1. Concussions

2. What is a Concussion? Concussions are brain injuries.
They are caused by a bump, blow, or jolt to the head.
They can range from mild to severe and can disrupt the way the brain normally functions.
Quite often signs of a head injury do not appear immediately after trauma but hours after the initial injury which is know as post-concussion syndrome.

4. Signs and Symptoms an Athlete or Individual Should be Aware of:
Nausea (feeling that you might vomit)
Balance problems or dizziness
Double of fuzzy vision
Sensitivity to light or noise
Severe headache
Feeling sluggish
Feeling foggy or groggy or just out of it
Concentration or memory problems
Confusion

6. Signs and Symptoms a Guardian or Loved one Should be Aware of:
Appears dazed or stunned
Is confused about assignment or position
Forget an instruction
Is unsure of game, score, or opponent
Moves clumsily
Answers questions slowly
Loses consciousness (even briefly)
Shows behavior or personality changes
Can’t recall events prior to hit or fall
Can’t recall events after hit or fall

7. Second Impact Syndrome(SIS)
An individual who receives a second concussion before symptoms from a previous one has healed may be at risk of developing a rare but deadly condition called SIS
Brain swells catastrophically after even a mild blow can cause the debilitating or deadly results

8. How is Second Impact Syndrome Diagnosed?
CT Scan (computed tomography) to detect acute intracranial bleeding

9. Who Gets Second Impact Syndrome?
Any athlete who returns to a sports competition while still experiencing concussion-like symptoms is at risk
Between 1.6 and 3.8 million sports related concussions occur every year. Injury rate per 1 thousand exposures
Football (2.34)
Mens Ice Hockey(1.47)
Womens Soccer(1.42)
Wrestling (1.27)
Cycling even greater than football

10. Prevention of Second Impact Syndrome
SIS has a higher mortality rate in young athletes.
The key to preventing SIS is to ensure that athletes do no return to sport with any post-concussion symptoms.
Legislation is trying to mandate that athletes do not return to sport on the same day that they are concussed and they do not return to sport unless they have been cleared by a sports medicine professional.

12. New Research and Statistics for Concussions
A 2007 study that post-concussion symptoms resolved in three days or less and more then 50% of high school athletes.
50% of these high school athletes return to play in nine days or less.
ALARMING 30-80% of those athletes still had post-concussion symptoms three months after being injured.
1/7 were still symptomatic after one year

13. Impact Testing
The Impact Test assists qualified practitioners in making sound return to play decisions following concussions.
In the test there are five cognitive categories and one category on self-reporting of symptoms.
There are times when the concussed athlete scores very well on the Impact Test, but is still experiencing symptoms. If this occurs we don’t send athlete to competition until symptom free for one week and is able to remain symptom free after graded exercise.
Impact Testing remains as a tool to the practitioner.
Impact Testing is not the final criteria to return to competition.

14. Left doesn’t have a concussion and the right with a concussion, the red areas indicate electrical activity during a memory test.

15. Recommendations for Coaches (By Dr. Jeff Radel at KU Medical Center)
When and doubt, sit them out
Insist your school to do neurocognitive testing
Use standard sideline decisions-if athlete is showing concussion-like symptoms-safety first do not return athlete to competition
Create a team culture that emphasizes these student athletes good health
Discourage plays with direct head contact
Make a point of obtaining yearly concussion waivers and making sure they are filed along with the students school records