What to look for
First, it is important to know what exactly a concussion is and how someone gets a concussion. A concussion is a type of traumatic brain injury. Generally, concussions are caused by a direct blow to the head, face or neck.
However, a concussion can also occur if the force or blow makes contact elsewhere on the body and results in a transmitted force to the head. For example, being knocked hard to the ground on the hip can potentially cause trauma in the head. In both scenarios — a direct or indirect impact — the force causes the brain to move in the skull, causing bruising of the brain. The bruising is what we call a concussion.
Second, athletes, coaches and parents should know the signs and symptoms of a concussion. Common symptoms include headache, feeling like your mind is in a fog, being more emotional than usual, behavioral changes, amnesia, loss of consciousness, slowed reaction times and trouble sleeping.
Usually, concussion symptoms occur right away and cause short-lived (minutes to hours in duration) neurological impairment. However, symptoms may not appear until several hours following a concussive injury. Therefore, if a concussion is suspected, the person should be monitored for a few hours following the impact.
Third, to prevent further injury, it is extremely important to know what to do if you suspect someone is concussed. If you suspect a concussion, the person should not be allowed to return to the game or activity on the day of injury. A subsequent blow to a recently concussed player can cause the brain to swell and lead to brain damage or even death.
A physician or other licensed health-care provider should evaluate all concussed individuals to help confirm the diagnosis and provide guidance for treatment. A concussion is diagnosed based on the signs and symptoms a person may have; there is no imaging or blood test that will diagnose a concussion. MRI or CT scans usually are not obtained unless the provider is trying to rule out other possible injuries like a skull fracture.
The majority of concussions resolve in seven to 10 days. However, in children and adolescents, the recovery can be around 10 to 14 days or even longer. Concussions are brain injuries; therefore, physical and mental rest is essential for healing. Patients should avoid physical activities and limit mental stimulation, which means staying home from school or work and avoiding TV or video games.
A gradual return to work, school, social and/or physical activities should be instituted in a manner that does not exacerbate symptoms. There are no medications or other treatments available to speed up recovery. People will recover from concussions over time, but having multiple concussions may increase one’s risk of potential brain impairments later on in life.
In 2009, Washington state passed a bill often referred to as the Lystedt Law. The law is named for Zackery Lystedt, a young athlete who, in 2006, suffered a catastrophic brain injury after sustaining a concussion in the first half of a junior high football game. Lystedt returned to the game in the second half but then collapsed and was rushed to Harborview Medical Center. Incredibly, Lystedt survived the ordeal but spent three months in a coma and years afterward recovering.
The Lystedt Law states that any youth athlete suspected of having a concussion needs to be removed from play: “When in doubt, sit them out.” The law prompted 40 other states and the District of Columbia to pass similar laws.
There are many ongoing studies to find ways to prevent concussions. The methods that have been shown to help lower the risk of concussions are rule changes in sports and teaching proper technique — for instance, proper tackling technique in football. Protective sports equipment like mouth guards and helmets can protect against other injuries, but they do not prevent concussions. It’s important for all athletes — youth, professional and recreational athletes alike — to understand that there is no piece of equipment currently available that has been proven to reduce the risk of concussion.
Concussions are all too common in sports, but knowing the signs, symptoms and treatment can help prevent further injury. In addition, better awareness of concussions can help us make sports safer for our athletes.
DR. CHRIS MAEDA practices sports medicine at Pacific Medical Centers (www.PacMed.org). To comment on this column, write to QAMagNews@nwlink.com.