Friday, August 29, 2014

Head games – the impact of concussions


As fall sports commence, Walter Panis, MD, of the MassGeneral Hospital for Children (MGHfC) Sports Concussion Clinic and the MGH Physical Medicine and Rehabilitation Service, explains the ins and outs of concussions.

Q. What is a concussion?
A. A concussion is a pathophysiological event that is caused by torquing or a twisting of the brain. It is not necessarily caused by a direct blow but by a quick – and usually unexpected – movement of the neck. That force applied to the brain appears to affect the nerve cells and causes them to malfunction.

Q. What are symptoms of a concussion?
A. A sort of change in a person’s recognition and level of awareness. The most severe form is a loss of consciousness. On the other end of the spectrum, a person might just feel a little dazed or out of it. Other symptoms include headache, sleep disturbance, cognitive and behavioral complaints and mood disorders.

Q. How are concussions treated?

A. Physical and cognitive rest is the most important and effective, immediate treatment and, of course, preventing another blow. If we think athletes
have suffered a concussion, we take them out of play until they have no further symptoms.

Q. How long does it take to recover after a concussion?
A. I would say 90 percent of people who have a concussion get better within a month. Most people get better even faster; however, it turns out that children recover slower than older kids and adults because of their developing brains.

Q. With fall sports around the corner, what are ways to prevent concussions?
A. The stronger and healthier you are, the better chance you have of
preventing a concussion. Good technique is important, making sure you
are well-hydrated and well-nourished. We are seeing more and more
concussions in girls; we think it is because they are more likely to
report their symptoms.  

Q. Why are concussions increasingly more prevalent?
A. We don’t know for sure, but perhaps it is because people are more aware. Education has increased, and there is more sports participation. People read in the newspaper everyday about concussions – it is part of our culture now. The vast majority of people who get a concussion do get better. When people don’t improve, there is often something else going on.

Q. What is key when it comes to concussions?
A. Recognize the symptoms. There is a great concern about the second impact syndrome, which is deadly yet very rare. An adolescent who has suffered a concussion and then has a second impact could develop a life-threatening brain problem, and kids have died or have been severely disabled. Someone who has had a concussion should be taken out of the game even if they recover quickly. If in doubt, take them out.

For more information about concussions, contact the MGHfC Sports Medicine Clinic at 617-724-9722.

Read more articles from the 08/29/14 Hotline issue.


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