Kids' Sports Concussions Can Have Long-Term Costs 

< Apr. 28, 2010 > -- A hard fall or hit in sports can put children in danger of a concussion. And if parents and coaches fail to recognize the signs and delay treatment of a concussion, kids could be at increased risk for a severe brain injury with lifelong consequences. But April's National Youth Sports Safety Month is an excellent time to learn who's at risk and how to spot symptoms of a concussion.

A concussion occurs when the brain moves around inside the skull because of a blow to the head. Spinal fluid that surrounds the brain in the skull cushions it against minor head trauma like a slight bump. But a heavy blow can cause the brain to hit the bone of the skull, resulting in bruising, torn blood vessels, and nerve damage.

Children and teens are more likely to have a concussion than adults because they are still developing, according to the U.S. Centers for Disease Control and Prevention (CDC). It also takes youngsters much longer to recuperate.

"If a concussion goes undiagnosed, it can increase the risk of re-injury," explains Paul Gubanich, MD, an orthopedic specialist at the Cleveland Clinic. "We know repeated head injuries can lead to chronic changes in the brain. Athletes who go back to play before they are fully recovered are at risk for having worse symptoms and more prolonged injuries."

Injury Can Occur in a Variety of Sports and Activities

Each year, emergency rooms in the U.S. treat an estimated 135,000 children ages 5 to 18 for traumatic brain injuries related to sports or recreation, according to the CDC.

But contact sports are not always to blame for concussions. While football and soccer injuries are common causes of concussion, activities like bicycling and playing on the playground are also associated with traumatic brain injuries, the CDC reports.

Even cheerleading, with its increased emphasis on throws and stunts, has become a rising cause of concussion. "I've seen a lot of them getting a concussion from someone not catching them during a stunt or from a misstep taken during a tumble," says Robert Agee Jr., MD, a sports medicine physician in Birmingham, Alabama, and a spokesman for the National Center for Sports Safety.

Know the Signs

Concussion has no physical signs, and symptoms may not appear right away. So it can be difficult for parents or coaches to detect concussions. Even doctor can struggle to diagnose them, because brain scans like MRIs and CT scans are unable to detect them with any degree of certainty, Dr. Agee says. "You can't see a concussion. You can't feel it," he explains. "You just know it from symptoms and how the person's brain is processing information."

Parents need to be able to recognize concussion symptoms after a child has sustained a hard blow to the head during sports or play. They include:

• Dazed or stunned appearance
• Moving clumsily and difficulty staying balanced 
• Answering questions slowly
• Losing consciousness, even for a moment
• Confusion about where he or she is or what he or she is doing
• Trouble remembering things that happened either before or after the blow
• Behavior that is strange or out of character
• Headache
• Nausea or vomiting
• Sensitivity to noise or light
• Blurred or double vision
  

Any of these signs should prompt parents and coaches to seek medical attention for the child right away.

Once diagnosed with a concussion, a child needs to stay out of sports long enough for the brain to heal. A brain recovering from concussion is susceptible to increased injury if a second head injury occurs, according to research.

"The brain is already compromised by the first hit," Dr. Agee says. "Your brain is already vulnerable, and you're susceptible to having a concussion again with very minimal trauma if you go back too soon."

Repeated concussions increase risk of memory loss, thinking difficulties, chronic headaches, epilepsy, and eventually Alzheimer's disease, say both Drs. Gubanich and Agee.

Protect Children from Concussion

To protect children from concussions and other sports injuries, make sure they wear the proper safety equipment for whatever sport they're playing. Make sure helmets fit properly and used as instructed. For example, they need to wear a chin strap if it's included.

Learning from a coach who focuses on fundamentals of play can also help kids avoid concussion. Children who know the proper stances and moves for their sport are less likely to be injured during play. Children should also always warm up before playing and avoid playing when they are very tired or in pain.

Parents can find an extensive guide to preventing children's sports injuries at the website for the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Always consult your physician for more information.