Minor traumatic brain injury (concussion) is one of
the most poorly understood injuries in sport.
Diagnosis and management are constantly evolving-
hence the dilemma.
Concussion is indeed a brain injury, hence
invisible to the naked eye. As such, it’s
seriousness is often underestimated. It occurs when
trauma (usually deceleration) is applied to the
head or neck. This causes a disturbance in brain
function which leads to biochemical and
neurological changes.
Concussion is largely NOT measurable by various
imaging ( CT, MRI X-ray etc.). It IS measured by
clinical examination ( see SACT2 and SACT2 pocket
card) and computerized testing ( ImPACT, Cogsport
etc.).
Serious head injury with declining neurological
status often merits a CT scan to rule out a bleed
or other pathology.
The effects of concussion generally wear off with
time – usually 5 days to 2 weeks. This recovery
must be physician monitored in order to determine
an appropriate time for return to sport. Once
symptoms are gone a graded return to activity is
necessary (see enclosed SACT2 info sheet)
Long term effects of concussion and recurrent
concussion are still poorly understood. We do
believe there is some cognitive loss in adulthood
associated with recurrent head injury. Several
studies are under way to look at the brains of
deceased athletes to assess the impact of recurrent
head trauma.
Today , I believe concussion is an epidemic. The
culture of sport seems to be more and more
competitive (read violent) . We, as physicians,
have not been vocal enough to express our concerns.
I have enclosed a copy of the latest Sport
Concussion Assessment Tool (SCAT2) for physicians,
trainers and the general public. Also take a look
at the following excellent website:
www.thinkfirst.ca
If you are requesting an assessment- please contact
me at one of the numbers listed in my website and I
would be happy to examine/determine a return to
play for a player.
