It has been said that we have a silent epidemic among our young athletes – Brain Injuries due to Concussion. Athletes age 14 and under account for 1/3 of Emergency Room evaluations for sports’ related head injuries. 60% of these Brain Injuries occurred in football & basketball. In the last 10 years, emergency room visits by children and adolescents with sports related concussions nearly doubled in organized team sports in the 8-13 age group and nearly tripled in the age 14-19 group. Symptoms such as confusion, dizziness, headache, slowed reaction times and memory problems are just some of the most common symptoms of a concussion. 90% of concussions occur without loss of consciousness. A player who has sustained one concussion is 3 to 6 times more likely to sustain a second concussion and studies have indicated that 14.7% of high school and college players suffer more than one concussion during the season.
The NFL and the NCAA have both taken notice of this epidemic and issued guidelines for proper evaluation and management of athletes suspected of having sustained a concussion which include removing the athlete from play or practice, requiring a sideline neurological examination of the athlete by a trained health care provider with experience in evaluation of head injuries and have issued guidelines for return to play. The Arizona State Legislature passed Senate Bill 1521 which mandated the education of parents of athletes, coaches and pupils participating in contact sports in the risks of concussions. In addition the legislation also provided guidelines for the immediate removal of the student athlete from play or practice if a concussion is suspected and the Arizona law requires proper evaluation by a trained medical professional. Management of concussions require that the athlete should not return to play or practice that day and may not return until the athlete is completely free of symptoms. Returning to play too early has a significant risk of a 2nd impact syndrome in which the brain has not recovered from the first injury and now is subjected to a second injury which may result in uncontrolled brain swelling and could result in death.
Prevention of head injuries in sports includes equipping players with proper equipment, supervised training to include neck strengthening and the proper enforcement of rules.
Coaches, parents and athletes must work as a team to change the mindset on brain concussions and to insist on proper evaluation and management of the student athlete who sustains a concussion. Blows to the head are not innocuous for there are serious short and long term consequences of these injuries.
By Robert P. Goldfarb, M.D., FAANS, FACS
– Neurosurgical Consultant, Carondelet Neurological Institute
– Neurosurgical Consultant, Western Neuro
– Chairman, Carondelet Neurological Institute