Internal Medicine

My teenage son suffered a mild concussion last year playing sports. Is it safe for him to play this year?

Back-to-school means back-to sports for many student athletes, and with it the increased risk of an injury that could continue to cause health complications when today’s school children are well into their adult years.

Each year, about 300,000 children in the U.S. sustain head injuries. Most are the result of motor vehicle accidents, but tens of thousands of children suffer concussions from sports activities such as football, soccer, lacrosse, gymnastics and cheerleading. The long-term neurological effects of these head injuries vary widely and can be serious.

When an athlete suffers a concussion, he or she is more prone to a repeat of that injury, especially when returning to the playing field too soon. Current guidelines recommend that athletes should wait to return to the playing field until they are free of symptoms – at rest and during exertion – for at least one and preferably for two weeks. This includes even the mildest concussion (one that does not result in a loss of consciousness and in which the symptoms disappear within 15 minutes). But a study published last month in the Archives of Neurology; however, points out that a four-week recovery period may be needed. The study, by a physician in the athletics department at Pace University, followed 49 athletes who had suffered concussions. Using several types of diagnostic tests, the researcher found that most of the athletes continued to have altered brain function for one month following a concussion.

Aside from the threat of re-injury, evidence is mounting of the potential long-term effects of concussions. Long-term effects can include chronic headaches, speech difficulties, memory and concentration problems, depression, sleep disturbances, and attention deficit/hyperactivity disorder. Mood disturbances and seizures can occur shortly after the head injury; however, they may also show up decades later.

Any head injury—especially when that injury occurs in a child or adolescent—requires caution. We only get one brain in this life and, unfortunately, our brains don’t heal easily from injury.

The most important step is prevention. Appropriate, and properly fitting, headgear should be part of any student athlete’s uniform. Impress upon your children the need to take the time to heal from any injury and that they should be open about any symptoms they are experiencing, even if it means they need to sit on the sidelines longer. Please remember to seek medical attention for any child who has symptoms—such as headaches, nausea, dizziness, confusion or memory problems—for more than a week following a head injury.

Originally Published in The University Doctors' MedicaLink - 10/08

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