May

8

In the United States, sports-related head injuries occur frequently. The Centers for Disease Control, (CDC), estimates more than 300,000 sports-related concussions occur each year just in the US. There are a number of myths and misunderstandings among health care professionals regarding concussions.  Many physicians serve as the team doctor for their community high schools. The demands of clinical practice may preclude them for staying abreast of the latest evidence-based information regarding management of concussions in their student athletes. From 1982 through 1996, only 101 articles had appeared in the literature on concussion whereas recently this number has more than tripled.  The following new findings have all been demonstrated in recent research: 1. High school athletes are more vulnerable to concussions than older athletes and may take longer to recover.  2. Failure to properly manage concussion may lead to long-term cumulative consequences.  3. Loss of consciousness is not an appropriate marker for the presence or absence of concussion.  4. High school athletes are 3 times more likely to experience a second concussion if concussed once during a season.  5. More than 5% of high school athletes are concussed each year while participating in contact sports. There are a number of myths and misunderstandings among health care professionals regarding concussions.  Failure to recognize that a concussion has occurred increases the susceptibility of the student athlete in three ways: 1. A rare but fatal event, second impact syndrome, can occur in which there is massive brain swelling. Typically, this can occur when the student athlete receives a second blow to the head while still experiencing symptoms from the initial concussion.  2. A less serious, but nevertheless debilitating, sequelae is the development of a post-concussion syndrome in which headaches, dizziness, irritability, and eventually depression continue to persist for more than 6 weeks. The activities of daily living for the student athlete become disrupted secondary to their symptoms. Both academic performance and social interactions are impacted, primarily because no explanation for these symptoms has been offered to the athlete, family, or teachers. If an understanding is gained of the changes observed in the athlete being secondary to neurophysiologic mechanisms, support and accommodations are more likely to be offered.  3. There is now clear evidence that effects of concussions are cumulative.  It is, therefore, important to know the concussion history of the athlete when formulating a return to play decision. More information on concussion/traumatic brain injury can be found on my TBI/concussion page.