Brain concussions common in contact sports

By David Pearce, M.D.

A concussion is one of the more common injuries suffered by high school athletes, particularly in contact sports like football.

A concussion is a brain injury produced by direct or indirect head trauma with symptoms that include amnesia, memory loss, difficulty concentrating, headache, sensitivity to light and dizziness (vertigo.) Delayed symptoms can include sleep disturbance, depression, fatigue, and feeling slowed down as if in a fog.

Because of the severity of a possible concussion, physicians will “over treat” head injuries and keep athletes out of the game if they are “not right,” appear to have memory loss or have a headache or nausea while running.

Athletes who sustain one concussion have a two- to four-time greater risk of sustaining another concussion injury. Though rare, “second impact syndrome” can result from a second closed head injury as a result of a second concussion before the original injury resolves. This condition is marked by severe brain swelling, increased intracranial pressure and cognitive impairment.

The brain, encased by the skull, does not tolerate or allow for swelling. Severe neurologic impairment or even death can occur with this syndrome, which is more common among children and young adults.

A concussion is serious; athletes who may have sustained a concussion should not be allowed to return to play until they are symptom free.

The U.S. Consumer Product Safety Commission (CPSC) estimated that about 358,000 concussion injuries (relating to all consumer products) occurred in 2001. This does not include concussions suffered in car accidents, boating accidents and other ways not under CPSC jurisdiction.

Of those injuries, about 28,000 were related to football in all age categories. About 18,700 were football-related and suffered by people 15 to 24 years old. About 17,000 of those were suffered by young people between 15 to 19 years old.

If patients continue to report symptoms related to concussions, such as headaches and dizziness, athletes should not be allowed to return to play. Severity is based on loss of consciousness or the presence of neurologic deficits. If these are present or loss of consciousness has occurred, the patient is sent to the emergency department for more extensive evaluations.

The universal consensus is that concussions are serious injuries, and athletes must be evaluated by experienced physicians before returning to play.