"Coaches, parents, and athletes need be aware that no sports-related concussions are minor," according to Larry Hoffer, Director of Communications for the Brain Injury Association. Both the American Academy of Neurology and the Brain Injury Association have launched an education campaign promoting the prevention of concussion, second-impact syndrome, and repeated brain injuries in both young and professional athletes.
The human brain is protected from injury by the skull bones. In addition, it is surrounded by fluid, the cerebrospinal fluid, which acts as an additional cushion. However, when a young athlete sustains a brain injury, the soft brain bounces up against the hard skull. This causes shearing injuries to the tiny nerve fibers and stretches or breaks the brain's blood vessels. The result can be a concussion, defined as a temporary disturbance of brain function producing confusion, amnesia, loss of consciousness or disturbances of vision. Additional symptoms include headache, dizziness, impaired orientation and difficulties in concentration.
It is often difficult for parents and coaches to recognize a concussion in a student athlete. Most players do not want to say anything for fear of being removed from the game. Others have no idea that they have sustained a concussion. Unless there is loss of consciousness, the seriousness of the injury is sometimes not appreciated. It is often the player's teammates who report to the coach that the injured player is confused or disoriented.
According to the Brain Injury Association, there is a dangerous misconception that loss of consciousness is necessary to diagnosis a concussion. The Association urges coaches, trainers, and parents to be more responsive in looking for other symptoms following a brain injury, such as a vacant stare, delayed verbal and motor responses, slurred speech, poor coordination, and nausea.
Unfortunately, many coaches and parents minimize athletic brain injuries. Many consider it "part of the game" and encourage injured players "to be tough" and return to the playing field (particularly if the injured boy or girl is the star player). Even if the brain injury seems minor, a player who returns to the game prematurely risks a more serious injury, known as second-impact syndrome. This condition occurs when the athlete experiences a second brain injury before the first injury has healed. Even if the second injury is milder than the first, together they may have a combining effect that can cause brain swelling and death, within minutes! After sustaining one brain injury, the risk for a second injury is three times greater; after a second injury, the risk for a third is eight times greater!
The level of consciousness is the single most important indicator of brain injury severity. Athletes who lose consciousness, even momentarily, must be removed from the contest. The next step, if the student athlete is alert, is to test memory. Loss of memory of the events just before the concussion is common. Loss of memory of events following the concussion may suggest a more serious concussion. Remember, the athlete is not going to volunteer much information for fear of being removed from game and may occasionally be less than truthful in responding to direct questions.
According to the Brain Injury Association and the American Academy of Neurology, grading concussions is helpful in deciding the future activity level of the injured player. Grade 1 concussions cause brief confusion, no amnesia, and no loss of consciousness. The student athlete should be immediately removed from the contest and examined on the sidelines at five minute intervals for other symptoms. Remember, the athlete will try to downplay the significance of his or her injury. Therefore, it is not
enough to ask them if they are "feeling all right."
Instead, ask them specific questions and test for orientation (time, place, score of game, etc.), concentration (for example, months of year in reverse order), and memory (recent newsworthy events, outcome of prior game, etc.). Also observe for nausea or vomiting, disorientation, slurred speech, unequal pupils, noticeable restlessness, or stiff neck. The athlete may return to play if no symptoms develop in twenty minutes of sideline evaluation. Grade 1 is the only grade at which a player can return to the game.
Players who sustain a Grade 2 concussion display confusion with amnesia but no loss of consciousness. They should be permanently removed from the game and watched carefully on the sidelines for signs of increasing brain injury. The parents should be instructed to watch the child carefully throughout the night for sudden changes in mental status--acting vague, forgetful, groggy, vomiting, unequal pupils, or severe headache. In addition, the youngster should be seen by a physician the next day. The first 24 hours after injury are critical, although serious aftereffects can appear later. Should no symptoms develop, the athlete can return to play in one week.
A Grade 3 concussion results in a loss of consciousness. Once the airway, breathing, circulation, and cervical spine are checked, the student athlete should be transported by ambulance to the nearest hospital emergency department. The player should not return to practice for at least a month and for the rest of the season if he or she has had more than one previous concussion.
A concussion is an invisible, often short-lived event that can be extremely dangerous to our young athletes, no matter how minor they may seem. Until the original "hit" heals, however, even a mild injury can leave the brain vulnerable to a second concussion, which can lead to serious injury and even death.
