Concussion Symptoms Linger in Children and Young Adults

Since our parents time we heard the euphemisms when people were hurt playing sports. They included ‘seeing stars’, ‘punch drunk’, ‘dazed’. There was a long period of time where the advice was to walk it off, have a rest, and keep playing, be a man, don’t let the team down, suck it up. We’ve all heard the phrases. Hopefully they weren’t directed at us personally.

Today we recognize the seriousness of concussion and thanks to many public health initiatives in sport we have head injury and concussion protocols to use. They are meant to allow us to do an immediate assessment of anyone we suspect to have suffered an injury to the brain and head, while playing sports and give a screening tool to direct people for further medical assessment, intervention and treatment as required. These new protocols have also allowed us to track head injury victims much better and to assess long term impacts of TBI (traumatic brain injury) and concussion in youth.

An article in the Canadian Press this last week examined the case of Julia Hamer, and young volleyball player. When she was 19 she was struck in the head twice in 6 weeks. Once during a dive for the ball, and once by a blow by a volleyball. She suffered a concussion with the first injury and had dizziness, confusion and chronic migraine. She also lost her sense of taster. She stayed out of the game for 3 weeks.

The second blow happened only three weeks after she started playing again and was much milder so she decided to only take a couple of hours away from playing despite her symptoms that included nausea and dizziness. She admits that she should have recognized the signs of the second concussion. A year and half later she had a third concussion.

The facts are very clear that after an initial concussion it takes far less of a blow to sustain a subsequent concussion and that the symptoms of subsequent concussions are more severe and last longer.

She is 4 now and she still suffers migraines and has not yet fully regained her sense of taste and smell. She is part of a long term study now examining the impacts of concussion on young athletes. The results so far are enlightening.

• There are marked differences in the brains of young athletes with/without concussion
• Concussed Athletes have 25-35% less brain flow to certain brain areas
• Concussed Athletes have smaller frontal lobes. This part of the brain is responsible for decision making and impulse control.
• Concussed Athletes have 10-20% less brain volume

Researchers at St. Michael’s Hospital in Toronto say this is the first study of its kind. They say it points to the possible long term effect to health for these young people including depression and cognitive impairment.

In America Return to Play laws have been implemented in all 50 states for youth athletics according to the CDC. In Canada we have been slower to adopt nationwide standards. Ontario recently approved Rowan's Law which does set out concussion rules for youth in sport. The federal government recognized the need for screening tools last summer and launched a mobile app for assessing concussions.

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