Health Care and Concussions

A blow to the head can be a serious injury. With the advent of football season and other school sports, concussions occur with frequency during the fall season. A concussion, according to WebMD, is a type of traumatic brain injury that is caused by a blow to the head or body, a fall, or another injury that jars or shakes the brain inside the skull. And, although there may be cuts or bruises on the head or face, there may be no other visible signs of a brain injury.

According to the Mayo Clinic, concussions are common, particularly if you play a contact sport, such as football. But every concussion injures your brain to some extent. This injury needs time and rest to heal properly. Luckily, most concussive traumatic brain injuries are mild, and people usually recover fully. The signs and symptoms of a concussion can be subtle and may not be immediately apparent. Symptoms can last for days, weeks or even longer. The most common symptoms after a concussive traumatic brain injury are headache, amnesia and confusion. The amnesia, which may or may not be preceded by a loss of consciousness, almost always involves the loss of memory of the impact that caused the concussion.

The brain is made of soft tissue and is cushioned by spinal fluid. It is encased in the hard, protective skull. When a person gets a head injury, the brain can move around inside the skull and even bang against it. This can lead to bruising of the brain, tearing of blood vessels, and injury to the nerves. When this happens, a person can get a concussion — a temporary loss of normal brain function, according to KidsHealth.org. Concussions and other brain injuries are fairly common. About every 21 seconds, someone in the United States has a serious brain injury. One of the most common reasons people get concussions is through a sports injury. High-contact sports such as football, boxing, and hockey pose a higher risk of head injury, even with the use of protective headgear. People can also get concussions from falls, car accidents, bike and blading mishaps, and physical violence, such as fighting. Interestingly, boys are more likely to get concussions than girls. However, in certain sports, like soccer, girls have a higher potential for concussion.

Signs and symptoms of a concussion, according to the Mayo Clinic, may include:
--Headache or a feeling of pressure in the head.
--Temporary loss of consciousness.
--Confusion or feeling as if in a fog.
--Amnesia surrounding the traumatic event.
--Dizziness or "seeing stars".
--Ringing in the ears.
--Nausea or vomiting.
--Slurred speech.
--Fatigue.

Some symptoms of concussions may be immediate or delayed in onset by hours or days after injury:
--Concentration and memory complaints.
--Irritability and other personality changes.
--Sensitivity to light and noise.
--Sleep disturbances.
--Psychological adjustment problems and depression.
--Disorders of taste and smell.
--Symptoms in children.

Head trauma is very common in young children, according to the Mayo Clinic. But concussions can be difficult to recognize in infants and toddlers because they can't readily communicate how they feel. Nonverbal clues of a concussion may include:
--Listlessness, tiring easily.
--Irritability, crankiness.
--Change in eating or sleeping patterns.
--Lack of interest in favorite toys.
--Loss of balance, unsteady walking.

You should see a doctor within one to two days if you or your child experiences a head injury, even if emergency care isn't required. The American Academy of Pediatrics recommends that you call your child's doctor for advice if your child receives anything more than a light bump on the head. If your child remains alert, moves normally and responds to you, the injury is probably mild and usually doesn't need further testing. In this case, if your child wants to nap, it's OK to let them sleep. If worrisome signs develop later, seek emergency care. Seek emergency care for a child who experiences a head injury and:

--Vomiting.
--A headache that gets worse over time.
--Changes in his or her behavior, including irritability or fussiness.
--Changes in physical coordination, including stumbling or clumsiness.
--Confusion or disorientation.
--Slurred speech or other changes in speech.
--Vision or eye disturbances, including pupils that are bigger than normal (dilated pupils) or pupils of unequal sizes.
--Changes in breathing pattern.
--Lasting or recurrent dizziness.
--Blood or fluid discharge from the nose or ears.
--Large head bumps or bruises on areas other than the forehead, especially in infants under 12 months of age.

Seek emergency care for anyone who experiences a head injury and are suffering the following:
--A loss of consciousness lasting more than a minute.
--Repeated vomiting.
--Seizures.
--Obvious difficulty with mental function or physical coordination.
--Symptoms that worsen over time.

No one should return to play or vigorous activity while signs or symptoms of a concussion are present. Experts recommend that an athlete with a suspected concussion not return to play until he or she has been medically evaluated. Experts also recommend that child and adolescent athletes with a concussion not return to play on the same day as the injury.

The severity of concussion is determined after all of the symptoms have resolved, the neurologic exam is normal, and brain function has returned to normal, according to Kids Health. There are different types of concussion:

1.) Simple concussion. Someone with a simple concussion experiences symptoms that get better in 7-10 days.

2.) Complex concussion. Someone with a complex concussion experiences persistent symptoms that last longer than 7-10 days. Doctors also consider it a complex concussion if a person loses consciousness (passes out) for more than 1 minute or has a seizure at the time of the injury. It's also a complex concussion if someone has had a concussion before, no matter how long ago. It's important for anyone who sustains a complex concussion to see a concussion or brain injury specialist.

A player should not return to sports practice or a game on the day that they are injured and they should not return to sports activities until they are no longer experiencing symptoms. In many teens the physical symptoms get better before the symptoms related to thinking, according to Kids Health. During the first few days following a concussion, a player should rest. Both physical and cognitive rest are important. Activities that require concentration and attention may make the symptoms worse and delay recovery. After a player's symptoms have resolved, he or she may begin a supervised gradual return to play. The player should advance from one step to the next only if there are no symptoms. The steps to return to play are:

--no activity.
--light aerobic exercise, such as walking or stationary cycling (no resistance training).
--sports-specific exercise (for example, running in soccer, skating in hockey).
--non-contact training drills.
--full contact training after medical clearance.

A concussion is a serious brain injury, and if left untreated can cause more health problems or worse. It is critical that trained athletic personnel or a medical professional treat someone who has suffered a concussion as soon as possible. Concussions are not to be taken lightly, and anyone who has one should be careful on how quickly they try to recover. If you suspect you or someone in your care has had a concussion, go to your family doctor or an emergency room as soon as possible. Don't delay medical treatment as the repercussions from ignoring a concussion are significant.

Until next time.