Sports-related concussions pose a big risk to children and teenagers, particularly since kids rarely tell parents or coaches that they've been bonked in the head so hard that they feel confused, nauseous, or have a headache that won't go away. Doctors increasingly realize that serious head injuries can cause permanent brain damage, particularly if they're not treated properly. Thus, parents need to make sure that young athletes know the symptoms and aren't afraid to report them.
That's the news from a review of problems with sports-related concussion, reported in the January Pediatrics. The numbers are eye-opening; 69 percent of high school football players in Minnesota who were hit so hard they lost consciousness kept playing that day, as did 81 percent of players who had a concussion without passing out. Someone who has just had a concussion is far more likely to have another within 10 days, the researchers say, and repeated concussions greatly increase the risk of permanent brain damage.
About 5 percent of high school football players have reported having concussions, but the number is probably much higher. A survey of coaches found that 42 percent think concussions happen only when someone loses consciousness, even though that's not true; 25 percent would let an athlete return to play with concussion symptoms. Add to that the fact that fewer than half of athletes understand the long-term deficits in thinking and memory that can come as a result of concussion, and you've got a big problem.
Tackle football players are clearly vulnerable, and soccer and hockey players also face elevated risk. But any blow to the head can cause a concussion, even from falling off a scooter in a driveway. Falls are the most frequent cause of nonfatal injuries among children, leading to 2.8 million emergency room visits a year, according to new data from the federal Centers for Disease Control and Prevention. New guidelines on diagnosing and treating concussion in adults, released today by the CDC and the American College of Emergency Physicians, can be found here. Information on the CDC's new child injury prevention program is here.
The doctors' advice: Make sure parents and children know the signs and symptoms of concussion, which include:
- Nausea or vomiting
- Difficulty balancing
- Vision changes
- Feeling "out of it"
- Difficulty concentrating
- Ringing in the ears
- Acting dazed or confused
- Problems remembering what just happened: "What quarter are we in?"
Anyone having one or more of these symptoms needs to stop playing and get to a doctor for neuropsychological testing.
A simple concussion resolves in seven to 10 days, and the new thinking is that a student athlete should be resting during that time. Younger children take longer to recover, and this is one situation where the American Academy of Pediatrics says it pays to be cautious. No kid likes to be out of the game, but when it comes to protecting the brain a child will use for a lifetime, it's worth sitting a few out.