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HEAD GAMES: Several consequences of young athletes' concussions (08/14)

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By Nathaniel Bryan

Having trouble sending a text, posting to Facebook or Twitter or watching a YouTube video.

Going from easily getting straight As to struggling to get Cs.

All are symptoms and consequences of kids suffering a concussion and the sooner the ability to pick up the keys, the better for children’s health.

According to ImPACT Applications, Inc., which has developed a baseline brain activity test utilized by many area high school sports teams, there are several common signs of a concussion: Answers questions slowly, appears to be dazed or stunned, forgets events after hit, forgets events prior to hit, forgets plays, is confused about assignment, is unsure of game or score or opponent, loses consciousness, moves clumsily and shows behavior or personality change.

Some common signs reported by athletes who have suffered concussions include balance problems or dizziness, changes in sleep patterns, concentration and/or memory problems, double or fuzzy vision, feeling foggy, feeling sluggish, headaches, nausea and sensitivity to light or noise.

“If they’re seeing that he’s having dizziness and having trouble concentrating and he’s having headaches, dizziness and nausea are very big red flags,” said Jimmy Coursey, a Master of Physical Therapy and the outpatient rehabilitation services manager for Hardin Memorial Hospital. “I would go ahead and go to the emergency room — that night.”

For children who have suffered concussions, there are many consequences. Untreated concussions or returning to play too soon from a concussion can lead to post-concussion syndrome (PCS). The red flags for PCS include chronic headaches, fatigue, sleep difficulties, personality changes such as increased irritability or emotionality, sensitivity to light or noise, dizziness when standing quickly and deficits in short-term memory, problem solving and general academic functioning.

“Short-term, there are several consequences as far as memory, abilities to perform in school and obviously there’s a long list of symptoms they can suffer from – and it can become chronic if that’s not treated,” said Heather Ruccio, a neurosurgery specialist and a certified physicians assistant for HMH. “Long-term (effects) usually happen if the concussion’s not treated and they get hit again. Then they could have long-term memory issues and long-term academic issues or performance.”

When she means long-term, Ruccio isn’t meaning just the rest of the season. In some cases, it could be years before things return to normal.

“People can go for a long time without having a concussion heal completely,” Coursey said. “Heather and I have a particular patient that I think of that when she came to us, her episode that she received the concussion was four years before we ever met her and she was still having symptoms. But through therapy, she was able to improve upon those symptoms over the course of four or four-and-a-half months.”

That particular patient and scenario is not considered typical for a concussion, although Coursey cautioned every concussion is different, no matter if the timing, ages, genders and impact are similar.

Coursey remembered stories Eric Oliver of HMH sports medicine would tell the staff, like Tim Tebow returning the next week after getting knocked unconscious against Kentucky and a Major League Baseball umpire missing the rest of the season after taking a foul ball off his head (which was protected by a mandatory facemask).

“Everyone is somewhat different and everyone will heal in different ways,” Coursey said.

Ruccio said memory can be skewed to the point it is hard to remember lists or tasks.

“You may not remember them all, so you might have to carry a notepad with you to write that down because you won’t have that memory, but most of the time, it doesn’t ever get that far,” she said. “But it could be a long-term issue for children. Usually though, with single concussions that are healed, they don’t have them because they get better, we put them through therapy and they get back to their baseline before they even had their concussion.”

When children suffer concussions, it’s pretty evident they won’t be returning to the field of play any time soon.

What sometimes gets forgotten in the healing and rehabilitation process, though, is the academic side of the coin.

They’re student-athletes, remember?

“For kids in general, it can be serious to the extent that academic-wise they’re decreasing and you may not think that (the concussion) is what it really is,” Ruccio said. “Then they have academic problems in high school and it can travel on into college.”

One of the biggest consequences of a concussion or multiple concussions is having suicidal thoughts. Granted it’s less of a problem for middle-school and prep athletes, but it is still one of the harshest downsides of a concussion.

“I have seen several adults who had not been treated for a concussion and they had chronic headaches and life-changing symptoms to where they could become suicidal,” Ruccio said. “That’s another downside of a concussion if it’s not treated – they don’t feel like themselves in their bodies. This can cause emotional and psychiatric issues as far as suicide. This is what they have seen in the NFL with the players who have been committing suicide. That’s the seriousness of it.”

Fortunately, Coursey pointed out, this is an area in which the schools, coaches, medical staffs and athletic trainers are proactive at heeding the warning sides of concussions.

“I think our local school systems have taken great strides, E’town and Hardin County for sure, because they have taken things a lot further than they are required to,” Coursey said. “… They have taken extra strides to make sure that their athletes are safe.”

Nathaniel Bryancan be reached at 270-505-1758 or nbryan@thenewsenterprise.com.