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What Every Athlete Should Know
About Sports Concussion
I. What is Concussion?
- Concussion is the most common form of head injury for
athletes. It is associated with disorientation, and sometimes with
loss of consciousness followed by amnesia (forgetting) of what
happened both immediately before and after the injury.
- However, it is important to note that it is not
necessary to lose consciousness to have a concussion.
- Mild confusion or disorientation about who or where you
are, what the time or date is, or what you were doing when the
injury happened can be signs of concussion. Also note that
statistics show that once you sustain a concussion, you are 4 to 6
times more likely to sustain another, even with a mild hit.
II. How do concussions
occur?
- Our brains are protected inside a hard outer covering of
bone, the skull, which is our own natural helmet. Between the skull
and the brain is a layer of cerebrospinal fluid (CSF) that suspends
the brain inside the skull. The CSF acts as a shock absorber,
allowing for some movement of the brain before it bumps into the
bone.
- There are two common types of injury to the brain
in sports: Acceleration-Deceleration and Rotational.
- Acceleration-Deceleration Injury usually
happens when the athlete's head and body are traveling at a certain
speed and then abruptly stop. When this happens, the brain will hit
the inside of the skull and brush against bony structures damaging
delicate brain tissue.
- Rotational Injury happens because the brain
is attached at its base where it joins the spinal column. Hits to
the head or body may cause rotational motion of the brain within the
CSF. This type of injury often leads to shearing of the brain nerve
cells.
III.
Second Impact Syndrome
- A very serious and even fatal brain injury may occur even
with a relatively mild hit in contact sports. A rare disorder,
Second Impact Syndrome, occurs when an athlete has a relatively
minor blow to the head, with a mild concussion, and then within a
short time later (usually within one week) receives a second blow to
the head. In rare cases, it is possible for rapid brain
deterioration and even death to occur. This happens because the
brain is still affected from the first injury and the second injury
results in rapid swelling and pressure within the skull. This
intracranial pressure, if uncontrolled, can lead to death.
IV. Post Concussion Syndrome
- Following a concussion, especially repeated or successive
concussions, the athlete may experience many different kinds of
symptoms, which may last for days, weeks, months, or longer. These
are generally problems with thinking, sense of well-being, and mood.
Headaches are a frequent complaint, as well as difficulty with
memory, concentration, attention, fatigue, dizziness, anxiety,
depression, and irritability. Sometimes, symptoms are described as
"not feeling as quick or clear- thinking" or feeling "more
disorganized or forgetful" than usual.
V.
Evaluation of the Effects of Concussion
- When concussion is suspected, medical evaluation and
treatment should be sought from your family physician and consulting
neurologist. If there are continued complaints of
attention/concentration/memory difficulties, irritability, fatigue,
lowered performance in school, headache, dizziness, emotional or
other symptoms, it is highly recommended that the athlete
receive a neuropsychological examination. A
neuropsychological examination can measure brain functioning in ways
that a neurological exam, MRI, CT scan cannot. In fact, in
cases of mild concussion and post-concussion syndrome, it is very
common for results of neurological exams and tests to be normal
whereas the neuropsychological evaluation is able to identify the
brain dysfunction. The neuropsychologist can also determine a
plan of treatment to help remediate the symptoms and to help in
return to play decisions.
VI.
What can athletes do to prevent the lasting effects
of concussion?
- It is important that athletes receive preseason
baseline cognitive testing before concussions occur. Then, if
an athlete sustains a concussion, her progress can be followed
by re-testing, comparing post concussion test results to
baseline results, to help make the proper decision about when to
return to play and when the athlete is healed.
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