Early Detection & Treatment Can Prevent a Concussion from Sidelining Young Athletes for Long
By Sam Smith, MD, Surgeon in Chief, Arkansas Children's Hospital
Who doesn't love the drama of fall football? When the chill is in the air and the players take the field, it's hard not to embrace that team spirit!
But at Arkansas Children's Hospital, we also know that with those pep rallies and thrilling plays comes the risk of additional injury to our young athletes. We want to be cautious about concussions in all children, and especially those active in sports.
Whether it's the quarterback who takes a hard sack or the cheerleader whose tumble doesn't end as planned, athletes need to remember that any impact that affects the head – even one that isn't direct – can put them at risk for a concussion. Parents, coaches and other supporters should also be aware that kids who sustain an injury to the head need to come out of play and be examined as soon as possible.
In the Emergency Department at ACH, there is one thing we frequently hear from parents whose children have experienced head injuries: "I wish he'd been wearing a helmet." This is one of the best ways to prevent or minimize concussions. Athletes should always have their helmets securely fashioned while they're in the game. The same goes for anyone riding a bike or recreational vehicle like an ATV – popular this time of year as hunting season gets underway.
If a child passes out after an injury that involved their head, the athlete needs to be assessed even if she indicates she feels OK. Those hit hard enough that they don't remember the impact should also be evaluated by urgent care immediately. The same goes for any child who acts a little fuzzy or just generally "out of it" after an injury. If the child appears dazed, confused, clumsy or experiences vomiting, loss of memory or loss of consciousness, these are all signs he needs to be seen promptly.
Most importantly, kids who have sustained force to the head need to discontinue the activity that caused the injury. They are at even greater risk for a second injury, which can cause more serious, longer-lasting side effects and much lengthier recovery times.
Studies have indicated that nearly 4 million concussions occur in the U.S. every year among kids who play sports and take part in other recreational activities. Dr. Damon Lipinski, a neuropsychologistin the ACH/UAMS Sports Concussion Clinic at the Centers for Children in Lowell, estimates that 80 percent of kids diagnosed with concussions recover within two to three weeks and can resume play when they're fully healed. That usually means kids may sit out a game or two but will be back at it soon after. Athletes who have experienced previous concussions or secondary injuries may take a little longer to heal.
At ACH, we stress to families the importance of visiting a multidisciplinary clinic like the ones on our campuses in Little Rock and Lowell. These programs get children the services they need to return to school and sports as quickly and safely as possible. Families benefit from a team that includes a physicians, neuropsychologists, athletic trainers and social workers who follow athletes until they have fully recovered.
If you take your child to the ACH Emergency Department and they are diagnosed with a concussion, you'll be given referral information for this kind of comprehensive program. A diagnosis will be made based on the history provided by the family, a thorough exam and possibly an imaging scan like a CT.
Sometimes it's not obvious to families that a child has experienced a concussion until a few days later. If parents notice any changes in their kids – an A student who starts performing at D level after an impact, for example – it's important to seek medical evaluation because the child may need accommodations at school.
In addition, if a physician warns that the family may notice a difference in mental status for two or three weeks but it seems to be lasting longer, don't write that off! Pay attention to your child's behavioral cues and follow up with their care team after an injury.
Concussions can be frightening, but with proper evaluation and care they'll heal quickly. Then everyone can get back to focusing on the fun of those fall sports!
Sam Smith, MD, is surgeon in chief at Arkansas Children's Hospital and a professor of Surgery at the University of Arkansas for Medical Sciences. He writes a column each week covering a variety of kids' medical concerns. If you have a topic you'd like him to consider addressing, email firstname.lastname@example.org.