Wednesday, October 25, 2006

 

Football season brings many concussions

I know football season has officially begun when there are more athletes in my waiting room complaining of headaches. These headaches are often the result of a concussion. Each year over 300,000 brain injuries occur in sports. Twenty per cent of all high school and collegiate athletes will experience at least one concussion during their sports careers.

Every year we recognize more concussions at college, high school and junior levels of competition. The increased numbers are not related to poor equipment or coaching techniques but rather an effort by the Centers for Disease Control and several medical organizations to educate coaches to recognize the early signs of concussion.

A concussion is a brain injury. It consists of an impairment of neurologic function secondary to mechanical forces, most commonly the result of impact between the brain and a solid object. This is typically caused by a collision or a sudden jerking motion of the neck (whiplash). Concussions vary from mild to severe. Typical symptoms include headache, nausea, dizziness, confusion and blurred vision. Brief loss of consciousness and amnesia at the time of injury is not uncommon.

Recently, I had the opportunity to examine a young man who had suffered a head injury during football practice. He immediately had a headache and dizziness, which improved after resting. He didn’t report the injury to his coaches and returned to practice where he was involved in a seemingly minor collision with another player. His headache returned, he became disoriented and began vomiting. His next stop was the Backus ER and eventually to my office. Unfortunately, his headaches have persisted and he is having difficulty concentrating days after the injury. While I believe this athlete will fully recover, his season and possibly his football career are over because he failed to admit having a concussion to the coach or athletic trainer.

Failure to recognize the symptoms of concussion may result in permanent neurologic injury or death. Several years ago, researchers identified the “second impact syndrome.” This is a situation where two or more concussions occur in a short period of time. The brain then begins to swell uncontrollably resulting in sudden death, often before the athlete can be removed from the field.

When asked to evaluate an athlete immediately after a concussion, I assess the level of alertness, eye movements, size of the pupils, limb strength and coordination. Before being allowed to return to the game, the athlete must be able to perform wind sprints and other exertional tasks without symptoms. More serious injuries require brain-imaging studies in the form of CT or MRI scans.

Early recognition of symptoms and proper use of helmets are the only ways to minimize neurologic damage from concussions. It is my hope that by educating coaches, parents and athletes, we can avoid catastrophic injuries.

For a CDC tool kit to help prevent sports-related concussions, and recognize symptoms, click here.

Healthy Living appears in the Norwich Bulletin on Tuesdays, written by rotating medical professionals at The William W. Backus Hospital in Norwich, Connecticut. Dr. Anthony G. Alessi is a neurologist on the Backus Hospital Medical Staff and in private practice at NeuroDiagnostics, LLC in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Dr. Alessi and all of the Healthy Living columnists at healthyliving@wwbh.org

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