Concussions

A concussion is a brain injury that commonly occurs in sports. It is estimated that up to 2 million concussions occur through sports and recreational activities each year. Concussions can occur from a direct blow to the head or a blow to somewhere else on the body that produces a jerking motion of the head. Most concussions do not result in being knocked out or losing consciousness, although if that happens a concussion having occurred is almost a certainty.

Symptoms
Common symptoms of a concussion include:

  • Headache
  • Fatigue
  • Dizziness
  • Confusion
  • Sensitivity to bright lights or loud sounds
  • Difficulty with concentration or memory
  • Feeling sick to your stomach and emesis (throwing up)

Athletes may experience one or more symptoms. If an athlete experiences any of these symptoms after a head injury, it should be assumed that the athlete has had a concussion until further medical evaluation has occurred.

An athlete who sustains a concussion should not be allowed to return to play or resume activity on the day of their concussion. Research has shown that athletes who continue to participate after their concussion are at a significantly higher risk for much worse symptoms and a much longer recovery. It is also unsafe to play, particularly if the athlete were to get another head injury while recovering. An athlete should not return to sports until evaluated by a medical professional who is experienced in concussion management, and determines the athlete to be free of symptoms both at rest and with activity and has proceeded through a return to play protocol. An athlete who is still having symptoms most likely has not cleared their concussion.

Diagnosis
Athletes typically are evaluated by a medical professional who will take a thorough history of the concussion and any prior head injuries. A physical examination, including a neurological examination, is performed. Memory and cognitive tests may also be performed. Some athletes are asked to complete a computerized neuropsychological test that takes about 20 minutes to complete to see how their brain is functioning. Imaging of the head, including CT (CAT) scans and MRIs, are generally normal with a concussion and are needed very infrequently following most concussions.

Treatment
The treatment for a concussion is a reduction of activity. Light physical activity during recovery, such as brisk walking, may be beneficial to recovery. A reduction in workload academically in school as well as other adjustments as seen fit by the school will also be beneficial. Students should not be kept from home for prolonged periods of time following their concussion. Athletes may need to take ‘brain breaks,’ meaning resting from what they were doing, for a short time if they have a worsening of their symptoms.

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