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Special Caution on Concussions

Special Caution on Concussions

Concussions occur frequently in athletes, but they are the type of sports injury about which we know the least. Experts say that's because of the brain's complexity, as well as a lack of research into concussions.

Concussions—defined as a trauma-induced alteration in mental status—are often difficult for doctors to recognize. A forceful hit to the head or any part of the body that cause a rapid movement of the head may result in a concussion.

The majority of concussions do not involve loss of consciousness. You don't even have to be hit on the head. A blow to the shoulder that violently snaps the head can cause a concussion.

According to the CDC, 65 percent of sports- and recreation-related concussions seen in the emergency department are in children ages 5 to 18 years. Symptoms may not happen immediately, but include impaired thinking, memory problems, and changes in emotions or behavior.

Helmets reduce injuries

Head injuries are most common in contact sports, but protective equipment can limit the risk. A helmet reduces the force of contact and slows the impact to the brain.

Unfortunately, helmets can give athletes a sense of invulnerability.

Soccer isn't risk-free, either. Children should not "head" the ball until they are in their mid-teens, although flying elbows, kicked balls, or collisions may pose bigger threats to unprotected heads.

The CDC recommends that you know your concussion ABCs: Assess the situation; Be alert for signs and symptoms, and Contact a health care provider. It's important to remember that you should not return to sports or recreation activities until you are evaluated by a health care provider experienced in treating concussions.

Rest is key for the treatment of a concussion; the brain needs time to repair itself.

Often athletes experience no symptoms after a few days. Headaches, nausea, and other problems may return from plunging back into sports too soon, though.

Other rules of treatment:

  • Immediately after injury, a doctor, school nurse, coach, or trainer who is experienced in evaluating concussions should check the person's mental status.

  • Remove the person from the activity, especially after loss of consciousness, until a health care provider experienced in evaluating concussions gives the person approval to resume sports or recreation activities. 

  • Initially monitor the person's level of consciousness very closely for 30 minutes, then monitor his or her state of consciousness closely for the next 24 to 72 hours.

  • Restrict activity until the person is cleared by his or her health care provider to resume normal activities.

  • The person should gradually return to light activity. Contact the person's health care provider if symptoms recur.

Experts agree that more research on concussions is needed. Having had one concussion increases your risk for a second, and may cause slower recovery from the second one if it occurs. Athletes tend to be bigger, stronger and faster these days. They are capable of causing much greater trauma than in the past.

Signs of a concussion

Although symptoms may not occur immediately, common signs include:

  • Headache

  • Dizziness or vertigo

  • Lack of awareness

  • Nausea and vomiting

  • Poor attention and concentration

  • Fatigue

  • Double or blurred vision

  • Irritability and/or bothered by light or noise

  • Memory problems

ImPACT Concussion Management 

Overview and Features of the ImPACTTM Test

ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is the first, most-widely used, and most scientifically validated computerized concussion evaluation system.

Developed in the early 1990s by Drs. Mark Lovell and Joseph Maroon, ImPACT is a 20-minute test that has become a standard tool used in comprehensive clinical management of concussions for athletes of all ages. ImPACT Applications, Inc. was co-founded by Mark Lovell, PhD, Joseph Maroon, MD, and Michael (Micky) Collins, PhD.

Given the inherent difficulties in concussion management, it is important to manage concussions on an individualized basis and to implement baseline testing and/or post-injury neurocognitive testing. This type of concussion assessment can help to objectively evaluate the concussed athlete's post-injury condition and track recovery for safe return to play, thus preventing the cumulative effects of concussion. In fact, neurocognitive testing has recently been called the "cornerstone" of proper concussion management by an international panel of sports medicine experts.

ImPACT Test Features 

Test features include:

  • Measures player symptoms
  • Measures verbal and visual memory, processing speed and reaction time
  • Reaction time measured to 1/100th of second
  • Assists clinicians and athletic trainers in making difficult return-to-play decisions
  • Provides reliable baseline test information
  • Produces comprehensive report of test results
  • Results can be e-mailed or faxed for fast consultation by a neuropsychologist
  • Automatically stores data from repeat testing
  • Testing is administered online for individuals or groups
  • Compatible with PC and MAC

The test battery consists of a near infinite number of alternate forms by randomly varying the stimulus array for each administration. This feature was built in to the program to minimize the "practice effects" that have limited the usefulness of more traditional neurocognitive tests.

The program measures multiple aspects of cognitive functioning in athletes, including:  

  • Attention span
  • Working memory
  • Sustained and selective attention time
  • Response variability
  • Non-verbal problem solving
  • Reaction time

ImPACT can be administered by an athletic trainer, school nurse, athletic director, team coach, team doctor, or anyone trained to administer baseline testing. ImPACT is the most widely used computer-based testing program in the world and is implemented effectively across high school, collegiate, and professional levels of sport participation.

For more information on how we can give you and your group a healthier advantage, contact a SportsCare representative at 214.603.3334, or use our online physician finder tool for a referral to an ImPACT certified physician on the Baylor medical staff.