Dr. Frederick Jaccarino, M.D.
Concussions, also known as head injuries, have been a major topic in the sports pages in recent years. The number of affected athletes really hasn’t risen; what’s increased is the recognition by the trainers and medical community of the serious, long- term consequences of even fairly innocuous hits to the head. The angst and concern emerge from high-profile examples such as Muhammad Ali and Sidney Crosby, though Little League coaches should be just as aware of the dangers of concussions as professional-team doctors.
Head injury can occur to anyone not living in bubble-wrap. The threat starts with infants who may slip out of an adult’s hands and hit the floor, to toddlers (the very definition of “toddle” is to walk unsteadily), to hard-hitting athletes, to slip-prone elderly adults. When the head is struck with more than a minor amount of force, the brain inside gets shaken and may also bang into the hard shell surrounding it—the bony skull. It may hit hard enough to cause a bruise on the brain, which may in severe cases even result in blood leaking into the skull cavity…where it does not belong.
There is limited space in the skull; the blood tends to crush the brain tissue, leading to headaches, seizures, and possibly death. Patients with these injuries usually have signs and symptoms which lead to prompt diagnosis and prompt treatment.
By far, most everyday concussions are much less severe. Recognition of these milder concussions is more challenging because the symptoms are more subtle and the diagnostic tests less readily available, yet the consequences of nonrecognition remain significant.
As best as the public knows, athletes Ali and Crosby never had blood or any visible—on CAT or MRI scan—abnormalities. But Crosby has missed dozens of games while Ali is left with the degeneration of his brain to the point of incapacity. Each is an example of the deleterious effects of multiple bangs to the head.
Most amateur athletes, from weekend warriors to school-team competitors, face similar risks as the pros. Brain injuries, even when not severe, need a lot of time to recover; if the victim does not rest the brain, it heals more slowly; if reinjury happens the effects multiply—so a normal CAT scan is not a ticket back into the game.
An astute healthcare provider will convince the gung-ho competitor that it is better to walk away and live to compete another day, even if it’s weeks later. Take concussions seriously—for your long-term health and brain function!
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