Study: Teens more likely to suffer after-effects of concussion

By BOB MASSEY

Feeling Fit Correspondent

On average, about 1.7 million Americans suffer from a traumatic brain injury (TBI) every year.

That figure, from the U.S. Centers for Disease Control (CDC), is high enough for the agency to call it "a serious public health problem" that contributes to "a substantial number of deaths and cases of permanent disability."

About 75 percent of all TBIs are classified as concussions -- a type of injury that has long been the bane of contact and collision sports.

But of particular interest to teen athletes is a Canadian study whose results were published earlier this year in the journal Brain Injury. It seems teens suffer disruption in short-term memory more than any other age group. This cognitive glitch not only affects the athlete's ability to read and calculate, it can also last for six months or longer.

Clearly, sports-related concussions are gaining traction as a critical issue.

Understanding concussions

The CDC defines a concussion as a TBI "caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth.

Even a 'ding,' 'getting your bell rung,' or what seems to be mild bump or blow to the head can be serious." Although most common in contact and collision sports, concussions can occur during any activity. Football is the most likely culprit -- but soccer, volleyball, baseball, basketball and other sports also carry a certain amount of risk.

TBIs can be mild (in which a change in mental status or consciousness is short) or severe (where amnesia or a long period of unconsciousness is present). While not all contact with the head results in a TBI, more extreme or sudden jolts should be suspect, and the athlete should be examined by a trainer or coach.

Symptoms experienced by the athlete can include:

•Headache or a feeling of pressure.

•Nausea or vomiting.

•Dizziness or lack of balance.

•Vision problems such as blurriness or light sensitivity.

•A sluggish or groggy feeling.

•Memory problems.

•Inability to concentrate.

•A feeling of confusion.

However, the athlete is not the only one to recognize a possible concussion. Coaching staff or athletic trainers may notice if the athlete:

•Appears dazed or is confused.

•Forgets instructions.

•Has trouble identifying the score or opponent.

•Is slow to answer.

•Becomes clumsy.

•Loses consciousness for a brief period.

•Shows behavioral changes.

•Has trouble remembering events either before or after the impact.

Remember, a concussion is damage to the brain -- and though some symptoms may be visible, the damage itself is not. In some cases, symptoms may not appear for hours or even days after the impact.

A rare -- but real -- danger is a condition known as "second impact syndrome" (SIS), in which a new concussion occurs before a previous one is healed.

The first concussion may have occurred weeks, days or even minutes before. With the exception of boxing, reported cases of SIS occur mostly in adolescents.

With SIS, the brain tissues swell rapidly, making emergency surgery a necessity. The condition has few survivors -- and those who do often suffer neurological impairment.

Preventing after-effects

"I don't think concussions are more common than any other injury, but on occasion we do have to deal with them," said James Vernon, athletic director at Port Charlotte High School. "It's not even close to be the most common injury we see. The most common ones are ankles. Concussions are, thankfully, pretty rare. You're talking between all the injuries you have in a football season, one or two a year."

Bill Hoke, athletic trainer at Charlotte High School, estimates somewhat more for his athletes -- about three or four in football last year, and two or three in baseball.

A low concussion rate is especially good news for teens.

The previously mentioned study, conducted by the Université de Montréal, found that teens are more susceptible to the effects of brain injury than adults. In addition, their symptoms are greater than those of children and adults. In some subjects, short-term memory deficits lasted as long as a year.

The damage from concussions is usually cumulative, and may have consequences later in life.

For example, a degenerative disease known as chronic traumatic encephalopathy -- the only preventable form of dementia -- has been found in retired athletes who have a history of multiple concussions.

Early detection of a concussion is key to a young athlete's safety. Outside of the field, court or rink, parents are encouraged to look for symptoms the athletic staff may have missed.

"We have an athletic trainer –-- Rob Gerofsky, who is provided by Peace River Regional Medical Center," Vernon said. "Our trainer is a little over-cautious, and football coaches are sometime a little under-cautious, so I think it's a good balance. Parents are educated about concussion, and there's a form from the state that explains the signs and symptoms of concussion. So if they see anything that's a concern, they can tell the trainer."