forward 24 hours. One of my student trainers approaches me regarding a rumor she heard about another athlete in the hospital after being hit in the head with a baseball. After Monday's situation I called the coach to find out that yes indeed we had an athlete in the ICU recovering from surgery to repair a bleed caused by a head injury.
I'm sure you're asking yourself why I am bothering you with this info. Here's why...after following up with all parties involved with the evaluation and treatment I found an interesting item. Neither of these athlete's had any symptom worse than a headache. They tested negative for all of the symptoms and signs we would ask when checking for a concussion. My second kid I'm told even finished practice without any complaints or change in performance. Thankfully both parents involved felt that this headache was too severe and went in search of professional treatment. Imagine how many student athletes we send home thinking a headache will just resolve itself or we will see them the next day. Both of these athletes could very well have been that 'athlete that died in their sleep' that we use as an example to scare home the severity of a concussion."
Why do we take extra precautions with concussions??
Concussions occur as the result of a head injury. We treat them with extra precaution, especially when they occur in adolescents. Young athletes who experience a head injury are often kept out of participation and competition for a minimum of 7-10 days. Why do health care providers do this? Mostly for the simple fact that the human brain does not stop growing and developing until around the age of 17 or 18, sometimes later. For this reason, it takes longer for the brain of an adolescent to recover from injury, especially if the injury occurs during the school year. Think about it--the brain is trying to heal from injury, learn and store new information being learned in school, and perform normal development. If an athlete returns to play too soon (that is, while still experiencing symptoms), Second Impact Syndrome can occur. Second Impact Syndrome is almost always fatal. If the athlete does survive, permanent dysfunction occurs. Second Impact Syndrome causes a catastrophic increase in intracranial pressure, causing massive swelling, paralysis, and/or herniation of blood vessels. The scariest thing about Second Impact Syndrome: it only occurs in kids!! Almost all cases have occured in athletes <21 years old. You will almost never see a college or professional athlete experience this because his/her brain is fully developed. Second Impact Syndrome often occurs as the result of a routine hit or minor contact. It has been shown to occur up to 14 days after the initial injury occurs. Also, if multiple concussions occur, the effects are like a waterfall, just adding onto each other. This is one of the reasons we are seeing many retired NFL athletes experiencing depression or vision and motor problems now. Concussions are extremely important to manage correctly so that a more severe injury does not occur.
Signs and Symptoms of a concussion:
Headache
Nausea/Vomiting
Balance problems/Dizziness
Ringing in the ears
Double vision, fuzzy vision, misty vision, seeing spots, blind spots
Sensitivity to light and/or noise (tends to increase symptoms)
Feeling sluggish or slowed down (like everything is moving in slow motion)
Feeling foggy or groggy
Concentration problems (increase in symptoms with reading, classwork, homework, watching TV, working on the computer)
Trouble remembering things that happened before or after the head injury
Confusion
Loss of the sense of taste or smell
Changes in personality/acting out of character
Trouble sleeping: sleeping too little or too much compared to normal sleeping patterns
**In order to have a concussion, a blow to the head must have occurred.**
Many people experience one or any combination of these symptoms in a day, but a mechanism of injury must occur to have a concussion. These mechanisms of injury include: a blow to the head (from an object or another athletes body), falling and hitting the head (usually on a wall or the ground or hard floor), and spearing (tackling with the head down, falling straight down on the head, etc.). While helmets help to reduce the risk of injury, they do not prevent injury. The best prevention of a head injury is proper technique.
Home management of a concussion:
Monitor signs and symptoms.
When athlete sleeps, wake every 2 hours to monitor symptoms.
If symptoms worsen, or new symptoms occur, take him/her to the emergency room immediatly! If you cannot wake your child, call 911 immediately!!
Do not give any medication to decrease symptoms until instructed by a physician. This may mask symptom severity, and make it impossible for health care personnel to accurately monitor symptoms and severity of the injury.
**If you have any questions during the home management of your child after he/she suffers a concussion, please do not hesitate to contact me, no matter what time of day or night.
Canton uses the ImPACT computer program as a management tool for concussions. This program monitors symptoms we are not able to see or get accurate feedback on otherwise. These symptoms include: changes in reaction time, changes in impulse control, visual motor speed, and visual and verbal memory. It also tracks the symptoms the athlete reports, which may or may not be reported to the athletic trainer or coach. All athletes participating in collision, contact, and certain non-contact sports are baseline tested so that if an injury occurs, the results can be compared to the normal functioning of that particular athlete. If a baseline test was not taken, there are normative ranges that the athlete can be compared to to generate results. More information on the ImPACT program and concussions can be obtained at www.impacttest.com.
Concussions in the News:
