Concussions in Child Athletes Video

Air date: Sept. 8, 2010

For more info: Sharp Chula Vista Medical Center and Emergency and Trauma

Transcript

Raoul Martinez, FOX 5 Morning Anchor: Two recent studies show that concussions among kids are on the rise, so of course, the fall sports season is getting into full swing and there are some things you need to know as a parent out there. We're joined by Dr. Karrar Ali from Sharp Chula Vista Medical Center. Doctor, we appreciate you taking the time to be here.

Dr. Ali, Emergency Medicine Physician, Sharp Chula Vista: Thanks for having me.

Raoul: OK, let's talk about this. Why are concussions on the rise? Is it that sports are getting more violent? Is it the equipment?

Dr. Ali: In the last 10 to 15 years, there's been a little bit of everything. Mostly, it's been awareness and not just public awareness, but health care providers' awareness. Fifteen to 20 years ago, you would get hit on a football field, get up, start playing again and no one would think anything of it. Then pediatricians and trauma surgeons started realizing that these people were having cognitive deficits, like not concentrating in school or doing their homework, and realized that these deficits were being caused by concussions.

Raoul: More education is definitely helping. A lot of the time, 10 to 15 years ago, if you fell down, perhaps you would get a concussion, but you wouldn't know it because you'd shake it off. Is it maybe that there are more kids playing sports or are things more competitive out there perhaps?

Dr. Ali: Participation has actually gone down in sports, but kids are more competitive. Sports are getting more competitive and parents are encouraging their kids a lot more, too.

Raoul: What causes a concussion? If you ask somebody on the street, they would say, "You hit your head and you fall on the ground," but what exactly causes one?

Dr. Ali: Concussion is part of a broader term called traumatic brain injury that goes all the way from bleeding in the head to any minor hitting of the head that forces some movement and can cause loss of unconsciousness, dizziness, vomiting, or anything like that. It could be very minor.

Raoul: Let's talk about some of the myths. A lot of people think that in order to have a concussion, you need to lose consciousness, but we've learned, for example, in the NFL the last couple of years, a lot of quarterbacks end up with concussions and by the third or fourth one is when it really gets serious, and you see them walking off the field and they have a concussion. So the truth is that you don't necessarily have to be unconscious, right?

Dr. Ali: Absolutely not. You could have no loss of consciousness. A concussion is, by definition, a functional deficit and not a structural deficit, so you don't have to have a stroke or bleeding. It has to be a cognitive deficit.

Raoul: Here's what I didn't know: Sometimes you do a CAT scan and it will be normal. So how can you tell that you're dealing with a concussion?

Dr. Ali: In general, when I see patients, 99 percent will have a negative, or normal, CAT scan. We actually hope for them to be normal, but that doesn't exclude them because they can still have a concussion. A concussion isn't really diagnosed by a CAT scan. We use a CAT scan to rule out a structural problem, such as bleeding or a skull fracture.

Raoul: Which can lead to more serious things obviously. Let's say something happens on the field and nobody notices it right away. Are there any symptoms that mom and dad can look for in their kids? Perhaps they get home and they just didn't mention it. Maybe they fell on the ground like they do all the time, but it was just something that was slightly off. What are the symptoms we can look for in case there’s a possible concussion?

Dr. Ali: The American Journal of Pediatrics has about 22 symptoms that you can look for. The most common ones are headache, dizziness, amnesia where they're not remembering events before or after it happened. And then you start looking after 24 hours at things like concentration, irritability, decreased appetite, any of these things that you feel a child is not acting "right," is something that needs to be an alarm and be seen by a health care provider.

Raoul: So you go to the doctor, how do you treat something like this? When you have a first concussion and then maybe you have a second one, does it compound on itself or does it heal?

Dr. Ali: It actually does. There's data out there, but there's not a consensus from even the experts. The number one thing is to make sure they do not go back onto the field and play. They need to go to the emergency department, but even then, they need to go to their primary care provider in order to get medical clearance. Long term effects for a concussion as far as neurological and neuropsychological testing that needs to be done. There's a whole battery of testing for that to determine the risk is to the patient and how well they are to going back to the field and playing again.

Raoul: How long does a concussion last? Just like a mild concussion?

Dr. Ali: There's no answer for that. It could last for a day. In general, 95 percent of them are within 24 hours to a week. There are some that last from 10 to 12 days. Believe it or not, even after three months, you could still have one, which is called post-concussive syndrome and has even more long-term effects. It also depends upon the age group of the child.

Raoul: You have to take care of the brain. What are some of the preventive things that we're doing? I know that technology has really caught up. Football helmets are a lot sturdier and a lot more protective. We have mouth guards. What kinds of things have the equipment makers done?

Dr. Ali: Helmets have been shown as the number one preventer for head injuries, especially for contact sports like football and hockey and I wish soccer had them as well. They're what have the most effect. Now even then, there are still studies that show that they may or may not have a huge effect, but in general, most pediatricians and primary care providers recommend helmets. The mouth guard is a little more tricky. It has been shown to absolutely prevent against dental trauma. But the issue is that if you got hit in the mouth, there are forces that go up to the brain and this would actually help prevent that as well. Anything that can be used for prevention, like shoulder pads, is worth it.

Raoul: Man, I’m telling you what, as a parent, I'm nervous already. Doctor, we thank you for your time. There's so much to worry about as parents but you just have to take precautions and be safe out there and if you see anything strange or different in your kids, go and get them checked out.

Dr. Ali: Absolutely.

Raoul: OK, doctor, thank you for your time.