This is one in an occasional series about children’s health issues. We know that many of our readers are grandparents keenly interested in the health and well-being of grandchildren. We hope this series will provide readers useful health information you can share with your family.
Stories about the devastating after-effects of multiple concussions experienced by pro football players appear frequently in the press. Each story is sadder than the next, with reports of early dementia, depression, memory loss and suicide.
With so many kids and teens playing contact sports, the effect of concussions is something parents and grandparents should be aware of and concerned about. Morgan Courty is a Doctor of Osteopathic Medicine specialized in family medicine; he is affiliated with Indian River Medical Center and has a private practice in Sebastian. Dr. Courty says that young people are more susceptible to concussions than most adults.
While any type of head trauma can cause a concussion, kids who play sports are particularly vulnerable. High school athletes suffer thousands of concussions every year, most often in football, ice hockey and soccer. And the effects of these injuries are persistent; it’s not a matter of just shaking out the cobwebs. It is typical for symptoms to last 10 days or so, and in some cases, they can last for weeks or even months.
A concussion has occurred whenever there is change in mental status due to a trauma – most often, a blow to the head. Dr. Courty says, “Concussions cause a change in the way the brain functions – a change in metabolic processes.” Confusion, difficulty thinking clearly and difficulty concentrating all signal that a concussion has taken place. Loss of consciousness is not a defining factor – it may occur, but it just as likely will not.
Other signs that a concussion may have occurred vary in seriousness and intensity, but in all cases medical treatment should be sought right away:
• Looks very drowsy or cannot be awakened
• One pupil is larger than the other
• Has convulsions or seizures
• Cannot recognize people or places
• Is getting more and more confused, restless or agitated
• Demonstrates unusual behavior
• Loses consciousness for any length of time
When seeking treatment, parents should ask specific questions of their child’s healthcare team:
• What are common (and less common) post-concussive symptoms?
• What symptoms will indicate a worsening brain injury?
• What medical follow-up should take place?
• When – if ever – should my child return to playing sports?
On that last point, a physician-reviewed article on the MomsTEAM website (a source of information for sports parents) outlines that a return to the playing field is a gradual process. First comes a period of physical and cognitive rest. Parents should talk to their child’s physician once all post-concussion symptoms are gone to ask if non-strenuous exercise can begin (this excludes sports, weight training, cardiovascular training and any leisure activity that could lead to another head injury). Only after a visit to the doctor and full medical clearance should a return to sports and other strenuous activities be permitted.
Dr. Courty says it’s critically important that parents not try to diagnose whether a concussion has or hasn’t occurred. He says that such an evaluation should only be done by a licensed healthcare professional. So, if there’s even a suspicion of a concussion, the parent should err on the side of caution and seek immediate medical attention, either by their child’s primary care physician, a walk-in urgent care clinic, or an emergency room. The doctor will devise a treatment plan, which often includes rest and a gradual increase in activity levels.
Dr. Courty also warns against parents administering any type of medicine without direction from a physician. “Other types of head injuries can mimic a concussion,” he says. “For example, aspirin can worsen the situation if the injury caused intracranial bleeding rather than a concussion.”
People who have had a concussion in the past are at higher risk of having others, and it often takes longer to recover from those subsequent concussions. In some cases, “post-concussion syndrome” can occur – with ongoing physical, mental, emotional and behavioral symptoms, including irritability, sleep disturbances and dropping grades. In these cases, an effective treatment plan will often combine education, cognitive rehabilitation, psychological support and, in some cases, medication.
There is no conclusive evidence – at least as of now – that helmets reduce the risk of concussion, but they should be worn in sports and when biking, as they do reduce the risk of skull fractures and bleeding in the brain. Bike helmets are most effective when properly fitted; they should comfortably touch the head all the way around, be as low on the head as possible to maximize side coverage, and held level on the head with a snug strap. Getting a helmet professionally fitted by someone with a lot of experience is a good idea and such experts can often be found at bike shops.
Dr. Courty is part of Family Practice North, located at 801 Wellness Way, Suite 200, in Sebastian; the phone number is 772-581-5581.
