Kessler Institute Offers Guidelines On Recognizing And Treating Concussion

Main Category: Sports Medicine / Fitness
Also Included In: Neurology / Neuroscience;  Rehabilitation / Physical Therapy
Article Date: 20 Aug 2010 - 3:00 PDT

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With fall sports season beginning, millions of students are preparing to take to the field. Among those playing football, soccer or other contact sports, more than 3.8 million will sustain a brain injury, with football-related injuries being the most prevalent.

"Mild traumatic brain injury (MTBI), often called a concussion, is the most common sports-related head injury, but one of the most difficult to diagnose," explains Neil N. Jasey, M.D., physiatrist at Kessler Institute for Rehabilitation. "A brain injury occurs when a blow or jolt to the head or body disrupts normal brain function, typically causing a change in mental status or consciousness. While radiographic evidence of an injury may not be apparent, long-lasting cognitive and behavioral effects can result. That's why it's critical to understand the symptoms, risks and guidelines for returning to play."

Unlike physical injuries, such as a sprain or fracture, signs of a brain injury may not be apparent. Initial symptoms may include confusion, disorientation, dizziness, headache, nausea, vomiting and/or extreme fatigue. Over time, other symptoms, including irritability, difficulty with memory or concentration, and depression, may appear, along with impaired judgment, behavioral issues and personality changes, which may be signs of "post-concussive syndrome."

"It is imperative that coaches, trainers, parents and players be aware of the serious after-effects of a concussion," advises Dr. Jasey. "Athletes also need to be honest about any problems they may experience. Players often ignore their symptoms, tough it out and return to play too soon in an attempt to keep a competitive edge. This can result in serious, long-term complications."

Kessler Institute for Rehabilitation, one of only 14 federally designated Model Systems for the treatment and research of traumatic brain injuries in the nation, offers these guidelines on recognizing and treating a concussion:

-- A baseline cognitive assessment should be part of pre-season physicals to help establish a "point of reference" which can be helpful in diagnosing the extent of a brain injury.

-- An athlete suspected of sustaining a MTBI should be removed from competition immediately, examined by a trained professional and observed for any symptoms.

-- Any athlete who experiences a loss of consciousness, even if just for a few seconds, should immediately be taken to an emergency room for a thorough neurological evaluation.

-- While there are no clear-cut guidelines for returning to play, rest is critical. It takes time for the brain to recover. Physical activities should be limited and the athlete should continue to be observed for several days. Adequate "cognitive" rest is also important, so television, video games and certain school work should be kept to a minimum.

"Most athletes recover spontaneously and completely from a concussion," says Dr. Jasey, "but remember that any injury to the brain is serious and requires immediate medical attention and appropriate treatment to avoid complications and optimize the health of the athlete."

Source: Kessler Institute for Rehabilitation

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