Basic HTML Version
14 • Touchline • Issue 16
It is recognised that most concussions get better in 7 to 10
days. However, ignoring concussion signs and symptoms or
not recognising them can result in potentially catastrophic
consequences. Acute brain swelling, traditionally referred
to as “Second Impact Syndrome” is usually fatal. Prolonged
symptoms, recurrent concussion, learning difficulties and
personality problems have also been reported. A recent study
showed how the recovery time from concussion became longer
with each concussion.
Sports administrators should make sure their team or sport
has a concussion programme in place. The components of a
community concussion programme include a concussion policy,
education modules to recognise concussion and strategies
to avoid or manage catastrophic head injury, baseline
computerised brain testing for all the athletes, establishing a
medical referral network and the co-ordination of treatment
programmes.
Baseline computerised brain testing should be completed pre-
season if possible. It is easily accessible on-line, cost effective
and easy to administer. It is able to detect when impaired
brain function lags behind complete subjective symptom
recovery and measures reaction time. It can also detect if
cognitive decline occurs in players with previous concussions
and identifies players needing more complex testing.
Sometimes athletes may under report their symptoms in order
to keep playing and younger players, in particular, may not
recognise the symptoms of concussion.
What should parents, coaches and administrators do in the
event of suspected concussion?
Any athlete with suspected concussion must be withdrawn
from the event or training immediately. Furthermore, no
athlete with concussion or suspected concussion should be
allowed to return to the same event or practice that day. All
athletes with concussion or suspected of concussion need a
formal medical assessment in the soonest possible time.
Before getting to a medical doctor, be on the lookout for signs
of serious neck or head injury. Protect the athlete’s neck and
secure an open airway when the athlete is not responsive.
Urgent hospital referral is necessary for any athlete who
has lost consciousness as a result of a blow to the head or
body. The injured person should be referred to a hospital
immediately in the event of:
•
Fractured skull
•
Penetrating skull trauma
•
Loss of consciousness
•
Deterioration in conscious state following injury
•
Increasing confusion
•
Worsening headache post injury
•
Persistent vomiting
•
Any convulsive movements
•
Focal neurological signs
•
More than one episode of concussive injury in a
match or training session
All children with head injuries, and any high-risk patients (e.g.
hemophilia, anticoagulant use) or those who have had a high-
risk injury mechanism (e.g. high velocity impact, missile injury)
must be immediately referred to hospital.
A concussed athlete should see a doctor with experience in
managing concussion as soon as possible after the impact.
The doctor should see the athlete on a number of occasions,
performing serial assessments. At the first visit, the doctor is
likely to do a full neurological examination and document
current symptoms. It is recommended that balance testing
and computerised brain function testing be repeated
and compared to the baseline test report. Recovery from
concussion may take longer in younger athletes under 18
years of age, therefore a conservative approach to playing
sport again should be followed in these cases.
Athletes should only return to high intensity exercise when
their symptoms have gone away and cognitive function has
returned to normal. Once the athlete feels better after about
72 hours, some low intensity exercise in the form of vision and
balance training can begin. Progression of exercise challenge
can occur every 24 hours. If athletes start to feel unwell
during or after exercise, they should rest for 24 hours and then
attempt the same exercise challenge. Only when an athlete
has completed all the stages of exercise challenge can they
obtain written medical clearance from a medical doctor. The
athlete should give this medical clearance to their coach.
WHY WORRY ABOUT IT?
WHAT SHOULD
WHAT SHOULD BE DONE
IN THE EVENT OF CONCUSSION:
HOW TO GET BACK TO SPORT?
ADMINISTRATORS DO?
“ . . . Alex was referred to the Herron Sports Concussion
Programme supported by Sportscover and benefited from
their expertise in concussion management. By individualising
concussion treatment in Alex’s case, he has made an excellent
recovery. Alex is now sponsored by Giant and races in Europe.”