Q&A Topic: Concussions and the Young Athlete

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Deborah L. Benzil, MD, FACS, FAANS

Q. What are the most common scenarios where a young athlete sustains a concussion?

A. Despite significant efforts at prevention, there is still an epidemic of sports-related head and spine injuries. The highest number of sports-related injuries comes from biking.  Proper protection reduces the risk of head injury, brain injury, and fatalities. It’s extremely important to wear a helmet 100 percent of the time! Adults need to model this important behavior for their kids. Team sports such as football, baseball, softball, and hockey, among others are also activities that contribute to head injury.

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Q. What symptoms should a parent or coach look for?

A. Every coach should take educational programs to learn how to recognize athletes with possible concussions and make sure they receive a proper evaluation. Parents can watch for symptoms, including headaches, nausea or vomiting, sensitivity to light, double vision, imbalance, serious mood alterations, or difficulty with concentration, focus, or memory. Anyone displaying these symptoms should be medically evaluated. Some athletes with a concussion might have few if any symptoms. This is why every child even suspected to have a concussion should receive a specialized medical evaluation before resuming sports.

Q. Should a parents’ first step be the emergency room?

A. Most pediatricians will be able to differentiate the seriousness of the problem and can refer to a neurosurgeon, if necessary. In the case of escalating symptoms, new weakness, numbness, language problems, any open wounds on the scalp or profuse external bleeding related to the injury, or any injury to other body parts, a visit to the emergency room is recommended.  Ultimately, a neurosurgeon is the specialist who will be consulted for any concussion-related problems or questions.

Q. How important is rehabilitation?

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A. Most concussions will get better quickly and there will be no long-term adverse impact. The general rule is that the student should refrain from all activity (physical and mental) until all the symptoms are gone. Once that happens, activities should be added back to their schedule slowly. If athletes return to their activities and the symptoms return, then they should stop, wait until the symptoms have abated, and then try again.  With sports, when that first aerobic activity is added, and only if this is well-tolerated, should the actual sport be resumed, even with less-contact sports like baseball. It is known that sustaining a second concussion in the first few months after the initial concussion can cause devastating results in a small number of people. For this reason, many doctors recommend months away from contact or collision activity in young patients, as their developing brains are more at risk.  Returning to school is safe when the symptoms resolve.

Q. How can the risk to young athletes be reduced?

A. Despite all the attention, too many coaches, especially as many are volunteers, are uninformed about proper equipment use, drills, etc., and end up putting young athletes at undo risk. As such, many are not well prepared to identify and handle sports-related injuries. The American Association of Neurological Surgeons (AANS.org) is very active in this field, working with the NFL, NHL, and coaching organizations to address this problem. You can learn more at www.aans.org—search “Sports Related Head Injury.”

Northern Westchester Hospital
Neuro-oncology, Spine Surgery, Stereotactic Radiosurgery
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Northern Westchester Hospital is a proud member of Northwell Health (formerly North Shore-LIJ Health System).


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