Don’t Play Games with Concussion

Don’t Play Games with Concussion: Question 1 True or False? A concussion is considered a brain injury.

Don’t Play Games with Concussion TRUE A concussion is considered a brain injury, which is why it is so important to let a parent or coach know when you’ve sustained a concussion. A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, stretching and damaging the brain cells and creating chemical changes in the brain. Concussions Are Serious Medical providers may describe a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, the effects of a concussion can be serious.

Don’t Play Games with Concussion: Question 2 True or False? You have to hit your head in order to sustain a concussion.

Don’t Play Games with Concussion FALSE You do not have to hit your head in order to sustain a concussion. All that is needed is a significant impact to the body that causes the brain to move within the skull. Your brain has the consistency of gelatin. It's cushioned from everyday jolts and bumps by cerebrospinal fluid inside your skull. A violent blow to your head and neck or upper body can cause your brain to slide back and forth forcefully against the inner walls of your skull. Sudden acceleration or deceleration of the head, resulting from certain events such as a car crash or being violently shaken, also can cause brain injury. These injuries affect brain function, usually for a brief period, resulting in signs and symptoms of concussion. A brain injury of this sort may lead to bleeding in or around your brain, causing symptoms such as prolonged drowsiness and confusion that may develop right away or later. Such bleeding in your brain can be fatal. That's why anyone who experiences a brain injury needs monitoring in the hours afterward and emergency care if symptoms worsen.

Don’t Play Games with Concussion: Question 3 True or False? You have to lose consciousness to be diagnosed with a concussion.

Don’t Play Games with Concussion FALSE You DO NOT have to lose consciousness to be diagnosed with a concussion. Concussions can occur with or without LOC. In fact, the vast majority of concussions (more than 95% in a 2010 study of concussion among high school athletes)1 do not result in LOC, a rate less than half the 10-11% reported in previous studies.  1. Meehan W, d'Hemecourt P, Comstock D, "High School Concussions in the 2008-2009 Academic Year: Mechanism, Symptoms, and Management" Am. J. Sports. Med. 2010; 38(12): 2405-2409 (accessed December 2, 2010 at http://ajs.sagepub.com/content/38/12/2405.abstract?etoc).

Don’t Play Games with Concussion: Question 4 What is the most reported symptom of concussion? Headache Dizziness Blurred or double vision

Don’t Play Games with Concussion Headache 71% of people with a concussion reported this symptom Additional symptoms include feeling slowed down, difficulty concentrating, fogginess, light sensitivity, memory issues, balance problems.

Don’t Play Games with Concussion: Question 5 True or False? Connecticut enacted a Concussion Law in 2010 regarding student athletes.

Don’t Play Games with Concussion TRUE The law mandates: Coaches training Comprehensive education for parents Removal from play following a concussion Medical clearance before return to play Connecticut law requires the Board of Education to develop a concussion and head injury training course and refresher course. Intramural and interscholastic coaches who hold coaching permits from the state Board of Education would be required to complete an initial concussion and head injury training course and then a refresher course every five years. Intramural and interscholastic coaches must immediately remove a student athlete diagnosed with a concussion or observed exhibiting signs, symptoms or behaviors consistent with a concussion. A student athlete removed from play may not participate in supervised team activities without a written clearance from a licensed health care professional trained in the evaluation and management of concussions.

Don’t Play Games with Concussion: Question 6 True or False? A concussion results in metabolic & chemical changes in brain cells that won’t show up on brain imaging

Don’t Play Games with Concussion TRUE A concussion creates a chemical imbalance in your brain that cannot be seen on a CT or MRI but requires rest and time in order for the imbalance to be restored. Because conventionial neuroimaging contributes little to concussion evaluation and management, [1,4] the 4th international consensus statement on sport-related concussion, [1] the 2013 American Academy of Neurology concusson guidelines, [2 the 2013 American Medical Society for Sports Medicine position statement on concussion in sport, [3] the American Academy of Pediatric's 2010 Clinical Report on Sport-Related Concussion in Children and Adolescents, [4]  as well as a first-of-its-kind 2015 Canadian study[5] all state that conventional CT or MRI scans of the brain are not needed or recommended in the vast majority of concussions. (the Canadian study found that neuroimaging was normal in 78% of cases of children and adolescents with sports-related concussion) 1.  McCrory P, et al. Concussion statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012, Br J Sports Med  2013;47:250-258. 2. Giza C, Kutcher J, Ashwal S, et al. Summary of evidence-based guideline update: Evaluation and management of concussion in sports: Report of the Guideline Development Subcommitee of the Amercian Academy of Neurology. Neurology 2013. DOI:10.1212/WNL.0b013e3182d57dd (published online ahead of print March 18, 2013).  3. Harmon K, et al. American Medical Society for Sports Medicine position statement: concussion in sport.  Br J Sports Med 2013;47:15-26. 4. Halstead, M, Walter, K.Clinical Report - Sport-Related Concussion in Children and Adolescents.  Pediatrics. 2010;126(3): 597-615.  5. Ellis MJ, Leiter J, Hall T, McDonald PJ, Sawyer S, Silver N, Bunge M, Essig M. Neuroimaging findings in pediatric sports-related concussion. J Neurosurgery: Pediatrics, published online ahead of print, June 2, 2015; DOI:

Why rest after concussion? Activities to Avoid Video games Driving Movies in theaters Concerts Sports Amusement parks Texting Surfing the internet ANY activity that increases blood flow to the brain can cause symptoms Rest Cognitive Rest Physical Rest Sleeping The same way you would rest a broken ankle you need to rest your brain and allow it to recover.

How much rest? In the first few days, avoid activities that cause you to use your body or brain Gradually work back up to your normal activity level but pull back if symptoms worsen We’ve learned that avoiding all activities can lead to anxiety and depression, and prolong recovery

Q & A

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