This time of the year, with the seasonal return to collision sports such as football and, later, ice hockey, I am reminded of an important health issue for kids: concussions.
If you follow sports, no doubt you are familiar with the concerns raised by former NFL players suffering the chronic effects of traumatic brain injury.
Yet, with their developing brains and high rate of participation in collision sports, kids face an equally important risk from head injury. Fortunately, more attention is being paid to this issue. Some football teams have even gone to “no tackle” practices to limit risk of head injury.
The annual incidence of sport-related concussion in the United States varies from 1 million to 3 million events. In football alone, an estimated 20 percent of high school athletes suffer a traumatic brain injury each season.
Concussion results from a blow to the head, which produces shear forces in brain tissue at the microscopic level. The most common symptoms are confusion and loss of memory. Loss of consciousness may or may not occur.
Soon after a concussion, the athlete may suffer from headache, imbalance, nausea and vomiting. Over a period of hours to days, symptoms may evolve to include mood changes, thinking problems, sleep problems and sensitivity to light and sound.
Several risk factors increase the likelihood of a concussion after head injury. As previously mentioned, children are more susceptible because of their developing brain. Other risks include history of a neurological or developmental disorder, headache syndrome or mental-health disorder. Girls are more susceptible to concussion than boys.
Other factors, such as dehydration, tiredness, lack of adequate sleep, illness or drug use also may lower the threshold for concussion.
One final risk for concussion is the history of a previous concussion or head injury. Evidence shows not only that prior concussion increases risk of another concussion but also that recurrent concussion can lead to more prolonged symptoms.
The highest-risk sports for concussion are collision sports such as football, hockey, rugby, boxing and lacrosse. Especially among girls, soccer and cheerleading carry increased concussion risk.
A greater awareness of concussion and its relevance to health has led to improved systems of care for athletes who suffer a concussion. Many sports leagues have implemented sideline evaluations by trained staff using validated assessment strategies for athletes who suffer a blow to the head.
In addition to medical evaluation in the emergency room for those with more serious injuries, close outpatient follow-up permits medical reassessment of persistent concussion symptoms. These evaluations permit informed decisions about the timing of return to play.
Parents can also be good advocates for young athletes, paying attention to the subtle and delayed symptoms of concussion after a head injury. These should prompt medical assessment, especially when the original injury may not have been recognized.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.