Children’s & Women's Physicians of Westchester, LLP

CONCUSSION CAN HAVE DRASTIC CONSEQUENCES

There are numerous advantages to students playing sports in school. Physical activity keeps them fit. Sports bolsters self-esteem, and healthy competition builds character, promotes camaraderie, leads to lasting friendships, and allows children to set and reach goals.

There are caveats, however. Aside from the risks of everyday sports injuries, another looming threat to children on the playing field, basketball court or playground is the possibility of getting a concussion.

Concussion is defined as any injury to the brain that disrupts normal brain function on a temporary or permanent basis. Typically resulting from a blow or jolt to the head, concussion can actually alter the way the brain functions, and can have a number of deleterious effects. These can range from headache and lack of concentration and judgment to loss of memory and poor balance and coordination.

“Since most victims do not suffer a loss of consciousness with concussion, it can be overlooked as just a minor incident, or ignored altogether,” explains Carey S. Goltzman, MD, FA AP , Chief of Pediatric Critical Care Medicine at CWPW. “Symptoms of a concussion range from subtle to obvious and usually happen right after the injury but may take hours to days to show up.” With most concussions, the player is not knocked out or unconscious. A number of athletes who have had concussions may report feeling normal before their brain has fully recovered.

“Concussions can happen in any sport but more often occur in collision sports, such as football, rugby, or ice hockey,” Dr. Goltzman says. They also are common in contact sports that don't require helmets, such as soccer, basketball, wrestling, and lacrosse. However, a concussion can also occur from a collision with the ground, a wall, a goalpost, or a ball that has been thrown, hit, or kicked.

Many concussions also occur outside organized sports. For example, a child riding a bike or skateboard can fall down and bump his head on the street or an obstacle. About 375,000 children and teens are treated in emergency rooms annually just for basketball injuries alone (basketball is the most popular competitive school sport).

“All concussions are serious, and all athletes with suspected concussions should not return to play until they see a doctor,” Dr. Goltzman advises. “A doctor can confirm the diagnosis of concussion based on clinical presentation and can determine the need for any specialized tests, such as a CT scan of the brain, MRI of the brain, or neuropsychological tests and then decide if it is safe for an athlete to return to play.” Prematurely returning to play after a concussion, he adds, “can lead to another concussion or potentially a significant brain injury that could lead to death. An athlete with a history of a singular or multiple concussion(s) may be more susceptible to another injury than an athlete without a history of concussion.”

The best treatment for a concussion is complete rest from all physical and mental activity, Dr. Goltzman says. “Children may need frequent monitoring but there is no need for wake-up checks during sleep.” Access to loud music, computer, and television should be limited or stopped if they increase the symptoms. School attendance and work may need to be modified. Students need to be excused from physical education/gym class or recess activities. “Any worsening of concussion symptoms or changes in behavior (e.g., agitation, grogginess, disorientation),” he adds, “should be immediately reported to your physician.

“The best advice with any head injury,” Dr. Goltzman says, “is that it should never be ignored, no matter how major or minor it may be considered to be.

Mitigating harm to the head is key in preventing concussion, Dr. Goltzman insists. “Not all concussions can be prevented, but some may be avoided,” he says. Helmets should be worn for any riding activities (like horseback, all terrain vehicle [ATV], motorbike, bike, skateboard, or snowboard) or contact sports (like football, hockey, or lacrosse). Helmets should fit appropriately and be in good condition. Athletes should be taught safe playing techniques and to follow the rules of the game.

“Most importantly,” he states, “every athlete needs to know how crucial it is to let their coach, athletic trainer, or parent know if they have hit their head or have symptoms of a head injury — even if it means stopping play. Never ignore a head injury, no matter how minor.”

Symptoms of concussion include the following:

• Headache	• Feeling dazed or stunned	• Changes in mood—irritable, sad, emotional, nervous
• Nausea or vomiting	• Feeling mentally “foggy”	• Drowsiness
• Dizziness or balance problems	• Trouble concentrating	• Sleeping more or less than usual
• Double or blurry vision	• Trouble remembering	• Trouble falling asleep
• Sensitivity to light	• Slow to answer questions	• Confused or forgetful about recent events
• Sensitivity to noise

Back to News