Concussions

Signs Observed

• Appears to be dazed or stunned
• Is confused about assignment
• Forgets plays
• Is unsure of game, score, or opponent
• Moves clumsily
• Answers questions slowly
• Loses consciousness (even temporarily)
• Shows behavior or personality change
• Forgets events prior to hit (retrograde amnesia)
• Forgets events after hit (anterograde amnesia)

 Signs Reported by Athlete

• Headache
• Nausea
• Balance problems or dizziness
• Double or fuzzy vision
• Sensitivity to light or noise
• Feeling sluggish
• Feeling “foggy”
• Change in sleep pattern
• Concentration or memory problems

Post-Concussion Syndrome

Although the majority of athletes who experience a concussion are likely to recover, an as yet unknown number of these individuals may experience chronic cognitive and neurobehavioral difficulties related to recurrent injury. Symptoms may include:

• Chronic headaches
• Fatigue
• Sleep difficulties
• Personality changes (e.g. increased irritability, emotionality)
• Sensitivity to light or noise
• Dizziness when standing quickly
• Deficits in short-term memory, problem solving and general academic functioning

This constellation of symptoms is referred to “Post-Concussion Syndrome” and can be quite disabling for an athlete. In some cases, such difficulties can be permanent and disabling.

Concussion Treatment

The goal of concussion treatment is to allow the brain injury to heal. Treatment of concussions differs depending on the level of severity. Concussion treatment may include:

• Rest. Provide adequate time for recovery from a concussion. Do not rush back into daily activities for work or school.
• Preventing re-injury. Avoid activities that might jolt or jar your head. Never return to a sports activity until your doctor has given you clearance. Ask when it’s safe to drive a car, ride a bike, work or play at heights, or use heavy equipment.
• Observation by a responsible adult. Ask someone to awaken you every few hours as advised by your doctor. The doctor will explain how to watch for complications such as bleeding in the brain.
• Limiting exposure to drugs. Do not take medicines without your doctor’s permission. This is especially true with aspirin, blood thinners, and drugs that cause drowsiness. Avoid the use of alcohol or illicit drugs.

Concussion Recovery

Athletes who are not fully recovered from an initial concussion are significantly vulnerable for recurrent, cumulative, and even catastrophic consequences of a second concussion.

Such difficulties are prevented if the athlete is allowed time to recover from a concussion and return to play decisions are carefully made. No athlete should return to sport or other at-risk participation when symptoms of concussion are present and recovery is ongoing.

In summary, the best way to prevent difficulties with concussion is to manage the injury properly when it does occur.

 Source: National Center for Injury Prevention and Control, Division of Injury Response Heads Up! Concussion Information for Physicians Centers for Disease Control and Prevention (2011).

The Ontario Brain Injury Association (OBIA) has teamed up with the Canadian Hockey Association (CHA) in a co-operative endeavour to raise the level of understanding and management of concussion in sports.

The ultimate goal is to promote the recently announced Management of Concussion in Amateur Sports guidelines adapted from the American Academy of Neurology.