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Wednesday, August 01, 2012 - Methodist Medical Center Neurosurgeon Explains Dangers of Head Injuries in Young Athletes
       
       “Coaches should always supervise young children who participate in sports and make sure they do use equipment that is suitable for their age,” according to Dr. Maccree.  “Safety inspections of the equipment should be performed regularly.”

Young athletes should not wear clothing that interferes with their vision, and they should stay on the sidelines when they are sick or extremely tired, he added.
       
More than 350,000 Americans receive emergency treatment for sports-related head injuries each year. Cycling accounts for most of the injuries, and football is second.

“Injured athletes want to get back to their sport as soon as possible, and their desire is understandable. However, when the head is injured, athletes may risk serious, long-term neurological impairment if they try to return to action before they have time to heal,” according to Dr. Lawrence Maccree, a board-certified neurosurgeon on staff at Methodist Medical Center.

 

Concussions

“Concussions are a fairly common sports injury, especially among football players,” he added. “They occur when the brain is shaken within the skull. In severe cases, concussions may result in damage to neurons and nerve fibers in the brain.”

Concussions range from mild to severe and are categorized according to whether or not the patient lost consciousness, the duration of the unconsciousness, the duration of any post-traumatic memory loss, and the persistence of symptoms.

Grade 1 concussions are the least serious. The athlete does not lose consciousness and post-traumatic memory loss and other symptoms are limited to a few minutes. Athletes can return to their sport after a week without symptoms, Dr. Maccree noted.

Grade 2 concussions may or may not involve loss of consciousness, and any unconsciousness may last up to five minutes. Post-traumatic symptoms are limited to 24 hours or less. Again, athletes may return to sports activities one week after having no symptoms, although in light of the findings pouring in regarding the long term effects of head injuries the tests to assess post-concussive symptoms are becoming much more rigorous than they have been previously.

 Athletes with a Grade 3 concussion lose consciousness as a result of their trauma. There is no specific timeframe for loss of consciousness in this grade level. Post-traumatic symptoms last for more than five minutes and may persist for 24 hours or longer. Athletes with a Grade 3 concussion should be sidelined for at least a month and resume their sport when they have had no symptoms for a week.

“Athletes who have had repeated concussions should be sidelined for longer periods,” Dr. Maccree said.  “Some thinking regarding repeated concussive injuries even goes as far as suggesting cessation of participation in the sport.”

 

Acute Subdural Hematomas

“Acute subdural hematomas are rare in football, but they are among the deadliest of all head injuries,” Dr. Maccree added. “Tiny veins between the surface of the brain and its outer covering stretch and tear. Blood quickly fills the space around the brain and compresses brain tissue. Emergency surgery to reduce the pressure is often necessary.”

The prognosis, or outlook, for each patient depends on the location and type of injury, the extent of brain damage, and the length of time between the injury and treatment. Whether or not surgery is necessary, patients may need to take medications to reduce swelling in the brain and to prevent or control seizures.

 

Sports Precautions

State laws vary for helmet usage. However, people who participate in certain sports should use helmets or other protective head gear every time they engage in their sport.

Among those sports are cycling, football, baseball, softball, use of recreational vehicles, skateboarding, horseback riding, snow skiing, snowboarding, white water kayaking, hockey, skating, and wrestling.

“It is absolutely essential that helmets fit properly,” Dr. Maccree noted.

 

Emergency Treatment

Dr. Maccree recommends emergency medical care for any athlete who sustains a head injury and experiences one or more of these symptoms:

·           Severe headache
·           Severe stiffness in the neck
·           Problems remembering recent events or personal information
·           Nausea or vomiting
·           Dizziness
·           Problems with balance
·           Mental confusion
·           Weakness in the arms or legs
·           Slurred speech
·           Problems with vision
·           Extreme drowsiness
·           Loss of appetite
·           Bleeding or loss of other fluids from the nose or ears
·           Convulsions
·           Loss of consciousness