Concussions are an unfortunate but common occurrence in sports. A sports medicine physician sees high school athletes who sustain thousands of concussions each year, most commonly in football, ice hockey, and soccer. Concussions are not always associated with being “knocked out” or losing consciousness. When a child’s mental status changes as a result of trauma, this is referred to as a concussion (usually a blow to the head). A concussion occurs when a child exhibits signs of mental confusion or is “dinged” by a blow to the head.
Sports-related concussions frequently cause both mental and physical symptoms (e.g., inability to concentrate, forgetfulness, headaches, fatigue, dizziness). Many athletes’ symptoms subside after about 10 days, and they rarely last more than a few months. However, in some cases, concussions result in persistent complaints of physical, mental, emotional, and behavioral symptoms, a condition is known as post-concussion syndrome. We don’t know whether persistent post-concussive symptoms are caused by medical or psychological factors. When athletes sustain multiple concussions in a short period of time, they may develop second impact syndrome, a pathological response of the brain that can be fatal if not treated promptly. Parents should seek careful evaluation, management, and administration of sports medicine from a sport medicine physician for any sports-related concussion.
Concussions are typically treated based on their severity. A child’s vital signs and level of consciousness require immediate medical evaluation following a concussion to determine a child’s vital signs and rule out any other injuries, such as those to the spine. According to recent guidelines, any child who loses consciousness as a result of trauma during a sporting event should be evaluated by a hospital emergency department right away. Athletes with less severe concussions are typically evaluated on-site by a sports medicine physician rather than in hospital emergency departments. There are several approaches to assessing “sideline” concussions. There are also guidelines available to help determine when a child is ready to return to play after a concussion.
Neuropsychological testing is widely regarded as the most sensitive method of detecting brain function disturbances associated with concussion. The National Football League and the National Hockey League, as well as many colleges, have implemented systematic programs of neuropsychological testing. Before the season, athletes are given brief tests of attention, memory, and information processing speed. Athletes who have suffered a concussion are tested again, usually within 48 hours of the injury and at regular intervals after that. Athletes are usually required to return to baseline performance levels before being allowed to play again. Similar cooperative programs can be implemented at the high school level for organized athletic programs. Athletes who complain of persistent post-concussive symptoms should be evaluated for a concussion in the absence of programmatic testing.
