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What parents and coaches should know about concussions

The risk of concussions, especially among young athletes, is getting more attention these days -- but there's still much we don't know. Linda Carroll, co-author of the forthcoming book "The Concussion Crisis: Anatomy of a Silent Epidemic," talked with NBC chief medical editor Dr. Nancy Snyderman about what parents and coaches should know about recognizing and preventing concussions.

Linda Carroll: How do you know if your child has experienced a concussion?

Dr. Nancy Snyderman: Well, first things first, let’s define what we mean by concussion.  In the medical literature, the term concussion really means "mild traumatic brain injury." It’s important to think of it that way because although concussions may be commonplace in the sports arena, any injury to the brain should not be taken lightly.

The clinical hallmarks of a concussion are confusion and amnesia which may be obvious immediately or appear several minutes later. If your child suffers a blow to the head, watch for any of the following signs:

  • Vacant stare
  • Delayed answers to questions
  • Easily distracted
  • Disorientation to time and place
  • Slurred speech
  • Emotionality out of proportion to circumstances
  • Memory deficits
  • Loss of consciousness
  • Headache
  • Vomiting

Does there need to be a loss of consciousness for there to be a diagnosis of concussion?

No.  This is a common myth.  The confusion that occurs after a concussion can occur with or without loss of consciousness.  The majority of concussions in sports occur without loss of consciousness and often go unrecognized. 

Can doctors see signs of a concussion on a brain scan?

People with concussions usually have normal brain scans.

Why is it important to rest the brain after a concussion? What can happen if an athlete (or anyone for that matter) doesn't take time off to allow the brain to heal after a concussion?

People with concussions typically make a full recovery.  However, it is important to give your brain some rest because the brain is especially vulnerable to damage from even minor jolts while it is still recovering.  In children, the consequences of not resting can be devastating because of a rare complication called “second impact syndrome.”  The term “second impact syndrome” refers to brain swelling which occurs when a person suffers a second concussion while they are still symptomatic from the first one.  Second impact syndrome can severely disable or kill a child.  The risk of this kind of serious injury has led to the guidelines that address when an athlete should return to play. 

What are some of the long-term effects of repeat concussions? 

Multiple concussions can lead to a number of problems including postconcussion syndrome, the main features of which include headache, dizziness and difficulty concentrating.  Less frequently, epilepsy, vertigo, personality changes, Parkinson’s disease and dementia have been linked to repeat concussions in boxers and football players. 

Since we can’t take concussions out of sports, how do we keep kids’ brains safe?

In most places, bicycle and motorcycle helmets are required by law because they reduce the severity of accident-related head injuries. When riding in the car, always remember to buckle up.  For contact sports, use sport-specific helmets. 

Still, helmets aren’t the total solution.  While helmets can provide some protection, they don’t prevent concussions.  The best way to protect kids is to carefully watch for signs of a concussion and then sideline players until their symptoms have resolved.  One way to keep track of concussions in kids — who often don't want to be sidelined by concussions — is to test them at the beginning of the season and then retest them each time they have a concussion.

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