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Concussions & Young Athletes

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Sports Physicals

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Concussion’s Effects May Linger in Kids

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Concussions have been in the news a lot lately, particularly when they relate to children. Awareness about the dangers of concussions has changed how schools, coaches and parents watch for and treat this kind of injury. A new study released this week points out that some concussion side effects can last longer than thought.

Children who suffer even a mild concussion can have attention and memory problems a year after their injury.

The study results were published in the Archives of Pediatrics and Adolescent Medicine, and suggest that problems such as forgetfulness, dizziness,  and fatigue may linger for up to about 20 percent after an accident.

Forgetfulness, difficulty paying attention, headaches and fatigue were more common in study children who lost consciousness or who had other mild head trauma that caused brain abnormalities on imaging tests, compared with kids who didn't get knocked out or who had normal imaging test results.

Longer lasting symptoms were not determined since the study only followed children for a year after their injury. For that year though, children who had injury-related symptoms experienced "significant functional impairment in their daily lives."

"What parents want to know is if my kid is going to do OK. Most do OK, but we have to get better at predicting which kids are going to have problems," said study author Keith Owen Yeates, a Neuropsychologist at Ohio State University's Center for Biobehaviorial Health.

Children who have concussion symptoms may need temporary accommodations such as extra time taking school tests, or wearing sunglasses if bright light gives them headaches, Yeates said.

Most of the children in the study received their concussion from a sports related injury or fall, but about 20 percent had a mild brain trauma injury from a traffic accident or some other cause.

The study included 186 children, aged 8 to 15, with mild concussions and other mild brain injuries treated at two hospitals in Cleveland and Columbus, Ohio. The reports are based on parents' reports of symptoms up to 12 months after the injuries.

The brain injuries studied were considered mild because they involved no more than half an hour of unconsciousness; 60 percent of kids with concussions or other brain trauma had no loss of consciousness.

Overall, 20 percent who lost consciousness had lingering forgetfulness or other non-physical problems a year after their injury; while 20 percent who had abnormal brain scans had lingering headaches or other physical problems three months after being injured.

The study adds to research showing that mild traumatic brain injuries, including concussions "should not necessarily be treated as minor injuries," Dr. Frederick Rivara, Archives' editor, said in a journal editorial.

More information is needed to determine who is most at risk for lingering problems after these injuries, and to determine what type of treatment and activity restriction is needed, said Rivara, a pediatrician and University of Washington researcher.

The Centers for Disease Control and Prevention (CDC) defines a concussion as a type of traumatic brain injury caused by a bump, blow, or jolt to the head that can change the way the brain normally works. Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth. Even a “ding,” “getting your bell rung,” or what seems to be mild bump or blow to the head can be serious.

According to the CDC, if your child has any symptoms of a concussion - which include different sleeping patterns, mood changes or problems with cognitive processes - you should bring them to a medical professional. If the child is having a headache that won't go away, weakness or decreased coordination, vomiting or nausea, slurred speech, will not nurse or eat and/or is crying and cannot be consoled, they need to be taken to a hospital immediately.


Daily Dose

Concussions: A Life Lesson

A life lesson from a professional football player who knows first hand there's more to life than playing football.As you know, I have written many times and done numerous radio segments on the topic of concussions.  In the past several years there has been more attention paid to the risks of long term brain injury secondary to concussions and the medical literature continues to update guidelines for screening and treatment of concussions.

Many  professional sports organizations like the NFL, as well as college and undergraduate athletic organizations have also become aware of the risks of recurrent concussions and are adhering to guidelines to prevent players from returning to play without medical clearance. As a UT Longhorn fan/alumni, it was with concern and admiration that I read the story of  Tre Newton’s decision to retire from the UT team due to his history of repetitive concussions. The media reports out of Austin stated that, “Tre along with his parents and physicians” had decided that it was time to give up football to prevent further head injuries.  What a difficult and heartfelt decision that must have been!!!  His father, Nate Newton, had played for the Dallas Cowboys and Tre was a starting running back for UT. It is obvious that this is a “football family”. But, having watched as Tre suffered another concussion during a recent UT loss, and then reading the stories about his past history of concussions in the previous football season as well as during his high school days, it seems as if this young man took a good long look at the newest data on recurrent concussions and long term complications and knew it was time to end his football career. He is obviously not only an athlete, but also a scholar. I think that Tre Newton will be a role model to other talented young athletes who too may have had the unfortunate luck to have suffered concussions.  Sustaining a concussion whether in football, hockey, cheerleading, or any other sport is a risk that comes with contact sports. Some athletes seemed to be luckier than others. Despite the best efforts at developing new helmets, and mouth guards, the incidence of concussions is on the rise.  Children, teen and young adult athletes continue to report symptoms seen with a concussion, and we pediatricians are seeing this in our own offices.  I recently saw an 8 year old whose mother brought him in to be examined as she thought he might have a concussion. As you know, a concussion is not a structural injury, but rather a chemical and functional injury to the brain. It is somewhat analogous to a “bruise or sprain”, but involves the brain rather than a bone. Therefore the x-ray or scan of the head and brain will appear normal, but the neurological exam or the cognitive exam will be abnormal. This little boy did not remember the hit or being brought to the sideline, he was nauseated for a bit afterward. But…after my exam my recommendations, his mother did not want to “bench him” for the next week as he had a playoff football game and lacrosse try-outs. My question is “WHY”?  Why would you worry that your child might have a concussion, take him to the doctor, and then not follow the established guidelines for return to play. This just doesn’t make sense to me.  She also pointed out that her husband was the coach and had not heard of any information regarding concussions and rest, with gradual return to play. Hmmm. But, Tre Newton’s decision to retire from football makes a tremendous amount of sense. It also shows a great deal of maturity and intelligence. Tough decision, supported by loving parents who also knew “what was best for their son”.  I commend each of them and wish Tre good luck in whatever field he “plays” on post graduation. That’s your daily dose for today. We’ll chat again tomorrow. Send your question or comment to Dr. Sue!

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