Concussion in Sports An Overview for Parents

1. Concussion in SportsAn Overview for Parents

2. Definition • 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

3. Which Sports? • Concussions can occur in any sport – contact with players, equipment, or facilities • Most common at the high school level: • Football • Boys & Girls Soccer • Lacrosse • Wrestling • Basketball • “Honorable Mentions” • Cheerleading, Baseball, Ice Hockey

4. Concussion Signs & Symptoms • Cognitive - Amnesia, confusion, disorientation • Physical - Balance difficulty, vertigo, tinnitus, blurry vision, nausea • Emotional - Change in mood, anxiety, depression, agitation

5. Common Signs and Symptoms May not develop until minutes, hours, or days after injury • Athlete Complaints • Headaches • Dazed feeling, not right, bell ringing, "out of it” • Blurry vision • Dizziness, unsteady • Athlete Injury Symptoms • Lethargy, mentally slow, perseveration • Harder to get them up in the morning • Loss of muscle tone, slow speech, aimless pacing • Detachment from game, anti-social, withdraw • Memory loss, cognitive dysfunction

6. Cognitive Function • Cognitive = Thinking • Ability to problem solve • Working memory & attention to task • Independent from amnesia, orientation, number recall

7. Memory Loss • 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

8. Conditions that can Mimic Concussion • Migraine • First week of contact football • Soccer Heading • Altitude sickness • Heat Exhaustion and Heat Stroke • Dehydration • Medication • Weight lifters headache • Hypoglycemia

9. Cognitive Testing • Gaining recognition as a valuable tool to assess cognitive impairment in the post concussive Athlete • Baseline & After Injury tests • Baseline - A benchmark used as a basis for comparison • Recommendation: Beginning of the sports season, or every 12 months • After Injury - A test taken post or After Injury when other symptoms have resolved

10. How to use 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 • Best effort • Share results with your Medical Provider • In the event of an injury, consult your Medical Provider • Take an After Injury test when other symptoms have disappeared • Medical Provider can compare results to help ensure cognition has returned to Baseline level

11. Today, we know… • 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 & emotional symptoms • Usually lags behind

12. Today, we know cont. • It’s best to evaluate Athletes in the post-concussive period for cognitive, physical, and emotional signs and symptoms • Cognitive testing aids the identification of persistent cognitive impairment • Clinical exam and attention to history important in evaluating physical and emotional dysfunction

13. After Injury Risk • In a concussion, the Athlete’s brain is damaged • Healing time and rest required for recovery • Affects Thinking • May consider postponing academic activities that concern an Athlete’s future (final exams, college placement exams) • If Return To Play too soon • Exacerbate condition – longer recovery time • Affects school (academics) & sports participation

14. Summing Up • 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

15. Recommended Actions • Manage Athlete’s cognitive health along with physical and emotional health • 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 concussion • Immediately remove from play • 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

16. Prepared by Dr. James MoriarityPresented by Axon Sports 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.