Concussion Basics

INTRODUCTION

300,000 sports-related concussions in the United States per year; concussions are an unintended consequence of collision sports. Estimates vary regarding the likelihood of an athlete participating in a contact sport experiencing a concussion, but this may be as high as 10% per year in some sports. Furthermore, the effects of concussion are now known to be cumulative, even when the concussions are believed to be minor.

Concussions are complex

An athlete’s presentation reflects unique combinations of cognitive, physical and subjective symptoms. An initial period of rest from physical activity and avoidance of high-risk activities are typically the most effective treatment strategy with most cases resolving relatively quickly (7 to 14 days).

Symptoms can resolve at different rates and to different degrees; it is important to objectively evaluate and monitor all symptoms, cognitive, physical and subjective, to best determine injury severity and to plan appropriately for the proper return to play (RTP) process. Although there are more than a dozen grading scales for severity and RTP guidelines the over-arching recommendation is that an athlete must be symptom free before they return to play.

Neuropsychological measures

Shown to be sensitive to the effects of concussion and proven to be effective in objectively evaluating brain function. It is most useful when pre-injury “baseline” data is available for each athlete that can serve as a unique comparison point for that particular individual in the event of an injury. Neuropsychology offers unique and critical information that, when combined with data from the athlete, parent, athletic trainer and medical doctor, provides for the most effective and comprehensive system to manage sport-related concussions.

DEFINITION

Concussion is a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces. Several common features thConcussion can occur from either a direct blow to the head or face or to the body with an “impulsive” force transmitted to the head.at incorporate clinical, pathological, and biomechanical constructs that may be used in defining the nature of a concussive injury include:

ATHLETES AT RISK

Concussions can occur in any sport or activity; and are often the unintended consequence of the game, with the exception of boxing. Concussions are most often seen in collision sports, where full contact collisions are an expected part of the game, such as football, ice hockey and rugby.

Concussions also occur during participation in sports where high-speed collisions may not be a central part of the activity but happen nonetheless, such as in soccer, wrestling, basketball, diving, and competitive cheerleading. Risks for injury are also present outside of traditional organized sports, such as mountain biking, snowboarding, skateboarding and BMX racing.

A list of at-risk sports is presented below and is not meant to be exhaustive. Keep in mind that parents and coaches in every sport, even swimming, should become aware of the signs and symptoms of concussion.

RECOGNITION