A new school year has started, and this is a good time to discuss concussions. A concussion is a brain injury, usually caused by an impact to the head. Symptoms can range from confusion and disorientation to loss of consciousness. The concern with concussions, is that multiple such head injuries lead to memory-related diseases like Alzheimers. Most concussions in teens and youth occur during car accidents. We have a new group of young drivers with this new school year. Also, over 40,000 high school students suffer concussions every year while playing football. Concussions from both of these causes are somewhat preventable. Concussions that occur during football are receiving a lot of attention. That is because the recurrent concussions from repeated injuries are much more preventable. Football is associated with a number of injuries, even death. The two most common are heat stroke and concussion.
Sports related head injuries account for over 20% of all traumatic brain injuries of childhood in the US. Since many of these occur during football, efforts are being made to protect teens. Impact forces on helmets are being studied, and helmets have been re-engineered. Football coaches and trainers are being taught how to administer testing at the time of an injury. There are several programs available, such as ImPACT and REAP that provide guidelines, protocols and baseline testing. If you have teens playing football, you need to make sure that such protocols are being followed at their school. Also, make sure their helmet fits properly, so it won't come off during play.
Baseline testing is key. This testing needs to be done at the beginning of the season, prior to any injuries. A good baseline test examines your teen for attention span, memory, sustained and selective attention time, non-verbal problem solving and reaction time. Such testing should be repeated 2-3 times to establish an accurate baseline. This same testing should be repeated at the sidelines, immediately after any significant impact to the helmet. Please, remember, not all concussions result in loss of consciousness. Do not wait until your teen passes out from an injury to have this testing done. If a sideline assessment indicates a concussion, your teen should be immediately removed from play, AND should follow up with his or her physician in 24-72 hours.
If your child sustains a concussion, they are usually restricted from play for a week, longer if is their second or third concussion in a season. Your physician may choose to let your child return to sports sooner. These decisions are made on an individual basis. At the very least, he or she should be completely symptom free for 24 hours. Symptoms can easily persist for 4-5 days. During this recovery phase, your teen may have additional restrictions. He or she may be put on brain rest. Brain rest means that certain every day activities are off limits so that the brain can actually rest. This may mean no school or physical activity. It also means no computer use or social media, no video games, no text messages, and no reading for school or homework.All of these activities require the brain to do extra work, which uses up the sugar in your blood. Healing of the brain also uses this sugar, called glucose. We don't want different parts of the brain competing for glucose, as this will slow healing. Have your teen see their physician soon after then injury, to see how much brain rest may be indicated.
All of this may seem like overtreatment to some parents. However, the link between multiple head injuries and later memory problems is quite strong. Also, if a teen plays sports while their concentration is decreased, they are at risk for additional injuries. Many parents feel that the newer helmets take care of all this. However, many teens feel that these helmets protect so well that they can take extra chances. We've seen some intentional spearing in practice already this season.
We want our teens to enjoy their youth. Let's help them to do it safely. As always, if you have questions or comments, please let me know.
~Dr Nan N~