Concussion Expert Offers Advice for Athletes As They Head Back to School

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Less than 20 % of indiv. who incur a concussion have associated loss of consciousness. 

When in doubt, sit them out. Better to miss one game than whole season. #concussions

CDC: as many as 20 % of all athletes involved in contact sports exp. a concussion ea. season 

The start of this year’s football season brings an increased focus on protecting players at all levels from experiencing a concussion. With the abundance of today’s contact and extreme sports there is a lot of news about concussions, however, many of us do not know much about this common injury.

“A concussion is a brain injury that occurs when the brain bumps against the skull,” said Dr. Aaron Karlin, Director of Ochsner Health System’s Concussion Management Program. “The force of the impact can cause ‘tearing or twisting’ of neuronal structures in the brain which then causes a breakdown in the normal flow of messages within the brain.”

A concussion can be caused by an external force hitting the head such as a linebacker tackling a quarterback or from the head hitting something, perhaps from a fall from a bicycle. Dr. Karlin says concussions are more common than one might think. According to the Centers for Disease Control, as many as 20 percent of all athletes involved in contact sports experience a concussion each season with the majority occurring at the high school level.

“One myth about concussions is that you have to be ‘knocked out’,” says Dr. Karlin. “This is absolutely false. In fact, less than 20 percent of individuals who incur a concussion have associated loss of consciousness.” Dr. Karlin also says that some people actually suffer a concussion and never realize it because their symptoms may go unnoticed.

Symptoms to look for include:

  •   *Headaches
  •   *Fatigue
  •   *Sleep cycle disruption
  •   *Excessive irritability or overly-flattened affect
  •   *Sensitivity to light and/or noise
  •   *Dizziness or imbalance
  •   *Disruption of memory, attention, and/or concentration
  •   *Difficulty with problem solving or slowed processing speed

 

Dr. Karlin says a concussion patient experiencing seizures, repeated vomiting, slurred speech or declining mental status, such as difficulty in being awakened, should seek emergency medical assistance as soon as possible.

When it comes to concussions, resting the brain is just as important as resting the body. “In addition to physical rest, it’s equally important for these patients to reduce cognitive stressors such as TV, texting, and computer usage that increase the brain’s metabolism so that it can adequately heal,” says Dr. Karlin. “Repeat head injuries following an initial concussion—and before adequate brain healing—can be quite serious, resulting in worsening or exacerbation of the patient’s symptoms, prolonging one’s recovery course, or even death in the case of second impact syndrome.”

To ensure that local high school athletes do not return to the playing field too soon, Dr. Karlin offers baseline neurocognitive testing utilizing ImPACT testing. ImPACT is a computerized evaluation system used by numerous professional and collegiate athletic teams which focuses on the potential cognitive effects a concussion can have upon the brain. Reaction time, memory, and processing speed are among the many facets of brain function assessed. Baseline testing allows for an individualized comparison of cognitive functioning specific to each athlete in the event of a concussion.

Dr. Karlin points out that ImPACT is just one tool of a concussion specialist’s evaluation, which should also include a review of each patient’s concussion-related symptomatology, a full neurologic examination, and balance testing. All of the components when evaluated together provide the necessary information for an experienced clinician to properly manage a concussion.

Not all concussions are preventable, but being prepared and following safety guidelines can help reduce an athlete’s risk. “Wear the appropriate gear for the sport you play,” says Dr. Karlin. In addition, Dr. Karlin says athletes, parents, and coaches should all be aware of and follow the rules and safety guidelines for a sport. Coaches and trainers should also learn the warning signs of a concussion and be prepared to take a player out of the game if they exhibit those symptoms. “When in doubt, sit them out,” says Dr. Karlin. “It’s better to miss one game or practice than a whole season.”