Friday, February 27, 2009

So you want to know more about concussions?

Many of you know Garrett (11 yo) suffered a concussion Wednesday night (February 18th) in the 4th quarter of his basketball game. He lost momentary consciousness and has little memory of the game.

Our doctor said he needed to be mellow (no sports) for the next 2-3 weeks. At least one coach was surprised it was so long.

An online friend mentioned she had done reseach after two of her sons suffered severe concussions. One suffered with pain for a year. She said Garrett should not do any sports for two weeks AFTER the symptoms subside. She said teaching others about the seriousness of concussions is a crusade of hers. It is now mine, too.

This got me looking around the internet. According to two sources, Garrett's concussion was moderate to severe (between a Grade 2 and 3) or severe (Grade 3). Shelly witnessed the whole thing.....she says Grade 3.

A week later, he still has a headache, neck ache and occasional dizziness......I will say he still has the ability to argue with his siblings......that's a good sign, right? :)

Concussions are a mild form of TBI, Traumatic Brain Injury.

It usually affects JR/SR aged kids, though occasionally into the college-aged adults.

I wanted to share the info I found, for those of you involved with sports, either as a coach, or a parent.....or both.

Be sure to view the mini-documentary below.

But first, here are some interesting quotes, all taken out of context, and from several sources:

Second Impact Syndrome. Aka SIS. The two cases described above involved repeated head trauma with probable concussions that separately might be considered mild but in additive effect were fatal. The risk for catastrophic effects from successive seemingly mild concussions sustained within a short period is not yet widely recognized. Second Impact Syndrome results from acute, usually fatal, brain swelling that occurs when a second concussion is sustained before complete recovery from a previous concussion that causes vascular congestion and increased intracranial pressure, which may be difficult or impossible to control. (There does seem to be debate about whether this actually exists or not.....seems like a moot point to me.......playing before healed seems pretty dangerous to me.)

Neurologists say once a person suffers a concussion, he is as much as four times more likely to sustain a second one. Moreover, after several concussions, it takes less of a blow to cause the injury and requires more time to recover. (Think football players & boxers.)

Depending on the extent and location of the injury, impairments caused by a head injury can vary widely. The irony of mild head injuries is that often, such injuries do not even require a hospital stay, yet they result in changes so profound that lives are forever changed.

The condition most commonly occurs in American football

Every documented case of SIS has occurred in males, but it is not known whether this is due to a special vulnerability or to a greater exposure of males to second impacts.

You must look at just one link: this is a great video documentary

This is a good, to the point definition

Another website here

Good list of signs and symptoms

About amnesia

About returning to play after a head injury

GRADING the concussion

a great handout for those of you needing one for parents, etc

Full of statistics, and from an MD point of view

Lots of info and links at wikipedia

Interesting info about POST-CONCUSSION SYNDROME

Summary of Recommendations of Management of Concussion in Sports below taken from here

Garrett had at least 6 of the nine below, at some point of his injury.

A concussion is defined a head-trauma-induced alteration in mental status that may or may not involve loss of consciousness. Concussions are graded in three categories. Definitions and treatment recommendations for each category are presented below.

Grade 1 Concussion

Definition: Transient Confusion, no loss of consciousness, and a duration of mental status abnormalities of less than 15 minutes.

Management: The athlete should be removed from sports activity, examined immediately and at 5 minute intervals, and allowed to return that day to the sports activity only if post concussive symptoms resolve within 15 minutes. Any athlete who incurs a second Grade 1 concussion on the same day should be removed from sports activity until asymptomatic for 1 week.

Grade 2 Concussion:

Definition: Transient confusion, no loss of consciousness, and a furation of mental status abnormalities of more than 15 minutes.

Management: The athlete should be removed from sports activity, examined immediately and frequently to assess the evolution of symptoms, with more extensive diagnostic evaluation if the symptoms worsen or persist for more than 1 week. The should return to sports activity only after asymptomatic for 1full week. Any athlete who incurs a Grade 2 concussion subsequent to a Grade 1 concussion on the same day should be removed from sports activity until asymptomatic for 2 weeks.

Grade 3 Concussion:

Definition: Loss of consciousness, either brief (seconds) or prolonged (minutes or longer).

Management: The athlete should be removed from sports activity for 1 full week without symptoms if the loss of consciousness is brief, or 2 full weeks without symptoms if the loss of consciousness is prolong. If still unconscious, or if abnormal neurologic signs are present at the time of initial evaluation, the athlete should be transported by ambulance to the nearest hospital emergency department. An athlete who suffers a second Grade 3 concussion should be removed from sports activity until asymptomatic for 1 month. Any athlete with an abnormality on computed tomography or magnetic resonance imaging brain scan consistent with brain swelling, contusion, or other intracranial pathology should be removed from sports activities for the season and discouraged from future return to participation in contact sports.

Features of Concussion Frequently Observed:

1.Vacant stare (befuddled facial expression)

2.Delayed verbal and motor responses (slow to answer questions or follow instructions)

3.Confusion and inability to focus attention (easily distracted and unable to follow through with normal activities)

4.Disorientation (walling in the wrong direction; unaware of time, date and place)

5.Slurred or incoherent speech (making disjointed or incomprehensible statements)

6.Gross observable incoordination (stumbling, inability to walk tandem/straight line)

7.Emotions out of proportion to circumstances (distraught, crying for no apparent reason)

8.Memory deficits (exhibited by the athlete repeatedly asking the same question that has already been answered, or inability to memorize and recall 3 of 3 words, or 3 of 3 objects in 5 minutes)

9.Any period of loss of consciousness (paralytic coma, unresponsiveness to arousal)

Prayers for his continued healing requested. He is missing the last two weeks of basketball season.........and at least two more weeks of ski/snowboard season. It is hard to keep him off the hill.........but I just have to.

A picture thought I am sharing........

A great, sunny and warm January ski day.


Looking for more of those days in March......

God bless,

Love Chari

1 comment:

Gloria said...

So sorry to hear about Garret. Yes, I always worry when my boys don't feel like arguing; that's when you KNOW somethings wrong :)I feel for him though the same way I felt for Daniel when he couldn't swing a hammer. So forlorn.....
Garret will be in what prayers I can manage and so will Marty's friends.