Concussion in SportsAn Overview for

Parents

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International experts: ◦ “a complex pathophysiological process affecting

the brain, induced by traumatic biomechanical forces -- either a direct blow to the head, face or neck; or a blow elsewhere on the body with an ‘‘impulsive’’ force transmitted to the head.”

A concussion is a brain injury caused by traumatic force

Definition

Concussions can occur in any sport – contact with players, equipment, or facilities

Most common at the high school level:o Footballo Boys & Girls Soccero Lacrosseo Wrestlingo Basketball

“Honorable Mentions”o Cheerleading, Baseball, Ice Hockey

Which Sports?

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Cognitive - Amnesia, confusion, disorientation Physical - Balance difficulty, vertigo, tinnitus,

blurry vision, nausea Emotional - Change in mood, anxiety,

depression, agitation

Concussion Signs & Symptoms

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May not develop until minutes, hours, or days after injury Athlete Complaints o Headacheso Dazed feeling, not right, bell ringing, "out of it”o Blurry visiono Dizziness, unsteady

Athlete Injury Symptomso Lethargy, mentally slow, perseveration

Harder to get them up in the morningo Loss of muscle tone, slow speech, aimless pacingo Detachment from game, anti-social, withdrawo Memory loss, cognitive dysfunction

Common Signs and Symptoms

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Cognitive = ThinkingoAbility to problem solveoWorking memory & attention to taskoIndependent from amnesia, orientation,

number recall

Cognitive Function

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Presence of amnesia or memory loss is an important clinical sign of concussion

May be delayed by 20 to 30 minutes following initial trauma

Amnesia may predict injury severity

Memory Loss

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Heat Exhaustion and Heat Stroke

Dehydration Medication Weight lifters

headache Hypoglycemia

Migraine First week of

contact football Soccer Heading Altitude

sickness

Conditions that can Mimic Concussion

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Gaining recognition as a valuable tool to assess cognitive impairment in the post concussive Athlete

Baseline & After Injury testsoBaseline - A benchmark used as a basis for

comparison • Recommendation: Beginning of the sports season, or

every 12 monthsoAfter Injury - A test taken post or After Injury when

other symptoms have resolved

Cognitive Testing

In the pre-season, or before the first contact practice of the sports season, establish a Baseline to measure brain speed and accuracy oBest effortoShare results with your Medical Provider

In the event of an injury, consult your Medical Provider oTake an After Injury test when other symptoms have

disappearedoMedical Provider can compare results to help ensure

cognition has returned to Baseline level

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How to use Cognitive Testing

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Most mildly concussed Athletes: o Recover cognitive function in five to 10 days

More severe concussions: o May take one to three months to resolve cognitive

function Recovery of cognitive function does not parallel recovery

from physical & emotional symptomsoUsually lags behind

Today, we know…

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It’s best to evaluate Athletes in the post-concussive period for cognitive, physical, and emotional signs and symptomsoCognitive testing aids the identification of persistent

cognitive impairmentoClinical exam and attention to history important in

evaluating physical and emotional dysfunction

Today, we know cont.

In a concussion, the Athlete’s brain is damagedoHealing time and rest required for recovery

Affects ThinkingoMay consider postponing academic activities that

concern an Athlete’s future (final exams, college placement exams)

If Return To Play too soonoExacerbate condition – longer recovery time

• Affects school (academics) & sports participation

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After Injury Risk

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You do not need to lose consciousness to have a concussion

Memory loss is an important clinical sign of concussion Most mildly concussed Athletes recover cognitive

function in five to 10 days More severe concussions may take one to three months

to resolve cognitive function Recovery of cognitive function does not parallel recovery

from physical and emotional symptoms

Summing Up

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Manage Athlete’s cognitive health along with physical and emotional healtho Complete annual Baseline Test. See www.axonsports.com

Be sure staff (Athletic Trainer, Coach, qualified Medical Provider) is knowledgeable about concussions and available on the sidelines to evaluate injuries

If Athlete suffers or is suspected of suffering from a concussiono Immediately remove from playo Consult with Medical Provider about recuperation, as well as

return-to-classroom and return-to-play decisions• Have Athlete complete an After Injury test to aid return-to-

play decisions

Recommended Actions

Dr. James Moriarity Head Team Physician –

University of Notre Dame Sports Medicine Consultant –

Axon Sports More than 10 years of

experience in Athlete concussion testing and the clinical application of computerized cognitive testing -- tenure matched by very few in American sports. 

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Prepared by Dr. James MoriarityPresented by Axon Sports