5 Facts to Know About Concussions

Michael Lobatz, MD

Thu August 27, 2015 7:30pm

From school sports to skateboarding, kids tend to play hard. Getting injured is often part of the game but, as a parent, you need to know when an injury is serious enough to warrant medical attention. This is particularly true with concussions.
According to the American Association of Neurological Surgeons, more than 300,000 sports-related concussions occur annually in the U.S. Thousands more result from falls, bicycle and skateboard mishaps, playground injuries, motorcycle and car accidents and other causes.
The following facts can help you understand this injury and how it should be treated.
1. A concussion is an injury to the brain.
A concussion occurs from an impact to the head, which causes the brain to bounce around or twist in the skull. This can damage brain cells and create chemical changes in the brain. Although most concussions are caused by a direct blow to the head, they also can result from impact elsewhere on the body that transmits force up to the head, such as from a hard fall or sudden impact.
Though concussions may range in severity, all temporarily affect brain function, a condition known as traumatic brain injury. A concussion may impair speech, balance, coordination, memory and cognitive thinking. Failure to understand the severity of the injury and seek immediate proper medical care can lead to long-term health problems, brain damage or death.
2. Most people who suffer a concussion remain conscious.
Fewer than 10 percent of concussions result in loss of consciousness. Immediate symptoms of concussion may include confusion, difficulty thinking clearly, quickly forgetting new information, headache, slurred speech, unusual behavior, and repeated nausea or vomiting. In some cases, there may be no immediate symptoms at all, but days or weeks later, concussion may cause balance or coordination problems, slowed movement, and vision or hearing disturbances. In rare cases, a dangerous blood clot may form and crowd the brain against the skull.
3. There is no such thing as a “minor” concussion.
Every concussion is serious and should be evaluated by a trained medical professional. Never try to judge the seriousness of a concussion on your own, even if the person claims to feel just fine. Often athletes try to resume their usual levels of activity because they don’t want to be taken out of the game. Don’t take chances with your child’s brain. Call a physician right away or go to a hospital emergency room for immediate evaluation. Proper care and management is essential for even mild injuries to ensure optimal recovery.
4. There is no universal rule for how long to wait before returning to activities.
Every concussion requires individualized care and management; what is right for one person may not be right (and may even be dangerous) for another. Factors including the person’s general health, medical history, age, prior injuries and post-concussion symptoms all must be considered. Baseline testing and/or post-injury neurocognitive testing can help to objectively evaluate the patient’s post-injury condition and track recovery for safe return to activities.
5. Second concussions can be more dangerous.
If a second concussion occurs before the first one has fully healed, the patent has significant risk of serious injury — this is why it is crucial to ensure an athlete is fully healed before returning to play. These “second impact” concussions are more likely to cause brain swelling and widespread damage, and may even be fatal. The consequences of repetitive concussions may include permanent long-term brain damage, motor dysfunction, and cognitive declines such as balance and gait disturbances, rigidity and slowed movement.
Scripps Memorial Hospital Encinitas educates parents, teachers, coaches and students about concussions in youth sports through Play Smart. Play Hard. Designed for high schools and athletic clubs, the free program offers comprehensive interactive presentations based on Centers for Disease Control guidelines. As part of the program, Scripps provides a 20-minute computerized test (called ImPACT) that evaluates attention, memory, reaction time, problem-solving skills and processing speed. The test creates a baseline evaluation for young athletes who have never had a head injury. If participants suffer a concussion, they can retake the test and clinicians can compare the results. The test is $10.
Michael Lobatz, MD, is a board-certified neurologist at Scripps Memorial Hospital ­Encinitas. For more information, visit www.scripps.org/SNS or call (858) 914-2297.