The most common symptoms of concussion
include:
• Drowsiness
• Headache
• Loss of consciousness
• Memory loss
• Irritability
• Confusion
• Balance problems, dizziness
• Difficulty speaking and communicating
• Depression
• Nausea and vomiting
• Changes in sleep patterns
Can neuropsychological
assessment help?
Because it is difficult to determine when
a concussion has fully healed, baseline neurocognitive
evaluation is an important tool
for assessing whether it is safe for an athlete
to return to play. Before the sports season
starts, each athlete takes a computerized test
that measures brain functions, such as memory
and reaction time. If an athlete later has
a concussion, post-injury tests can be compared
to the baseline evaluation to measure
the severity of the concussion and help doctors
monitor healing.
In addition, pre-season evaluations can
help identify athletes who have had previous,
unrecognized concussions and who are at risk
for repeat concussions. For example, past injuries
to the face or neck may have been accompanied
by an unrecognized concussion.
Neuropsychological assessment is widely
regarded as the most sensitive way of detecting
disturbances in brain function associated
with concussion. The National Football
League and the National Hockey League
have both instituted systematic programs of
neuropsychological testing, as have many
colleges.
Athletes are administered brief tests of attention,
memory and speed of information
processing before the season. Athletes who
sustain concussions are tested again, typically
within 48 hours of the injury and at regular
intervals afterward. Recovery to
baseline levels of performance is typically
required before
athletes are allowed to
return to play. Similar cooperative
programs can be instituted
for organized athletic programs at
the high school level. In the absence of programmatic
testing, athletes who complain of
persistent post-concussive symptoms should
be considered for a more comprehensive
neuropsychologic evaluation.
What can be done to
prevent or treat concussions?
Changes in the rules for athletic competition
have reduced the number of sports-related
concussions. After the National Collegiate
Athletic Association made the use of the head
when tackling illegal in 1976, the annual number
of head and neck injuries in football declined
by about 50 percent. The required use
of helmets in many contact sports and advances
in helmet design also has resulted in
fewer head injuries. Improved conditioning of
young athletes, especially strengthening of
neck muscles, may also help to prevent concussions.
The key to healing from a concussion
is complete rest. This includes not just
physical rest, but mental rest, as well. Reading,
computer work, video games and television
should be limited until all symptoms have
resolved. This typically takes 7 to 10 days, although
some people have symptoms for
weeks or months after the injury.
Once you are free of symptoms, you can
gradually return to physical and mental activity.
It is important to slowly return to daily activities
because being symptom-free does not
mean the brain injury has fully healed. Your
doctor may recommend a step-by-step program:
first add an activity, then monitor your
symptoms. If your symptoms do not return,
you can continue increasing the challenges.
This slow, steady approach typically reduces
the time spent away from school, work, and
athletics because it provides enough time for
the injury to heal. Diving back into activities
as soon as your symptoms have resolved can
bring them back on and require a return to
complete rest.
If a child sustains a concussion, parents
should seek appropriate medical care. They
should request a description of symptoms indicative
of worsening brain injury and of common
post-concussive symptoms, as well as
guidelines for return to play and for medical
98 BC The Mag FALL 2018