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Vail Daily Health: Concussions need serious evaluation

Dr. Jim Harding
Special to the Vail Daily
Vail, CO Colorado

VAIL, Colorado –According to a study done by the National Center for Catastrophic Sports Injury’s, 55 college and high school football players have died since 1995 from brain injuries. Many of these are believed to involve athletes who suffered Second Impact Syndrome (SIS). SIS occurs when an athlete is still suffering lingering symptoms from one concussion and has a second concussion, even a mild concussion.

This occurs only in athletes under the age of 23 whose brains are still forming. While rare, the result is usually fatal, no matter how quickly and efficient the care.

Concussions have become such a major concern that in April the NCAA revised the concussion guidelines for its member institutions. All NCAA colleges and universities are required to have a concussion management plan on file and athletes who suffer even a mild concussion must obtain medical clearance before returning to play. Fortunately, these catastrophic deaths have made everyone who deals with athletes in all sports more aware of the severity of concussions and the need for education about understanding the symptoms of a concussion.



So what is a concussion? A concussion is a blow to the head that moves the brain within the skull. When this happens, potassium is released from neurons into the brain and calcium leaks inside the neuron. This results in symptoms including:

•-Headache, nausea and vomiting;



• Imbalance from dizziness or vertigo;

• Disorientation of one’s surroundings;

• Foggy and dazed, and even amnesia of the event; or



• Loss of consciousness.

In most cases these symptoms resolve with rest in 7 to 10 days. A second blow to the head, even a mild or indirect one, sets off a series of events including massive swelling of the brain, major nonreversible damage and more often than not, death. It is this reason that inappropriate management by the doctors, coaches and trainers can be so significant.

In 2004 the International Symposium on Concussions in Sport developed a classification for concussions. This system goes away from the traditional method of grading concussions in favor of more individualized assessment and recovery. In this system:

•-A simple concussion is classified as one where the symptoms resolve in 7-10 days with rest and removal from the sport. The athlete becomes completely asymptomatic. No additional intervention or treatment is necessary and the athlete resumes normal participation.

•-A complex concussion involves persistent symptoms, including those brought on by exertion and prolonged cognitive problems. Treating a complex concussion requires a more multidisciplinary approach than the standard care delivered by a medical doctor and athletic trainer. These athletes will also need to be under the care of a neurosurgeon or even a neurophysiologist. If baseline neurological screening took place before the season started then these are used to help determine when the athlete might return to their sport. In these cases, great care is taken to ensure that the athlete does not return too soon for fear of permanent damage or SIS.

The bottom line is that concussions are very serious and even life threatening. All coaches, no matter what level, should be trained to understand and recognize the symptoms of a concussion. Additionally, all athletes, no matter what sport, should be required to obtain a medical release before returning to play, even a simple concussion.

The U.S. Ski and Snowboard Teams and Ski and Snowboard Club Vail are at the forefront of concussion education and have been recognized for their efforts to train their coaches and staff. I applaud these organizations for protecting the health and well being of their athletes.

Dr. Jim Harding is a member of the American Academy of Sports Dentistry and an Official Medical Provider for the U.S. Ski and Snowboard Teams. The Harding Dental Center (www.hardingdentalcenter.com) is located in Avon.


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