What parents and coaches should know about concussions

As the school year and fall sports season resumes, parents and coaches must be aware that children and adolescents may be at risk for concussions, experts warn.

According to a report by the Centers for Disease Control and Prevention, about 1.6 to 3.8 million sports- and recreation-related traumatic brain injuries occur in the United States each year. Most of these are concussions that are not treated in a hospital or emergency department, according to the CDC.

“Parents, coaches and the athletes themselves all need to be aware of the signs and symptoms of a concussion,” said Dr. Michael W. Barrow, medical director of The Sports Medicine Center at Good Samaritan North Health Center in Dayton.

We asked Barrow what parents and coaches should know about concussions.

Q: What is a concussion?

A: “A concussion is a disturbance in how the brain works. It is not a structural problem in the brain but rather a functional problem. As such, taking a picture of the brain with an MRI or CT scan does not generally identify where the problem actually is. For example, if your car has a knock, you would not expect a mechanic to pop the hood, take a picture of the engine, and hand it back to you indicating it looked fine. He really did not address the knock issues. The knock issues are the functional deficits we see with concussions.”

Q: What causes a concussion?

A: “A concussion is caused by a sudden trauma to the brain resulting in a change in mental status. Basically, the brain gets shaken or twisted rapidly, which causes a functional disturbance in the brain with symptoms such as headache, dizziness, forgetfulness, etc.”

Q: Does playing any sport pose a risk for a concussion for children and adolescents?

A: “Sports are the leading cause of concussions in children and adolescents. Sports involving contact and/or collision are the highest risk. This includes football, hockey, soccer, wrestling, etc. However, concussions can also be caused in golf as well as tennis. In addition, concussions can be caused by other activities such as bicycle or motor vehicle accidents.”

Q: What are the signs and symptoms of a concussion for children and adolescents?

A: “Signs and symptoms can include dizziness, headache, memory problems, concentration problems, fatigue, thinking followed by the feeling of photophobia (abnormal sensitivity to light) or phonophobia (sensitivity to sound). There may be forgetfulness as well as difficulty with sleep initiation and maintenance. Some people develop mood problems such as irritability or increased fatigue.”

Q: Is it possible for children and adolescents to have a concussion and not know it?

A: “It is possible to have a concussion and not recognize it. With a concussion, there is a disturbance in how the brain works. Sometimes the symptoms are so subtle that only others identify it. For example, teachers may note that students are having more difficulty with learning or that individuals are more irritable than usual.”

Q: Can a child or adolescent only be diagnosed with a concussion if they experience a loss of consciousness?

A: “Loss of consciousness is not necessary in order to be able to diagnose a concussion. In fact, it has been removed from the diagnostic criteria that we currently use for evaluation of concussions.”

Q: What should parents and coaches do if they suspect a child or adolescent has a concussion?

A: “If an athlete is suspected of having a concussion, they need to be immediately pulled from all activities and observe physical and mental rest. They should also be promptly seen by a physician that is comfortable with concussion management.”

Q: How is a concussion treated for children and adolescents?

A: “Concussions in adolescents and children tend to be more conservatively managed. We have learned that adolescent brains are going through puberty much like the rest of the body, and a brain going through puberty is more vulnerable to injury and less able to recover.”

Q: How long does it take for children and adolescents to recover from a concussion?

A: “Eighty percent clear in two to three weeks with the remainder generally taking over a month.”

Q: What are the long-term effects of repeat concussions for children and adolescents?

A: “Learning disabilities, ADHD (attention deficit hyperactivity disorder), depression, mood disorders, chronic headaches, chronic dizziness.”

Q: How can parents and coaches work to prevent children and adolescents from getting concussions?

A:“Proper equipment, proper coaching on hitting techniques, neck strengthening programs, not using the head as a weapon or battering ram, being smart when playing such as not diving into the stands for a loose ball, reduce or eliminate heading the ball.”

Q: What else should readers know about concussions?

A: “Concussions can be very serious and are frequently not identified. As such athletes sometimes go a week or two with concussion symptoms before they are appropriately diagnosed and treated. Any symptoms should be taken seriously. Athletes should not be told to push through the symptoms. Don’t go back too soon. If you have recurrent symptoms, promptly notify your coach and be removed.”

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