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, evaluation 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.
Where Experts Agree
It is therefore 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.
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.