Professional Opinion

Professional Opinion: How to recognize the symptoms of concussion

Dr. George Warner
Dr. George Warner

This week, Dr. George Warner, a board certified neurologist on the medical staff at Coastal Carolina Hospital, discusses concussion, how to recognize its symptoms and its long-term effects.

Question: "I've watched with interest the news about the connection between playing football and concussions as also depicted in the new movie "Concussion." What are the signs and symptoms of a concussion? How would I know if one of my loved ones has sustained a concussion?"

Answer: Concussions are most commonly triggered by a blow to the head caused by biomechanical forces, such as a fall or a header in soccer. In many cases, there are no external signs of head trauma, Concussions can result in temporary loss of normal brain function.

According to the National Center for Biotechnology Information, there are 1.6 to 3.8 million recorded sports-related concussions in the United States. This is most likely an underestimated number because of all the concussions that do not get medical attention. In the US, males have the most concussions by sheer number while females get them at twice the rate. Pediatrics and juveniles also have some of the highest rates.

Once a concussion is suspected, the injured party should be removed from play for an initial evaluation. Consecutive post-injury evaluations should occur for the player until there are no concussive signs or symptoms while at rest. Only at the point can graduated external activity (sprinting, drills, and sport specific exercise) be reintroduced.

If the patient and the people closest to him do not resolve each step to identify the concussion, the risk for injury becomes significantly higher when they return to play. It takes multiple caregivers to manage a concussion, and those closest to the athlete or patient needs to know what important questions need to be asked. This "team" approach can be made up of trainers, coaches, family, teachers, pediatricians and other physicians.

Symptoms of a concussion range from mild to severe. They can last for hours, days, weeks, or even months and fall into many categories.

The cognitive and mental status changes to monitor may include amnesia, confusion, inattention, disorientation and cognitive slowing. You will also want to pay attention to the person's physical symptoms. Physical indicators to watch for are headaches, nausea, light and sound sensitivity, incoordination, slurred speech and blurry vision. A person's mood can be affected causing depression or anxiety along with sleep disturbance.

Repeated concussions can cause micro-injuries to the brain that accumulate and go unnoticed over time. Every potential concussion or head injury needs to be well documented. In some cases, the brain can have adverse responses to the injuries causing advanced neurodegenerative disorders similar to Alzheimer's.

Many concussions are preventable if the proper changes in equipment, techniques and rules are made across the board. Examples may include not allowing headers in soccer and having harsher penalties for head to head contact in football. There are available concussion grading tools and programs available for pre-game activities, during a game and during rehabilitation.

It seems that sports-related traumatic head injuries will always be a topic of significance because of the abundance of high intensity sporting events in the US. The conversation is especially in the forefront because of the recent release of the Will Smith film, "Concussion." This biographical sports thriller and medical drama is about a physician who fought against efforts by NFL to suppress his research on the brain damage suffered by professional football players. The movie is bringing knowledge to the forefront and will hopefully help athletes to better understand the potentially devastating head injury.

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