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Thursday, April 5, 2012

Concussions and the Young Athlete

By Roy Benaroch, MD

Young Athletes

Concussions can cause real, lasting brain damage. After a concussion, athletes (both professional and student) can suffer from poor attention, headaches, memory problems, and depression—symptoms that may or may not improve with time. Fortunately, big changes seem to be occurring on playing fields that will protect athletes. Parents need to know how to protect their children, too.

A concussion is a brain injury resulting from a blow to the head. By definition, there is no “structural injury”— x-rays or CT scans or MRI scans will not show any problem. Yet there obviously is a problem: the brain, after a concussion, doesn’t work right. Neurologic symptoms after a concussion can include unconsciousness, but more often the symptoms are more subtle: disorientation, confusion, and problems with memory and balance. With time and rest, these symptoms will usually improve, especially after a first concussion

New attention lately has been focused on symptoms of concussions that don’t improve. Among pro athletes, rising concern about permanent damage has led 106 former NFL football players to sue, accusing the league of negligence in diagnosing and treating their injuries. The NFL, it seems, is listening. They’ve taken recent stories about one pro team paying extra for tackles that cause game-ending injuries like concussions very seriously.

Unfortunately, young athletes may be more at-risk than the pros. Young brains are still developing, and are more likely to be injured. Repeated concussions appear to be especially dangerous—a “second hit” after a concussion that hasn’t completely healed can be catastrophic.

What can parents and coaches do to help keep their kids safe?

  • Provide good training so young athletes know how to play safely. Support coaches who teach student athletes well, and take potential brain injuries seriously.
  • Make sure that athletes have good protective equipment, including helmets and mouth guards. These don’t prevent all (or even most) concussions, but using them consistently and correctly is still important.
  • School systems need to have mandatory, science-based concussion management systems, developed in accordance with national guidelines.
  • Officials and referees need to call fouls, and discontinue play when it’s dangerous. Players who put themselves or others at risk should be sent off the field without hesitation.
  • Coaches on the sidelines need to look for even subtle signs of concussion in their players, and pull them out of the game if there are any signs at all. When in doubt, players should sit out.
  • Players themselves need to know that they should never tough it out—any “dinger” needs to be reported, even if that means they’ll be pulled from the game. Young brains are far more important than scores.
  • If your child does have a concussion, be sure to follow the guidance of his physician. A gradual return to sports should not begin until all signs and symptoms of concussion have resolved. If your child has had more than one concussion, or a concussion with prolonged symptoms, consider working with a neurologist to ensure that there’s no lasting damage.
Photo: iStockphoto

Posted by: Roy Benaroch, MD, FAAP at 2:48 pm

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