With school back in session and many children and teens getting back into school sports programs, I thought it would be a good idea to address a subject that has been gaining a lot of media attention lately.
That subject is: Concussion, and it's defined as: an immediate and transient loss of neuronal function secondary to trauma. It's important to realize that concussion often goes unrecognized in adolescent sporting activities for 2 primary reasons. First, athletes who suffer concussion have admitted in recent studies that they do not report their concussive events due to their concern over letting the team down or being taken out of play. Second, concussions are often not reported due to a lack of understanding of what constitutes a concussion. Both of these reasons are cause for concern and be should be addressed with greater clarity between coaches, athletes and their parents. It is a serious matter and could make a difference between life and death or permanent neurological impairment.
Concussion is not confined to just "getting knocked out" or losing consciousness, although that is the most prominent feature of a severe head trauma. Concussions are actually more frequently sustained (85% of the time) without a loss of consciousness. So here is a simpler definition of what is meant by a "loss of neuronal function secondary to trauma".
I will list the 5 most prominent symptoms: (one or more usually indicate concussion)
- Loss of Consciousness (not required to be classified as a concussion)
- Loss of Memory, (of events before or after the trauma)
- Confusion with possible slurring of speech.
- Decreased motor skills, (uncoordinated movements, loss of balance, etc.)
- Emotional or personality changes. (acting noticeably "different" than usual)
Concussion can occur without actual blunt trauma to the head. If an athlete sustains a full body trauma in the form of a collision with another athlete or object, or from a fall to the ground, without actually striking the head, there can still be significant trauma to the brain that results in a concussion, or even bleeding into or around the brain.
The key factors involve immediate recognition of a concussive event through proper observation and attention following a trauma. Properly trained, the coach, trainer, or fellow team mates can contribute significantly to recognizing the trauma an athlete endures, and then making sure they receive the proper attention through medical evaluation with a team physician or specialist right away. This sequence is of utmost importance to the injured athlete, as concussive injuries can be lethal, especially when they occur more than once! Second Impact Syndrome is where a second concussion can lead to bleading within or around the brain, resulting in permanent paralysis, other severe loss of neurologic function, or death.
A well trained team doctor can immediately administer a Standardized Assessment of Concussion (SAC) that only takes 5 minutes. The testing includes grading the concussion in terms of orientation, memory, neurologic function, Loss of Consciousness duration, amnesia (degree of retrograde or anterograd), sensation, coordination, concentration, exertion maneuvers, and delayed recall, to name a few. This would be followed by appropriate neurological evaluation and testing, resting physically and psychologically (cognitive function, ie. schoolwork, video games, and internet), and adherence to carefully constructed "return to play" guidelines. As mentioned above, these types of injuries must be taken very seriously due to their potential for becoming lethal.
Click this link for a "Concussion Check List" for a quick simple reference for concussion.
Yours in excellent health . . . with no head trauma.
Dr. Bruce Bell, D.C., Q.M.E., Qualified Medical Evaluator, American Academy of Spine Physicians, American Society for Laser Medicine and Surgery
619-472-2225
If you have any questions about concussion or second impact syndrome, please feel free to contact Dr. Bruce Bell for more information. He has recently completed an extensive training program in sports injuries under the direction and instruction of the head of the U.S. Olympic Teams Medical Clinics. Dr. Bell can be reached at: 619-472-2225. On the web go to: www.SouthCoastSpine.com
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