Confronting Concussions

Confronting ConcussionMuch as we hate to admit it, back to school season is upon us, which means that students are gearing up for fall sports. If your child had had a sports physical, you’ve probably noticed that the pre-visit questionnaire asks several questions about head injuries. But what exactly is a concussion and why do we worry so much about them?

In the simplest terms, a concussion can be thought of as a ‘brain bruise.’ It occurs when the player’s skull hits another object, causing the brain to be bounced back and fourth or even twisted within the skull. There are many factors that contribute to the severity of injury, many of which we don’t completely understand. Some studies show that developing brains in young individuals are susceptible to longer and more serious effects from head injuries.

It is important to note that concussions can happen even if the injury did not cause a complete loss of consciousness. In some cases, a person may not show any signs of injury until a few hours later. Sometimes the signs of concussion can be subtle and difficult to recognize. Some common signs and symptoms of a concussion are: headache, nausea, balance problems, dizziness, vision problems, sensitivity to light or noise, concentration or memory problems, feeling sluggish, slurred speech and confusion.

If you suspect someone might have a concussion, here are a couple of things to look for. Is the athlete dazed, confused or disorientated? Are his movements more clumsy than usual? Is he having difficulty remembering what happened immediately before the injury? Is she behaving strangely or showing personality changes? If the answer to these questions is “yes,” the athlete should be evaluated immediately. Signs like vomiting, severe headache or difficulty staying awake also need emergent attention.

The 2011 North Dakota legislature passed a Concussion Management bill requiring that each official, coach and athletic trainer receive training on the signs, symptoms, and risks of concussions. Athletes should be cleared by an appropriate health care professional before being allowed to return to play in games or practices. This process takes time (sometimes weeks or even months) and must be customized to each individual athlete. In general, the first step is allowing the brain to heal so that there are no symptoms of concussion at rest. Once that happens, the athlete can proceed with activity in a step-wise fashion to allow the brain to re-adjust to exertion. We start with minimal to light exercise, gradually progressing back to full activity.