Concussion Management

Concussion is defined as an IMMEDIATE and transient loss of NEURONAL function(Loss of Consciousness,  memory, and motor skills) secondary to trauma.  Concussion may be caused either by a direct blow to the head, face, neck or elsewhere on the body with and impulsive force transmitted to the head.  There are 300,000 sports related concussions yearly and brain injury causes more death than any other injury in sports.

Sports with the highest incidence of concussion includes: Football(accounts for more concussions than any other sport in North America; 250,000 injuries/yr), Soccer(upper limb to the head), Skiing, boxing, Equestrian, Biking(more children ages 5-14 go to the ER with head injury related to biking than any sport)

What can we as parents, coaches, or doctors do to prevent or assess someone who have a concussion?  Safety should always be the number one the agenda.  Make sure to wear a helmet CORRECTLY for the appropriate sport.  Ask him or her if have you EVER hurt your head before?  Do not ask if they have had a concussion before because they might not know what a concussion is!

Why is the have you ever had one(concussion) before such an important question?  The brain heals slowly and before the brain has completely healed it is very susceptible to a second injury.  This second injury can lead to a second impact syndrome.  If you have a concussion the odds are 2-6 time greater for another.  Also, being a female may increase the risk of suffering a concussion and injuries on the head and face.

Coaches, also be aware that there is a significant difference in the incidence of concussion as reported to the coaching staff or health care providers verses the incidence of symptoms of concussion experienced by the athlete.  They will often tell their teammates or their teammates will pick up clues that there is something wrong with a concussed athlete.

Management of a concussed athlete includes:

  1. Record the time of the initial injury and document serial assessments.
  2. Monitor vital signs and level of consciousness every 5 minutes after a concussion until the athlete’s condition improves.
  3. The athlete should also be monitored over the next few days after the injury for the presence of delayed signs and symptoms and to assess recovery
  4. Assess the cervical spine and cranial nerves to identify any cervical spine or vascular intracerebral injuries.

You need to know what you need to know BEFORE you need to know it!

Yours in Health,

Dr. Nam