The American Academy of Neurology recommends the following for parents of youngThe human brain is protected from injury by the skull bones. In addition, it is surrounded by fluid, the cerebrospinal fluid, which acts as an additional cushion. However, when a young athlete sustains a brain injury, the soft brain bounces up against the hard skull. This causes shearing injuries to the tiny nerve fibers and stretches or breaks the brain's blood vessels. The result can be a concussion, defined as a temporary disturbance of brain function producing confusion, amnesia, loss of consciousness or disturbances of vision. Additional symptoms include headache, dizziness, impaired orientation and difficulties in concentration.
It is often difficult for parents and coaches to recognize a concussion in a student athlete. Most players do not want to say anything for fear of being removed from the game. Others have no idea that they have sustained a concussion. Unless there is loss of consciousness, the seriousness of the injury is sometimes not appreciated. It is often the player's teammates who report to the coach that the injured player is confused or disoriented.
According to the Brain Injury Association, there is a dangerous misconception that loss of consciousness is necessary to diagnosis a concussion. The Association urges coaches, trainers, and parents to be more responsive in looking for other symptoms following a brain injury, such as a vacant stare, delayed verbal and motor responses, slurred speech, poor coordination, and nausea.
Unfortunately, many coaches and parents minimize athletic brain injuries. Many consider it "part of the game" and encourage injured players "to be tough" and return to the playing field (particularly if the injured boy or girl is the star player). Even if the brain injury seems minor, a player who returns to the game prematurely risks a more serious injury, known as second-impact syndrome. This condition occurs when the athlete experiences a second brain injury before the first injury has healed. Even if the second injury is milder than the first, together they may have a combining effect that can cause brain swelling and death, within minutes! After sustaining one brain injury, the risk for a second injury is three times greater; after a second injury, the risk for a third is eight times greater!
The level of consciousness is the single most important indicator of brain injury severity. Athletes who lose consciousness, even momentarily, must be removed from the contest. The next step, if the student athlete is alert, is to test memory. Loss of memory of the events just before the concussion is common. Loss of memory of events following the concussion may suggest a more serious concussion. Remember, the athlete is not going to volunteer much information for fear of being removed from game and may occasionally be less than truthful in responding to direct questions.
According to the Brain Injury Association and the American Academy of Neurology, grading concussions is helpful in deciding the future activity level of the injured player. Grade 1 concussions cause brief confusion, no amnesia, and no loss of consciousness. The student athlete should be immediately removed from the contest and examined on the sidelines at five minute intervals for other symptoms. Remember, the athlete will try to downplay the significance of his or her injury. Therefore, it is not
enough to ask them if they are "feeling all right."
Instead, ask them specific questions and test for orientation (time, place, score of game, etc.), concentration (for example, months of year in reverse order), and memory (recent newsworthy events, outcome of prior game, etc.). Also observe for nausea or vomiting, disorientation, slurred speech, unequal pupils, noticeable restlessness, or stiff neck. The athlete may return to play if no symptoms develop in twenty minutes of sideline evaluation. Grade 1 is the only grade at which a player can return to the game.
Players who sustain a Grade 2 concussion display confusion with amnesia but no loss of consciousness. They should be permanently removed from the game and watched carefully on the sidelines for signs of increasing brain injury. The parents should be instructed to watch the child carefully throughout the night for sudden changes in mental status--acting vague, forgetful, groggy, vomiting, unequal pupils, or severe headache. In addition, the youngster should be seen by a physician the next day. The first 24 hours after injury are critical, although serious aftereffects can appear later. Should no symptoms develop, the athlete can return to play in one week.
A Grade 3 concussion results in a loss of consciousness. Once the airway, breathing, circulation, and cervical spine are checked, the student athlete should be transported by ambulance to the nearest hospital emergency department. The player should not return to practice for at least a month and for the rest of the season if he or she has had more than one previous concussion.
A concussion is an invisible, often short-lived event that can be extremely dangerous to our young athletes, no matter how minor they may seem. Until the original "hit" heals, however, even a mild injury can leave the brain vulnerable to a second concussion, which can lead to serious injury and even death.
athletes:
- Teach your child to report all symptoms (if they're feeling anything unusual after a hit), no matter how trivial.
- Confirm that your child's coach is familiar with the new guidelines.
- Watch for even fleeting confusion or memory loss after a whack- -and keep an eye out for lingering symptoms, like headache, vomiting, or unusual irritability.
- Call a timeout when you're the coach--in backyards and on playgrounds.
- Forbid bicycling, inline skating, or football (even backyard) without a helmet.
For more information on brain injury prevention, treatment and support services, contact the Brain Injury Association of Florida at 800/992-3442. The Guidelines for Concussion Management described above are available for purchase in a laminated palm card format. To purchase the guidelines, contact HDI Publishers at 800/321-7037.