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Concussions: Advice For Parents Of Youth Athletes
By Robert C. Cantu, MD

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No More Challenging Problem
Where Experts Agree
Advice To Parents: Be Proactive
Are Children More Vulnerable To Brain Injury?

No More Challenging Problem

Team physicians, athletic trainers, and other personnel responsible for the medical care of athletes face no more challenging problem than the recognition and management of concussions (generally defined as injury to the brain caused by a sudden acceleration or deceleration of the head that results in any immediate, but temporary, alteration in brain functions, such as loss of consciousness, blurred vision, dizziness, amnesia or loss of memory).

No consensus has developed in the medical community on either the definition and grading of concussions or when it is safe for an athlete to return to play, as evidenced by the different guidelines that have been proposed.

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Where Experts Agree

It is up to a physician, in the exercise of his or her clinical judgment, to decide when an athlete should be allowed to return to play a contact or collision sport after suffering a concussion. Experts, however, do agree on one thing: that an athlete should never return to contact or collision sports while still suffering post-concussion symptoms at rest and with exertion. To allow such an athlete to return to play risks not only cumulative brain injury, but also Second-Impact Syndrome (SIS), which occurs when an athlete who sustains a head injury - often a concussion or something worse, such as a cerebral contusion (bruised brain) - sustains a second head injury before symptoms associated with the first injury have cleared (i.e. healed). Not surprisingly, it would also be against the recommendations of all current guidelines. [For an article comparing the three most commonly used guidelines, click here.

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Advice To Parents: Be Pro-Active

Parents should not be passive bystanders when it comes to the subject of concussions in sports.

Here are some things parents can do to minimize the risks that their child will suffer a concussion while playing sports and, more important, is not allowed to return to play too soon:

  • Educate yourself and your child about the signs and symptoms of a concussion and the dangers of returning to sports too soon after a concussion, especially SIS.

    • Remember: an individual does not have to suffer a loss of consciousness (LOC) to have suffered a concussion.

    • In fact, the vast majority of concussions (more than 90% in one study) did not involve LOC.

    • Because SIS can occur after a mild (Grade 1) concussion, just as it can after more serious head injuries, it is very important, even for parents, to recognize all grades of concussion.

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Related Articles

 Treating Athletes With Concussions: No Clear Consensus
 Concussion Grading Systems And Return-To-Play Guidelines: A Comparison
 Post-Concussion Signs & Symptoms: A Checklist
 Standardized Assessment of Concussion (SAC)
 Balanced Error Scoring System (BESS)
 Managing Concussions In High School Sports: A Proposed Model
 Having An Emergamcy Plan

Robert C. Cantu, MD is Chairman, Department of Surgery, and Chief, Neurosurgery Service at Emerson Hospital in Concord, Massachusetts. Dr. Cantu is also medical director of the National Center for Catastrophic Sports Injury Research in Chapel Hill, North Carolina, a past President of the American College of Sports Medicine, a fellow of the American College of Surgeons (FACS), and an editorial board member of The Physician and Sports Medicine.

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