Can a concussion change your or your child’s life? Absolutely.
Over 1.6 million sports related concussions occur in the US per year. Maybe as many as 3.7 million.
Concussion is most commonly associated with sports, although many concussions occur outside the sporting arena and in the military. Concussion is at the milder end of the spectrum of Traumatic Brain Injury (TBI), but may have life changing consequences. The National Collegiate Athletic Association (NCAA) Sports Science Institute studies show that per participant, the highest risk sports are wrestling, hockey, football, and soccer, but many other sports and activities have risks for concussion.
The Centers for Disease Control (CDC) defines concussion as follows:
“A concussion is a type of traumatic brain injury-or TBI-caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.”
Concussion can occur with relatively low force. There is no one test that can diagnose or monitor concussion, and requires multiple inputs. Initial identification of the symptoms is important. Symptoms may include headache, dizziness, confusion, blurred vision, sensitivity to light, imbalance, memory and concentration problems, irritability, as well as 15 other symptoms.
The State of Oklahoma has enacted a law related to sports participation that requires game officials, coaches, and medical staff to remove an athlete from participation showing symptoms of concussion until evaluated by a licensed healthcare professional.
An evaluation of many functions of the brain are performed by an experienced healthcare professional to include orientation, memory, and balance as well as a neurologic examination. In some situations, paper or computer based neuropsychological testing is performed. Imaging, like CT or MRI scan, may or may not not be recommended as these are usually normal and decisions for proceeding with imaging studies are based on the full evaluation.
Guidance on treatment is based on the judgement of a medical practitioner trained in concussion assessment and management.
It is important to avoid vigorous physical activity. A second concussion soon after can be much worse. Even catastrophic.
Initial treatment is physical and mental rest. At times this includes time off or modification of school or work, avoiding screen time (television, computer, video games, mobile phone use) that stresses the injured brain.
During recovery, symptoms continue to be monitored. When symptoms have resolved, a gradual and monitored return to mental and physical activity is instituted. Reevaluation is performed by the medical professional on ability to return to activities.
Multidisciplinary research on concussion continues in the United States and international community on the best approach for identifying, treating, and return-to-play decisions. Based on the prevailing data, these guidelines have been updated regularly.
Daniel Constance, MD, MS
Primary Care Sports Medicine, Internal Medicine — Memorial Medical Group — Orthopedic Office