Wednesday, September 29, 2010

Head Bonks - don't laugh

If you hang out with enough former football players, you've probably heard them talk about having gotten their "bells rung" at least once.  Fortunately, at this point, most people take head injuries more seriously, leading to the current policy on head injuries in the NFL.  Unfortunately, too few people really understand concussions.

The following short list encompasses the answers I get when I ask adults and kids "What do you think a concussion is?"

  • "It's when the brain smacks into the inside of the skull and gets bounced around and bruised."
  • "When you get knocked out."
  • "It's when you get hit in the head."
The first explanation is really what happens in a coup-contrecoup injury, and represents a more serious head injury; most head injuries don't feature this problem, fortunately.  The second and 3rd quotes are partial truths, and are part of the reason people, including doctors, miss concussions.

For definition purposes, a concussion occurs when a person sustains a significant impact, and then, essentially, feels funny.  Bonk/crunch ---> feel funny.  The impact can involve the head, or it can merely be a strong enough jolt to cause a snapping motion of the neck - back, forward, to the side, whatever.  The "feeling funny" refers to what doctors would call a change in mental status, and the following is a partial list of those symptoms:

  • loss of consciousness
  • blurry vision
  • feeling foggy
  • memory loss
  • dizziness
  • being off-balance
  • speech issues
  • discoordination
I have seen a lot of concussions, and here's (yet another) list of how they happened:
  • Kid boarded during a hockey game
  • Gymnast fell off uneven bars and landed on her backside but had her neck "bounce" hard
  • Any number of football collisions
  • Lacrosse cross-checking injury
  • Child shoved hard by another child
  • Kickball to the face
  • Teen in a rush, hit side of head against door frame of car
  • Home plate collision
  • Fastball to the (helmeted) head
  • Car accident with whiplash only.
Why are concussions so bad?  Instead of calling them concussions, let's call them "traumatic brain injuries," since that what these are - brain injuries.  I think most of us would agree that injuring your brain is bad, but how bad is it?  People with concussions and the dreaded post-concussion syndrome can suffer long-term or even permanent damage to vital brain functions like attention, judgement, balance, memory, and emotional control. 

Furthermore, some people have sleep problems, chronic headaches, and fatigue, chronic or not.  Some people even appear to suffer from ADHD/ADD-like or depression.  Google enough, and you'll see that former athletes have committed suicide after suffering from these issues.  Kids especially seem to be vulnerable to something called "second impact syndrome," which can result in either severe neurological damage or death when a person who already had a concussion suffers a similar injury before the original injury resolves.

Deep breath.

What can you do?  Read up on it; here are some good websites:
Most importantly, if your children sustain big bonks and are acting funny, take them out of the game or situation and watch them carefully.  Call your doctor if you're concerned.  Have them checked out as soon as you can, in the ER right then if you're worried.  You don't need a CT scan or MRI, but you do need a good doctor who will listen to you and your concerns.

If you're really motivated, move for your town or school system to institute concussion education programs and make sure that your coaches, from youth sports all the way to high school sports, are aware of what traumatic brain injuries are.  Push for your school to have certified athletic trainers at every game.  Hopefully, with enough awareness, I won't hear the following after I advise parents to pull their kids from sports until they're feeling better...

"Yeah, doc, I hear're trying to cover your butt, and I get that, but I had my bell rung a few times when I played football, and I'm just fine..."

1 comment:

  1. Hey B-
    Here's a scary one for you. My friend's niece tripped and fell (FORWARD.) She didn't hit her head at all but the forward jerk of her head caused the blood vessel that fed her spinal column to rupture. She got up and felt okay and went home. She developed a terrible headache so her mother called the doctor. When the girl got up to go to the doctor she immediately fell. It was several hours after the incident and the lack of blood to her spinal column had killed the cells that controlled her extremities. They called an ambulance which brought her to a local hospital. An MRI/CT scan did not show what was going on. Finally she was transported to Children's who identified the issue and repaired the bleed. She is a quadripelegic and has spent several months in PA at a Shriner's. They told her she would never walk again but she is already starting to. It's amazing but the crazy thing is that I never would have thought that a forward fall would cause something WORSE than a concussion.
    Thanks for the post - as usual, great to read.


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