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It’s Time to Talk Seriously About Concussions

Sixty-one thousand. That’s nearly how many deaths occurred related to traumatic brain injury (TBI) in 2019, according to the Centers for Disease Control and Prevention (CDC). Even more troubling? A leading cause of TBI-related emergency visits among children are sports and recreation-related concussions.

As a school administrator, you oversee both recreational and organized athletic activities that potentially expose your students to traumatic brain injuries. These injuries can have both short-term and lifelong impacts on students’ lives. By being aware of concussion consequences and taking action, you can help bring concussion stats down.

What Is a Concussion?

The CDC defines a concussion as “a type of traumatic brain injury – or TBI – caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.”

Inside the skull, the brain floats in cerebral spinal fluid. This fluid acts like a shock absorber to help protect the brain. When a person is hit in the head, the brain can move. With enough force, the brain can hit the walls of the skull, resulting in a concussion. A person can also get a concussion by a hard, indirect blow to the neck or body. A hit to the neck or body can create a whiplash effect that causes the brain to move.

When Do Concussions Happen?

The short answer: at any time. It's easy to associate concussions primarily with full-contact sports like football and ice hockey. However, concussions can occur during any recreational or competitive activity. The list below, from the American Association of Neurological Surgeons, highlights the top ten activity-related head injury categories among children ages 14 and younger*:

  • Playground equipment
  • Football
  • Basketball
  • Cycling
  • Baseball and softball
  • Soccer
  • Swimming
  • Trampolines
  • Powered recreational vehicles
  • Skateboards

*Data from reported head injuries treated in U.S. hospital emergency rooms in 2018.

What Are the Warning Signs?

Every person may experience and exhibit different signs and symptoms when concussed, and symptoms may not be apparent at the time of the injury. That’s why it’s important to keep an eye on the situation. Additionally, it’s also normal for someone to experience different signs and symptoms during the healing process. The list below, from the CDC, highlights the various concussion warning signs you should watch for.

Concussion Signs Observed

  • Can’t recall events prior to or after a hit or fall.
  • Appears dazed or stunned.
  • Forgets an instruction, is confused about an assignment or position, or is unsure of the game, score, or opponent.
  • Moves clumsily.
  • Answers questions slowly.
  • Loses consciousness (even briefly).
  • Shows mood, behavior, or personality changes.

Concussion Symptoms Reported

  • Headache or “pressure” in head.
  • Nausea or vomiting.
  • Balance problems or dizziness, or double or blurry vision.
  • Bothered by light or noise.
  • Feeling sluggish, hazy, foggy, or groggy.
  • Confusion, or concentration or memory problems.
  • Just not “feeling right,” or “feeling down.”

Why Are Concussions Serious?

Medical providers may describe a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, the effects of a concussion can be serious, the CDC says.

Signs and symptoms generally show up soon after the injury, but judging the severity of the injury can be tricky. To make matters more challenging, some symptoms don’t surface for hours or days. For example, in the first few minutes following a hit to the head, a child might be a little confused or a bit dazed, but an hour later, they might not be able to remember how they got hurt. That’s why it’s crucial to keep an eye on the situation right after the injury and in the days following. If signs develop – or they worsen – the student should immediately be taken to the emergency room.

What Are the Long-term Effects?

Severe brain injuries can create unexpected lifestyle changes, according to the CDC, because they can affect the following areas:

  • Thinking
  • Memory
  • Learning
  • Coordination and balance
  • Speech, hearing or vision
  • Emotions

Severe brain injuries can also affect relationships and the ability to do daily activities like work, complete chores and drive. Consider these case studies:

  • Jennifer1, a high school student, hit her head while playing a recreational lawn game in 2007. She received immediate medical attention, but showed no lasting symptoms after a few days, so she did not receive further treatment However, in 2015, during her second pregnancy, Jennifer started experiencing seizures. She would become unresponsive for anywhere from 30 minutes and five hours. It took 14 months for doctors to determine that the seizures were a result of damage to the base of her spine from the high school injury. She is now in therapy, which requires her to live in a temperature-controlled, stress-free and distraction-free home. Jennifer, along with her husband and children, had to move in with friends to assure the round-the-clock supervision she needs. Jennifer is making progress toward the healing of her brain, but she will suffer the effects of her head injury for the rest of her life.
  • Susan1 was beginning a college cheerleading career when she suffered a series of three head injuries during team practices. She was removed from practice after each injury. However, there was no baseline testing for the doctors to compare her cognitive functions to. After further medical testing, Susan admitted to additional possible head injuries in high school. She was forced to take a leave of absence from school for the remainder of the semester while she underwent treatment. Because of this, she lost her scholarship and had to transfer to a different school to complete her degree. Six years later, Susan still has moments of confusion. A severe brain injury can affect all aspects of people’s lives, including relationships with family and friends, as well as their ability to work or be employed, do household chores, drive, and/or do other normal daily activities.

What Are Next Steps?

It’s time to take action and raise awareness about concussion by developing, implementing and adhering to concussion management protocol. This article explains the components your policies and guidelines should include, and this checklist offers high-level tips to ensure you’ve covered your bases.

Resources

For more information on concussions, check out these resources:

1 Names have been changed to protect medical records.

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