SPORTS AND CONCUSSION – “THE DING” increased risk – WHAT TO DO NEXT

SPORTS OFFICIALS AND COACHES WORRY ABOUT THE PLAYER THAT GETS HIT, DAZED, AND WANTS TO KEEP PLAYING.   Surprised   WHAT TO DO?

MILD TRAUMATIC BRAIN INJURY (mtbi) OR "CONCUSSION" IS A TRAUMATIC INJURY THAT CAUSES AN ALTERATION (CHANGE) IN MENTAL STATUS – WITH OR WITHOUT A LOSS OF CONSCIOUSNESSS.

HALLMARKS FOR CONCUSSION ARE:  AMNESIA (CAN'T REMEMBER) AND CONFUSION.

THE SPORT OF GREATEST CONCERN IS FOOTBALL – ABOUT 19 % OF H.S. PLAYERS GET DINGED.

SEIZURES ARE ESTIMATED AT 12 % OF ALL CONCUSSIONS BUT DO NOT NECESSARILY MEAN IT IS A WORSE LONG TERM PROBLEM.

WHAT TO DO.

DIFFERENT NEUROLOGICAL SPECIALISTS HAVE CREATED CRITERIA FOR THE APPROACH.

AAN GUIDELINES SAY:

GRADE ONE INVOLVES NO L.O.C. OR THE CLASSIC DING.

GRADE TWO INVOLVES NO LOC, TRANSIENT CONFUSION, BUT SYMPTOMS OVER 15 MINS.

GRADE THREE INVOLVES ANY LOC.

GRADE ONE MUST BE WITHOUT SYMPTOMS COMPLETELY AND REFRAIN FROM ACTIVITY FOR AT LEAST 15 MINUTES AFTER SYMPTOMS CLEAR.

GRADE TWO MUST STOP ACTIVITY AND BE SYMPTOM FREE FOR 1 WEEK BEFORE RETURNING TO ACTIVITY.

GRADE THREE MUST STOP ACTIVITY AND BE SYMPTOM FREE FOR 2-4 WEEKS BEFORE RETURNING TO REGULAR ACTIVITY.

THERE IS DEBATE AMONG THE NEUROSURGEONS, NEUROLOGISTS, AND SPORTS MEDICINE SPECIALISTS AS TO WHEN CATSCANS ARE DONE, AND WHEN HOSPITALIZATION IS DONE.

THE "BIG REASON"  FOR CONCERN IS THE FACT THAT AT LEAST 28 PERSONS HAVE DIED DUE TO "SECOND-IMPACT SYNDROME."  THIS IS WHEN A PLAYER GOES BACK TOO SOON, OR THE EVALUATION ON THE FIELD IS NOT DONE, THE PLAYER GETS "HIT" AGAIN AND CAN DIE.  THIS IS DUE TO A RAPID SWELLING OF AN ALREADY INJURED BRAIN.  A VERY MEDICALLY STRANGE BUT LIFE-THREATENING PHENOMENON.  IT WAS DESCRIBED INITIALLY IN 1973 AFTER TWO ATHLETES DIED AFTER "MINOR" DINGS AND REINSTITUED PLAYING.

SERIAL CONCUSSIONS THAT FOLLOW ONE ANOTHER, MANDATE CLOSE SCRUTINY AS THE RISK INCREASES.

EVEN QUARTERBACK STEVE YOUNG OF THE SF 49ERS AND THE HOCKEY PRO LAFONTAINE PREMATURELY ENDED THEIR CAREERS OVER THIS SERIOUS ISSUE OF MILD TRAUMATIC BRAIN INJURY.

WHEN IN DOUBT, SEEK PROFESSIONAL MEDICAL ADVICE FOR YOUR ACTIVE SPORTS PLAYER OR ANYONE GETTING "DINGED" IN THE HEAD.   THE RISK IS ENORMOUS YET MANAGEABLE.

ALL PROTOCOLS AND RECOMMENDATIONS MANDATE THE PATIENT IS ASYMPTOMATIC AND HAS RETURNED COMPLETELY TO NORMAL MENTAL (COGNITIVE) CAPACITY AND BEHAVIOR.  Cool

 

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(adapted concepts from e.m.)

 

 

 

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