Ask The Expert

concussions

April 24, 2008|By Holly Selby

There are between 1.6 million and 3.8 million sports-related concussions a year, according to the U.S. Centers for Disease Control and Prevention. The majority of those injuries are caused by playing football, says Dr. Yvette Rooks, a family medicine physician at the University of Maryland Medical Center and team physician for the University of Maryland, College Park.

As the weather warms up and kids stream outside to participate in sports such as lacrosse and bicycling, it makes sense to take precautions against head injuries.

"I think that we may be seeing more injuries because we have more kids -- even at 4 or 5 years old -- playing a higher level of sports at younger ages. And we also may be recognizing the injuries more," Rooks says.

What is a concussion?

A concussion is an injury to the brain typically caused by a blow or strike to the head that can cause a range of symptoms. It is an injury that temporarily interferes with brain function.

What are the symptoms of a concussion?

A concussion can affect memory, judgment, speech, balance and coordination. There may or may not be a loss of consciousness accompanying the injury. The injured person could have a headache, visual problems -- there really is a constellation of symptoms.

If you suspect that your child, or anyone for that matter, has suffered a blow to the head, what should you watch for?

Irritability, headache, sometimes nausea or vomiting, ringing in the ears, poor concentration, really just not acting themselves. And these symptoms could occur immediately after the injury to a few days out.

As a doctor, when do you typically see the most concussions?

We tend to see concussions all year long -- because kids play sports all year round. But we see the most during football season and in male athletes. We are seeing more injuries in young female athletes because of the aggressiveness of soccer and because they head the ball. But you can ride a bike without a helmet and get a concussion.

If a concussion goes untreated, what are the repercussions?

If a child has a mild concussion, they typically will recover from that. The issue is (if they play a sport regularly) whether they have suffered multiple concussions, which can have long-term effects. They are researching now whether repeated injury to the brain can cause a predisposition for Alzheimer's.

And there is something called second-impact syndrome, which can be very dangerous and can lead to death. It occurs if the brain has been injured and hasn't yet recovered from that injury when it is injured again. A second injury can cause the brain to swell to a point where it has no more room to swell in.

How is a concussion treated?

Treatment will vary depending upon the signs and symptoms that a patient has. Watchful waiting and short-term re-evaluation to see if there are signs of improvement is typical.

If, for example, the patient were an athlete who suffered a loss of consciousness, that individual might be "imaged" [given a CT scan or MRI]. But there is no magical medication for concussion.

What do you typically tell a patient who has a concussion?

I'm the team physician at the University of Maryland, College Park, and the first thing I do is get a history of events previous to the event and immediately after. At that time, if there are signs such as headache or visual symptoms, I tell them to be quiet -- not bed rest, but to get no stimulation.

Getting them out of an exciting environment so their brain can heal is important. And I see them as often as needed (it can be as often as every 15 minutes) up to 24 hours after the event. After that, we follow them accordingly.

Are there any steps to be taken to help prevent concussion?

It is important to be really careful with young children. All the studies have shown that multiple concussions can cause more long-term damage. Coaches need to recognize the symptoms of these injuries. Other steps you can take to protect children include:

Make sure they have appropriate coaching.

Make sure they wear a helmet that is the proper size for lacrosse, football, bicycling, Rollerblading, riding a scooter -- anytime they are at risk for falling and striking their heads.

Know the symptoms, and if they are present, consult a medical expert.

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