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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).
ImPACT Concussion
Evaluation Software
UPMC concussion experts have helped to develop a computerized testing
system to evaluate the severity of concussions in athletes. Known as ImPACT
(Immediate Postconcussion Assessment and Cognitive Testing), the system
helps to provide a more accurate determination of when an athlete who
has had a concussion can safely return to active contact sports.
ImPACT is being
used by several professional, college, and high school sports teams around
the United States as part of studies funded by the National Collegiate
Athletic Association and the National Academy of Neuropsychology.
With ImPACT, doctors
can conduct 20-minute preseason computer evaluations to establish baseline
data about each athlete. If an athlete experiences a concussion during
the season, he or she is retested and the postconcussion data is compared
to the baseline data. When the athlete's brain functions return to normal,
he or she is then allowed to resume the sports activity.
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