NEW ORLEANS – The start of this year’s football season brings an increased focus on protecting players at all levels from experiencing a concussion. Concussions are much more serious than just “getting your bell rung” or “seeing stars”. In fact, many concussion sufferers, especially high school athletes, take weeks to recover. With the abundance of today’s contact and extreme sports there is a lot of news about concussions, however, many of us do not know much about this common injury.
“A concussion is a brain injury that occurs when the brain bumps against the skull,” said Dr. Aaron Karlin, Director of Concussion Management Program and Section Head of Pediatric Physical Medicine & Rehabilitation, Ochsner Medical Center – North Shore. “The force of the impact can cause ‘tearing or twisting’ of neuronal structures in the brain which then causes a breakdown in the normal flow of messages within the brain.”
A concussion can be caused by an external force hitting the head such as a linebacker tackling a quarterback or from the head hitting something, perhaps from a fall from a bicycle. Dr. Karlin says concussions are more common than one might think. In fact, according to the Centers for Disease Control, as many as 20 percent of all athletes involved in contact sports experience a concussion each season with the majority occurring at the high school level.
“One myth about concussions is that you have to be ‘knocked out’,” says Dr. Karlin. “This is absolutely false. In fact, less than 20 percent of individuals who incur a concussion have associated loss of consciousness.” Dr. Karlin also says that some people actually suffer a concussion and never realize it because their symptoms may go unnoticed.
Symptoms to look for include:
- Sleep cycle disruption
- Emotional lability (e.g. excessive irritability) or overly-flattened affect
- Sensitivity to light and/or noise
- Dizziness or imbalance
- Disruption of memory, attention, and/or concentration
- Difficulty with problem solving or slowed processing speed
Dr. Karlin says a concussion patient experiencing seizures, repeated vomiting, slurred speech or declining mental status, such as difficulty in being awakened, should seek emergency medical assistance as soon as possible.
When it comes to concussions, resting the brain is just as important as resting the body. “In addition to physical rest, it’s equally important for these patients to reduce cognitive stressors such as TV, texting, computer usage, reading, video gaming, or other activities that increase the brain’s metabolism so that it can adequately heal,” says Dr. Karlin. “It is also critical that the patient has full recovery from their concussion and has completed an appropriate graduated return to play protocol before they return to any sports activity. Repeat head injuries following an initial concussion – and before adequate brain healing - can be quite serious, resulting in worsening or exacerbation of the patient’s symptoms, prolonging one’s recovery course, or even death in the case of second impact syndrome.”
Dr. Karlin recommends that any athlete suffering from a concussion be monitored by a medical provider trained in the management of concussions in order to determine when it is safe to return to play. To ensure that local high school athletes do not return to the playing field too soon, he offers baseline neurocognitive testing utilizing ImPACT testing. ImPACT is a computerized evaluation system used by numerous professional and collegiate athletic teams which focuses on the potential cognitive effects a concussion can have upon the brain. Reaction time, memory and processing speed are among the many facets of brain function assessed. Baseline testing allows for an individualized comparison of cognitive functioning specific to each athlete in the event of a concussion.
Dr. Karlin points out that ImPACT is just one tool in the toolbox of a concussion specialist’s evaluation, which should also include a review of each patient’s concussion-related symptomatology, a full neurologic examination and balance testing. All of the components when evaluated together provide the necessary information for an experienced clinician to properly manage a concussion.
Not all concussions are preventable but being prepared and following safety guidelines can help reduce an athlete’s risk. “Wear the appropriate gear for the sport you play,” says Dr. Karlin. “For example, if you play football, wear a helmet that fits properly; if you bike, wear an appropriate bicycle helmet.” In addition, Dr. Karlin says athletes, parents and coaches should all be aware of and follow the rules and safety guidelines for a sport. Coaches and trainers should also learn the warning signs of a concussion and be prepared to take a player out of the game if they exhibit those symptoms. “When in doubt, sit them out,” says Dr. Karlin. “It’s better to miss one game or practice than a whole season.”
Ochsner Health System is southeast Louisiana’s largest non-profit, academic, multi-specialty, healthcare delivery system. Driven by a mission to Serve, Heal, Lead, Educate and Innovate, coordinated clinical and hospital patient care is provided across the region by nine hospitals, both owned and managed, and more than 40 health centers in Louisiana. Ochsner has been named the Consumer Choice for Healthcare in New Orleans for 17 consecutive years and is the only Louisiana hospital recognized by U.S. News & World Report as a “Best Hospital” across 8 specialty categories. Ochsner employs more than 14,000 employees, over 900 physicians in over 90 medical specialties and subspecialties and conducts over 300 clinical research trials annually. Ochsner Health System is proud to be a tobacco-free environment. For more information, please visit ochsner.org and follow us on Twitter and Facebook.