Concussions at any age should be taken very seriously, especially in the young devloping brain. Whenever they occur, the important thing is that the athlete's brain has completely healed before risking another hit. Each concussion should be evaluated by a licensed medical professional educated in concussion management using current best practices.
Yes, when a concussion is suspected the athlete is to be removed from participation and referred for evaluation by the licensed athletic trainer. Symptoms of a concussion do not always manifest immediately, so we also frequently see athletes the following day(s) indicating they "got hit" in the game or practice but did not realize any symptoms. Sometimes this may be due to the athlete minimizing the symptom immediately after, sometimes the symptoms do not appear until hours or even a day or two later. This is one of the reasons concussion management is very complicated and never black and white.
We have been reviewing literature that indicates a history of migraines appear to elicit a longer recovery period. I am not aware if there is one answer to the connection with migraines and concussions, but it is something we continue to monitor. There are specific symptoms that are included in the "migraine cluster" that occur following head trauma. More research is needed in this area.
Information on concussions has been included in both parent meetings and athlete meetings as well as coaches meetings provided by FCPS schools over several years now. The law that goes into effect July 1, 2011 will require all student athletes and their parent to complete a concussion education program prior to participation in sports.
This past October, the Virginia High School League passed a rule that all coaches complete a concussion education course.
We continue to work on the education piece and feel it is essential to the overall concussion management policy.
Penlights are adequate, so is the sun (if outside) or indoor light (if inside).
At this point, it is safe to say that no headgear approved for sports (including helmets) can prevent concussion. Concussions can occure with no contact to the head (whiplash type movement from hit to body). More research needs to be completed to determine the true validity of how much a particular headgear may reduce the severity of a concussion, if at all.
A 17 y/o female family member was struck in the head (front lobe) by a golf club (an iron, not a wood). Although her skull was not fractured, she was unconscious for a few minutes and she suffered headaches, fatigue, etc., for several days afterward. Lack of insurance precluded follow-up care. In her early and mid-twenties, she suffered amnesia for certain current day events, amnesia that has stayed with her into middle adulthood. Although her later amnesia spells were never linked to the injury, I wonder: can such a head injury cause amnesia two, five, or more years after the fact?
The answer to this question would be best provided by a team of experts following an in-depth review of the history as well as a thorough clinical evaluation.
As with all concussions, attempting to place them into a cookbook protocol is not advised. There is no way to tell if an athlete will be out for 4 days with symptoms or 11 days with symptoms. Same is true when attempting to determine how many is too many. What is important is to confirm that there are no "bridges" between concussions. Has the brain really healed completely before returning to stress. Any athlete (non-athlete as well) suffering from multiple concussions should be evaluated extensively by experts in concussion management. Case by case basis, too many variables to consider to offer a blanket statement.
Absolutely NOT, you did the right thing. I would question having my son participate on any team in a league that allows a coach to make poor decisions such as that. (trying to be polically correct here!!)
I believe there is a significant effort to provide appropriate education on concussions to coaches at the youth level. Some organizations are more aggressive at this than others.
Yes, there is a question on the VHSL Pre-participation Physical Evaluation form that addresses previous conucssions. We are also reviewing our epidemiological data to look at the number of athletes who have suffered multiple concussions and the timeframe between cases.
I'm not sure anyone is certain of the answer, but that could be a possibility. We do know that every kid responds differently and some will have symptoms with 15 g's of force, while others of the same body size will not have symptoms when hit with 25 g's of force. What the difference is between the to kids? Perhaps the answer is in the DNA. More research is needed.
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