Warning Issued On Concussions Government Officials Say Athletes Who Have Head Injuries May Return To Games Too Soon
A second brain concussion shortly after the first can prove fatal, and athletes should not rush back into action after a head injury, the government said Thursday.
“We simply don’t know how many young athletes are returned to play without a proper evaluation,” said Dr. David Thurman, an epidemiologist with the Centers for Disease Control and Prevention.
About 100,000 football players suffer head injuries each year, said Dr. James Kelly and Dr. Jay Rosenberg, whose guidelines for diagnosis and treatment of concussions in sports were issued by the American Academy of Neurologists and appeared earlier this week in the journal Neurology.
Thurman estimated sports-related head injuries at 300,000 a year.
“We’re trying to see that more attention is paid to this so young athletes are not sent back in when they should be recovering from an injury,” he said.
Besides football, soccer, field hockey and wrestling are sports in which head injuries are common.
Not all concussions cause loss of consciousness. Thurman cited the case of a 17-year-old high school football player who injured his head and told a teammate, but not his coach.
The player returned to the game but collapsed on the field after several blows to the head during routine blocks and tackles. His brain swelled, and he died four days later.
An athlete who loses consciousness momentarily should not compete again for at least a week, and one who remains unconscious for several minutes should stay on the sidelines for two weeks or more, Thurman said.
If an athlete is knocked unconscious a second time, regardless of how long after the first time, he should stay out at least a month, he said.
Trainers must assess any athlete who might have a head injury, and an athlete who seems confused, dizzy or unsteady must be examined by a physician, Thurman said. If the problem doesn’t clear up within 15 minutes, the athlete should not be allowed back in the game.
Asking an athlete if he remembers his name or the day of the week is not good enough, Thurman said.
“The athlete should be asked to remember a list of three objects, then asked 5 minutes later what the objects were.”
People with brain injuries may be able to answer rote questions but will have more difficulty if they are required to memorize or calculate, he said.
Coaches and trainers who allow athletes to return to the field might not do so if they knew how dangerous it was, Thurman said.
“If they occur too close together, brain injuries can have a devastating effect. Even if they are spaced out, they can have a cumulative effect.”
If tests reveal brain swelling or brain contusions, an athlete should be discouraged from participating in contact sports, the guidelines say.
Mike O’Brien, football coach at Valdosta High School in Georgia, said doctors are on the sidelines at every game and at most practices.
“What we try to impress upon our kids is that if you are hurt, you go see the doctor or trainer,” O’Brien said.
Thurman said the CDC will be working with the states that survey head injuries most thoroughly to determine how common second-impact injury is.
xxxx SYMPTOMS A glance at the symptoms of concussion: Early symptoms: dizziness, headache, lack of awareness of surroundings, nausea and vomiting. Later symptoms (days or weeks): persistent low-grade headache, lightheadedness, poor attention and concentration, memory dysfunction, tires easily, irritable, intolerant of bright lights, difficulty focusing vision, anxiety or depression, sleep disturbance. Frequently observed symptoms: vacant stare, delayed verbal or motor responses, inability to focus attention, slurred or incoherent speech, loss of coordination, overly emotional, forgetfulness, loss of consciousness. Source: American Academy of Neurologists