NEITHER PROFESSIONAL ATHLETES, nor parents of an aspiring Olympian expect a trip to the emergency room while cheering on the sidelines. But then there is that moment when a cartwheel goes awry, a horse decides to throw its rider off, or a hockey stick collides with someone’s scalp.
A crowd gathers.
It all becomes a blur of flashing lights, antiseptic smells, and personnel in white coats.
Concussions are some of the most common resulting injuries from these scenarios. Even though, memory loss is always something everyone tends to freak out about, even a minor blow to the head may cause amnesia that lasts for hours.
So when should you worry?
There are signs and symptoms that call for an immediate evaluation. Loss of consciousness is one, and probably the most obvious. Anyone with a headache that is intensifying and nausea, or anyone who may have had a few beers before the game should get a scan of the head. Headache and irritability are common, but clumsiness, drowsiness, or the onset of new symptoms within hours after an injury warrant an evaluation.
Then there is the postconcussion syndrome. Headache, dizziness, and having trouble concentrating and focusing are common signs. These symptoms can recur daily for up to 2 weeks following a concussion, if not longer, in severe cases.
And what about the long term effects? Some studying the topic suggest that multiple concussions are linked to depression, anxiety, and learning difficulties. When analyzing kids between the ages of 5-18 who had a history of multiple concussions, neuro psychological testing indicated performance deficits up to 6 months, and even a year later. Some of these kids also experienced sleep disturbances, and problems with emotional regulation. While the extent of the effect of a concussion on lifelong function is still not definitively reported, there are brain changes that take place.
Not everyone with a concussion is at risk for permanent brain damage, but studies have shown that those with multiple concussions do have brain shrinkage in areas involved with emotional regulation, concentration, and attention.
A hiatus for at least 2 weeks or until the player is symptom free is key to recovery. Leaving the game altogether should be taken into serious consideration with multiple concussions in a young athlete.
Ref: Ropper et al. Concussion NEJM
Clinical Journal of Sports Medicine