Sports concussions are on the rise, particular among younger players, and neurologists are standing together to address the ever-growing epidemic.
From 1997 to 2007, the number of emergency room trips for concussion-related symptoms doubled for youngsters aged 8 to 13 and increased three-fold for teens between 14 and 19. Questions abound as to why physicians are seeing more concussion patients these days than in the mid-90s. Insufficient or improperly fitted equipment could be to blame. Even drastic body-weight disparities in youth programs could be causing the spike in the number of reported cases.
But more likely, those involved -- doctors, parents, coaches, and players -- are becoming increasingly aware of the hidden dangers of these head injuries, and may finally be taking necessary medical precautions by having a player get checked out when he or she is first suspected of having a concussion.
To that end, the American Academy of Neurology released new guidelines this week for an advanced call to action. Under the new provisions, players suspected of sustaining a concussion should refrain from further athletic play until they can be properly evaluated by a physician. The AAN also requested that a properly certified athletic trainer be present at all sporting events, whether championship games or the humdrum of weekday practices.
For a successful initiative, knowledge is key. "We need to make sure coaches, trainers and even parents are properly educated on this issue, and that the right steps have been taken before an athlete returns to the field," said Dr. Jeffery Kutcher, AAN sports-neurology section chair and director of the Neurosport Program at the University of Michigan.
With more players likely heading to the hospital for medical evaluation of a potential head injury, clinical-testing procedures will have to evolve to aid physicians trying to determine if a player has, in fact, suffered a concussion. Fortunately, new research by Nadia Gosselin and colleagues suggests that advanced imaging (fMRI, or functional magnetic resonance imaging) and brain-activity tests (event-related potential and electroencephalogram) could gain the necessary resolution to pinpoint even subtle injuries to the brain.
Beyond standard neuropsychological examinations that include simple tests that measure verbal and motor responses, these new diagnostic tools, according to the study authors, may one day provide a clear-cut method to determine if it’s safe for players of all ages to return to their sport.
Citation: Gosselin N, Saluja RS, Chen JK, Bottari C, Johnston K, & Ptito A. (2010) "Brain functions after sports-related concussion: Insights from event-related potentials and functional MRI." The Physician and Sportsmedicine, 38(3), 27-37. PMID: 20959693
Image: Flickr/jamie-williams-photo, CC
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