Head Impact

Know the risks, the symptoms and treatment needed for children and teens to recover from a concussion.

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Whether it’s through an organized sport or recreational activity, more young people are suffering from concussions. The American Orthopaedic Society of Sports Medicine (AOSSM) reports a 60-percent increase in concussion incidence among those aged 5 to 24 from 2007 to 2014.

“A concussion is any alteration of brain function caused by an impact to the head,” says Dr. Jennifer Norman, a pediatric neurologist at INTEGRIS in Oklahoma City. “This typically is associated with headache, dizziness, confusion, memory loss and difficulty concentrating.”

The AOSSM also states that youths between 15 and 19 years old were the most likely to have a reported concussion and that male patients were 1.5 times likelier to have a reported concussion regardless of the sport.

“It is incredibly important for children, parents and coaches to be educated in the signs and symptoms of a concussion,” Norman says. “If there is even a slight suspicion of a concussion, the athlete should immediately be removed from play until they can be evaluated. Athletes tend to be very competitive and will often sacrifice their own health for the team when in the heat of competition.”

She says athletes are at high risk for severe injury or death if they return to play before the symptoms of a concussion have resolved.

“If an athlete is hit again while they are recovering from a concussion – the ‘second hit phenomenon’ – the brain can suddenly swell,” Norman says. “In addition, an athlete continuing to push themselves physically or mentally while still recovering from a concussion will only lengthen the recovery process.”

She recommends physical and cognitive rest until a medical professional determines the symptoms of the concussion have ceased. This period includes restrictions on electronics, schoolwork and physical activity.

Dr. Theron Bliss, a family medicine physician specializing in sports medicine with St. John Health System in Tulsa, emphasizes the recovery process and says many adolescents don’t always follow the recommendations to help modify symptoms.

“Symptoms often don’t get better if kids are still on their phones, playing video games or trying to go to school,” Bliss says. “Many parents don’t want to keep their kids out of school, but then the symptoms will keep persisting and that tends to complicate treatment.”

Parents should track the number of concussions and include that in a child’s medical history, especially in preseason physical evaluations.

“If they have had too many concussions, we may have to keep them out of a contact sport based on their risk of having another one,” Bliss says.

For youths who have had multiple concussions, Norman recommends several sports that minimize the risk of physical contact, such as golf, swimming, cross country, track and tennis. These sports allow kids the benefit of participating in athletics while minimizing the risk of recurrent head injury.

“I tell all of my patients that doctors can fix a lot of problems,” Norman says. “They can replace your kidneys, liver, even heart. But you only have one brain, and there is no way to fix or replace it. Use your head wisely and save your brain.”

HEADS UP: Developed by the Centers for Disease Control and Prevention, HEADS UP is a series of educational initiatives to help improve prevention, recognition and response to concussion and other brain injuries. Resources are available for parents, coaches, athletes, schools and sports officials at  www.cdc.gov/headsup.

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