Vital signs

What should you do if your son comes home from football practice with a headache that seems to be getting worse?

What if your daughter bonked heads with another player at soccer practice and complains about feeling nauseated or becomes irritable a few days later?

The answers – seek medical attention immediately – can be found in a new online tutorial about concussions at www.Michigan NeuroSport.com.

“The big point is learning to recognize the injury,” said Jeffrey Kutcher, the director of Michigan NeuroSport and the head of the concussion program at the University of Michigan.

The tutorial is available just in time for coaches, parents and students who are getting ready for high school football and soccer practices to start in a few weeks. It takes about 20 minutes to complete.

“It’s a common misconception that a concussion is caused by one big dramatic hit like we see on ESPN, but that’s not the case,” Kutcher said. “I think the biggest misconception goes back to the general concept that all concussions are alike – that the number of concussions that a person has had is the most important thing, not the circumstances or situation or duration of symptoms.”

Symptoms of a concussion include a headache or feeling pressure in the head; temporary loss of consciousness; confusion or feeling as if in a fog; dizziness, nausea or vomiting; and sensitivity to light.

“A concussion is not always the loss of consciousness, the loss of memory or somebody not being able to walk,” Kutcher said. “It can be more subtle. We are trying to get the message out that this is an individual injury. You have to be seen by health care professionals who have experience examining nervous systems and dealing with this type of injury.”

After an athlete suffers a concussion, Kutcher said, it is important to get the player out of a game or practice and have him or her evaluated to prevent more injury. He said there is no set formula for how long a player should sit out after a concussion.

“It is a very individual injury,” Kutcher said. “It must be managed individually. You can’t just have a set way to do it. It requires some pretty hands-on management. It’s when injuries are mismanaged that you can have a problem.”

Kutcher said that one of his patients, Spencer Helgren, is the perfect example of what can happen when an athlete returns to the field too quickly after a concussion.

Helgren, a 16-year-old from Ely Township, Mich., suffered a concussion last fall in a high school football game and was sent to a neuropsychologist. After an evaluation, Helgren was cleared to play in the next game, just six days after his injury.

“Other than a headache, he seemed to be OK,” said his mother, Jill Koski.

In the next game, Helgren took another hit to his head and suffered another concussion.

“He obviously wasn’t healed enough for the first one,” Koski said. “We were ignorant to all the ins and outs of the concussion issue. We know a lot more now than we did then.”

After his second concussion, Helgren developed several problems. He had a severe headache that lasted for months. He was extremely sensitive to light. He was irritable and had concentration issues, even though he was an honor roll student. “

Our house was basically candlelit for a good couple of months,” Koski said.

Five months later, Helgren was taken to Michigan NeuroSport for an evaluation.

“Spencer had a concussion that was pretty obvious to us, in retrospect,” Kutcher said. “If that had been managed differently, I would predict a much different outcome.”

Helgren has improved dramatically under Kutcher’s care, which included medication to help him sleep despite the pain in his head.

Kutcher said there is an important lesson at the center of Helgren’s story.

“The biggest lesson, by far, is the upfront recognition and management of concussion,” Kutcher said.