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Approximately ten
percent of all athletes involved in contact sports, such as football,
hockey, and soccer suffer a concussion
each season (some estimates are as high as 19 percent). Because many mild
concussions go undiagnosed and unreported, it is difficult to estimate
precisely the rate of concussion in any sport. Symptoms are not always
definite and knowing when it is safe for an athlete to return to play
is not always clear.
The recognition and
management of concussion in athletes can be difficult for a number of
reasons:
- Athletes who have
experienced a concussion can display a wide variety of symptoms. Although
the classic symptoms of loss of consciousness, confusion, memory loss,
and/or balance problems may be present in some athletes with mild concussion,
there may or may not be obvious signs that a concussion has occurred.
- Post-concussion
symptoms can be quite subtle and may go unnoticed by the athlete, team
medical staff, or coaches.
- Many coaches and
other team personnel may have limited training in recognizing signs
of concussion and therefore may not accurately diagnose the injury when
it has occurred.
- Many players may
be reluctant to report concussive symptoms because of fear that they
will be removed from the game, or that it may jeopardize their status
on the team or their careers.
- Methods and tools
used to detect concussion and help make accurate return-to-play decisions
are inadequate.
- Traditional neurological
and radiological procedures, such as CT, MRI, and BEG, although invaluable
in discerning more serious head
injuries, are not consistently useful in evaluating the effects
of mild head injuries.
Recovery and safe
return-to-play
Allowing enough healing and recovery time following a concussion is crucial
in preventing further damage. Research suggests that the effects of repeated
concussion are cumulative.
Most athletes who experience an initial concussion can recover completely
as long as they are not returned to contact sports too soon. Following
a concussion, there is a period of change in brain function that may last
anywhere from 24 hours to 10 days. During this time, the brain may be
vulnerable to more severe or permanent injury. If the athlete sustains
a second concussion during this time period, the risk of permanent brain
injury increases.
Diagnostic tools like ImPACT computerized
software can help to make safe return-to-play decisions by comparing
an athlete's brain function before and after a suspected concussion.
For more information on safe return-to-play, download the sideline
evaluation card (pdf file).
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