You worry about your child breaking a bone or spraining an ankle while doing a favorite sport. But your child is also at risk of concussions. Each year about 300,000 sports-related traumatic brain injuries occur in our country, and most can be classified as concussions. This number could be much higher because many concussions go undiagnosed. Concussions can occur in any sport—and all are serious injuries. Learn from R. Robert Franks, D.O., an orthopaedic physician and Assistant Director of Sports Medicine at the Cooper Bone & Joint Institute, about how to identify such an injury and what you should do.
What is a concussion?
Dr. R. Robert Franks: A concussion is a brain injury caused by a force to the head or a direct force to the face or neck that is transmitted to the head. Concussions are the number one head injury among athletes. They are most likely to occur in football, boxing, hockey, wrestling, gymnastics, lacrosse, soccer and basketball. People can also get concussions from falls, accidents and physical violence, such as fighting.
What are the signs and symptoms of a concussion?
Dr. Franks: Early symptoms of a concussion are headaches, dizziness, confusion, ringing in the ears, nausea, vomiting and visual changes. Not everyone will experience these symptoms. Symptoms that can occur later include memory disturbances, poor concentration, irritability, sleep disturbances, personality changes and fatigue.
Cognitive symptoms may include unawareness of what is happening around the person (e.g., game score, opponent or quarter if playing football), confusion, amnesia, loss of consciousness and inability to detect time, date or place. Physically, someone with a concussion may experience loss of consciousness, impaired conscious state, poor coordination or balance, convulsions/impact seizure, problems walking, slowness in answering questions or following directions, distraction, problems concentrating, nausea/vomiting, vacant stare, glassy eyes, slurred speech, personality changes and decreased playing ability.
When is medical treatment necessary?
Dr. Franks: Seek immediate medical attention if you suspect a concussion. Untreated symptoms may lead to complications, with some even being fatal.
How is a concussion treated?
Dr. Franks: The doctor will examine the patient to determine whether there is a concussion, and, if so, how serious it is. An MRI or a CT scan may be ordered to rule out additional or more serious injury.
Most of the time concussions are treated with rest and, sometimes, medications to relieve the symptoms. DO NOT give any medications unless the doctor gives permission. Aspirin, for example, may contribute to bleeding, which may be a complication in a brain injury. Watch the person for several days for neurological deterioration or the development of additional symptoms.
How long will the symptoms from the concussion last?
Dr. Franks: Often the symptoms of concussion last a few days to a week. Unfortunately, they can last much longer, especially if the person has had more than one concussion.
What happens if these prolonged symptoms do not go away?
Dr. Franks: When symptoms last several days, they usually encompass physical as well as cognitive and possibly psychological difficulties. These symptoms should be treated by a sports medicine physician who specializes in concussion, a neuropsychologist, sports psychologist or psychiatrist and possibly a neurologist. These doctors often must work as a team to help clear these persistent concussion symptoms within the athlete.
Why is a team of doctors needed to treat a concussion?
Dr. Franks: When symptoms do not go away, sometimes more than one doctor is needed. Sports medicine doctors can treat physical symptoms with medicines and treat minor cognitive problems after checking brain function with a neuropsychological computer program such as IMPACT. When more severe cognitive symptoms are present, neuropsychologists may need to administer more in-depth neuropsychological testing to assess brain function to help treat the patient. Sports psychologists and psychiatrists may be needed to help with emotional features of concussion such as depression.
When can the athlete go back to playing sports?
Dr. Franks: Someone with a concussion should not go back to a sport until symptoms have gone away. No athlete should return to play until cleared by a physician. Most people recover fully, but the healing process takes time. The risk of complications from concussion increases when patients are not given adequate time to heal.
How can concussions be prevented?
Dr. Franks: Using protective equipment and properly following the rules of a game often can help prevent a concussion, but unfortunately, it is a common injury in many sports.
Is there anything that can help the doctors treat a concussion?
Dr. Franks: Providing a good concussion history, like any part of a patient’s medical record, can help doctors determine appropriate treatments. It is now widely accepted that using neuropsychological computer testing such as IMPACT can help give doctors an idea of what the athlete’s brain function is like before a concussion so that they can follow the patient with serial testing to track improvement after concussion symptoms. This addition to concussion management has been deemed so important that the Brain Injury Association of New Jersey has tried to get this computer program into 100 high schools for this school year to help treat athletes with concussions.
If you would like to schedule an appointment with a Cooper University Hospital physician, please call (800) 8-COOPER.