Taking concussions more seriously

In the past five years, brain experts have learned more about concussions than in all the previous years put together.

It’s now known that a concussion is actually a mild form of brain injury, with potential long-term consequences if it’s not managed correctly. We now know that when children and teens sustain a sports-related concussion, it takes longer for their still-developing brain to heal than it does for an adult, and that cognitive rest needs to be part of the recovery process.

The science has literally been a game-changer. This year Minnesota became one of the latest states to implement a law requiring young athletes to be removed from play if they’re suspected of having a concussion. The new state law also requires coaches and officials to undergo training on how to recognize and manage concussions. It’s hoped that, down the road, fewer sports-related concussions go undiagnosed and fewer kids end up with memory problems or long-term cognitive disabilities from a blow to the head.

It may take some time, though, for all of this knowledge to percolate down to the public’s level. In a report published last year in the Pediatrics journal, researchers came to the rather disturbing conclusion that many parents don’t take concussions as seriously as they should.

The researchers analyzed the medical records of 434 children admitted to a children’s hospital in Hamilton, Ontario, with a diagnosis of acquired brain injury. Out of 341 of these kids who had a brain injury, 32 percent were formally diagnosed with a concussion.

The kids who were diagnosed with a concussion left the hospital sooner and returned to school sooner, the researchers found. In fact, they noted an apparent trend: Simply being labeled as having a concussion seemed to be a strong predictor for how soon these young patients were sent home from the hospital.

Do parents understand what is meant by the term “concussion”? Many of them may not realize that a concussion involves injury to the brain and hence regard it as less serious, the researchers wrote. They argue for calling a spade a spade: The term “mild traumatic brain injury” should be used so parents have a more accurate understanding of their child’s head injury and can make better decisions.

Concern for the long-term impact of concussion extends to the world of professional sports as well. There are signs that pro baseball and the NFL are beginning to take head injuries more seriously. But only this week, an editorial in Canada’s National Post blasted the National Hockey League for caring more about market share than “the woozy, battered elephant in the room.”

If people don’t take concussions seriously enough, perhaps the real issue is that many of them are relying on outmoded information. After all, it wasn’t that long ago that young athletes were sent right back onto the field after taking a blow to the head, and it was considered acceptable to do so. As the state of knowledge continues to evolve, many of these practices are being discarded in favor of approaches backed by the accumulating evidence on the long-term impact of concussions.

Could some concussions be prevented altogether? Although this issue doesn’t seem to be talked about very widely, it seems ripe for further study. A study last year found that in the decade from 1997 to 2007, sports-related concussions among pre-teens and adolescents doubled in incidence, in spite of an overall slight decline in the number of kids participating in organized sports.

Some of this may simply be due to better recognition of sports-related concussions. But there also appears to be an overall increase in the number of concussions among middle-school and high school-aged kids, period. Is it because many young athletes these days are larger? Is it because they play more aggressively? The reasons aren’t clear.

Science will no doubt continue to advance what we know about concussions. It’s to be hoped that athletes will some day be much better protected against permanent damage from a blow to the head, and that there’ll be a better public understanding that concussions can be serious indeed.

West Central Tribune photo by Ron Adams

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