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askthedoctor Concussion Facts


More than 1 million people have a concussion each year. Fortunately, managing a concussion appropriately usually prevents long-term deficits. By Rear Adm. Joyce Johnson, D.O.


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Athletes Are at Risk for Concussion


■ The Centers for Dis- ease Control and Pre- vention has developed “Heads Up: Concussion in Youth Sports,” a pro- gram offering printed material and short videos for coaches, parents, and athletes. Visit www.cdc .gov/features/concussion.


early any type of head trauma can cause a concussion, whether it’s a head hitting the windshield in a car accident or high school athletes colliding. At the time of head trauma, there might be a brief but total loss of conscious- ness. (If so, seek medical evaluation.) Often someone with a concussion can’t


remember what happened around the time of the injury. Headaches are common. The person might seem drowsy, disoriented, and/or confused, or display a lack of co- ordination, difficulty walking, clumsiness, or weakness. These symptoms usually will last a few minutes and rapidly improve; if they don’t resolve immediately, seek emer- gency medical care. Fortunately, most pa- tients recover in a couple of hours or less, though some symptoms, such as recurrent headaches, can last a month or more. Even if symptoms have resolved, it can


take several months for the brain to heal completely. However, if a concussion is managed properly, there usually are no long-term deficits. Management includes two steps — identifying more serious problems and preventing further injury. The most important, immediate step


in managing a concussion is to identify any more serious problems. If symptoms worsen instead of improving, call 911. There might be bleeding inside the brain, and im- mediate medical care could be lifesaving. Stay alert for a headache that gets worse; increasing confusion; balance or ability to walk that becomes more impaired; vision changes, including double or blurred vision;


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unequal pupils or strange eye movements; vomiting; seizures; or continued drowsiness or disorientation. These are signs of serious progressive brain injury — including bleed- ing inside the brain and other problems that might be fatal — and require immediate medical evaluation, which usually will in- clude a CT scan or an MRI of the head. Even a patient who seems stable should be monitored for changes for at least 24 hours, as a small bleed in the brain might not be apparent immediately. Do not ad- minister aspirin or NSAIDs (ibuprofen, naproxen, etcetera) for headache or other pain as they can contribute to bleeding. The second key to concussion manage-


ment is prevention of further head trauma. The healing brain is very susceptible to further injury. An athlete who has had a concussion should stop playing im- mediately and shouldn’t play again until after medical evaluation. Often an athlete (sometimes with the support of his or her parents and coach) wants to return to the game. However, repeated head trauma can cause permanent brain injury. A child with a recent concussion should not play in contact sports; many recommend a child who has had a concussion with loss of consciousness be suspended from sports for at least three months.


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— Rear Adm. Joyce Johnson, USPHS-Ret., D.O., M.A., is vice president, Health Sciences, Battelle Memorial Institute, Arlington, Va. Find more health and wellness resources at www .moaa.org/wellness. For submission information, see page 20.


PHOTO: STEVE BARRETT


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