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St. Mary's Center for Orthopaedics

Concussion

With sports participation by both children and adults on the rise, so are sports-related injuries.  Beyond sprains and strains, a more serious and potentially catastrophic risk of participation in certain sports is head injury. Head injuries, specifically concussions, are not limited to contact sports such as football, hockey and lacrosse. Concussions can occur in almost every sport.

What is a Concussion?

A concussion is a disruption in normal brain function due to a blow or jolt to the head, as defined by the Centers for Disease Control and Prevention (CDC). When a concussion occurs, brain cells are injured and the brain’s delicate chemical balance becomes disrupted. Since a concussion is a traumatic brain injury, it needs to be taken seriously.

Physical impact is usually involved and may include external impact against the skull or internal impact of the moveable brain against the skull or other fixed intracranial structures. In some cases, no direct impact is observed and only rapid acceleration, deceleration or rotational motion is needed to produce the symptoms of concussion.

Patients with concussions may have many different types of symptoms. Symptoms may fluctuate with time, may be easily noticed by bystanders or may be more subtle and discovered by in-depth testing. Symptoms may be physical, emotional or sleep-related. Loss of consciousness may be the most obvious symptom, but most people with a concussion do not lose consciousness.  Following a blow or jolt to the head, it is important to watch for symptoms.

Signs and Symptoms of Concussion

  • Severe headaches
  • Nausea and vomiting
  • Sleepiness
  • Irritability or change in personality
  • Loss of memory
  • Confusion
  • Slower movement
  • Visual changes
  • Weakness
  • Numbness

Evaluating Concussions

  • Depending on the nature of the concussive event, and the forces involved, additional injuries (hemorrhage, fracture, spinal injury) may accompany a concussion. Patients with loss of consciousness or neurological deficit should go to the emergency room for further evaluation.
  • A medical professional will examine the patient and determine the need for a CT scan, MRI scan or additional tests such as computerized neurocognitive assessments.
  • For some athletes, baseline neurocognitive testing may also been recommended, so the pre-concussion status of an individual athlete is documented. If a healthy athlete undergoes this type of test, after a suspected concussion is sustained, comparisons to baseline results can be made to interpret symptoms more accurately. Such neurocognitive testing can also help guide return-to-play decisions.
     

Treating a Concussion

The most important treatments for a concussion include rest and close monitoring. It is critical that patients rest their brains, both physically and cognitively, with the exact time frame based on the severity of the concussion. Such restrictions may include temporarily restricting:

  • Participating in sports, recreational and other physical activities
  • Reading and/or completing school work
  • Viewing screens on television, smartphone devices, computers, video games, etc.
  • Driving, if applicable.

Preventing Future Concussions

Preventing repeat brain injury, especially when the brain is vulnerable during the recovery phase, is of utmost importance. While a concussion is healing, subsequent head injury can have devastating consequences.  Once a patient has experienced and recovered from a concussion, precautions should be taken to avoid future head trauma. Studies show that the brain takes longer to heal following repeat concussions and multiple concussions can lead to learning and psychiatric problems. Correct use of safety equipment and other preventive measures helps keep sports injuries to a minimum.

Important Points to Remember

  • Sports related concussions are common, and are seen more frequently in younger athletes.
  • Recognizing the injury and appropriately treating each athlete is critical to avoid further injury.
  • Athletes themselves must recognize the importance of reporting concussions.
  • Returning to the sport while still experiencing symptoms from a concussion can lead to worsening symptoms, concussion recurrence, longer time out of the sport
  • Prevention of multiple concussions is important to the overall health of athletes, especially to avoid complications associated with repeat head trauma
  • Correct use of safety equipment and other preventive measures helps keep sports injuries such as concussions to a minimum.

Ideally, the tests are given to athletes before the season begins so a “baseline” score is obtained. Then, after a suspected concussion is sustained, a follow-up test is given and scores are compared to the initial assessment.