What parents need to know about kids and concussions

Maribel Piccinini, the mother of 16-year-old Conant High School football player Troy Piccinini, knows well the risks associated with pediatric concussion. She's navigated the medical maze to evaluate and treat her son's head injuries three times in the last three years as he “got clocked time and again.”

“It's the constant headaches, dizziness and memory issues which are most troubling,” says Piccinini, who admits she also worries about long-term impact and the risk of future play. “The reality is that if he gets hit in the head again during play or simply by accident, risk for those long-term complications and serious injury increases.”

Piccinini says sports play is her son's passion and notes, “Whether he's playing defense on the football team, weightlifting or playing third base in baseball, he's competitive by nature. What teenage boy doesn't feel invincible?”

However, Piccinini says her son also has hopes of going to college and becoming a physical education teacher, trainer or even a meteorologist.

Gina Lazzerini of West Chicago can relate. Her 14-year-old freshman quarterback son landed on his head during a game last season leaving him stunned and disoriented.

“The trainers came out to immediately evaluate and he missed two games before being approved by doctors to return to play,” she recalls. “Total brain rest meant no video games, no TV and the need for us to monitor him during sleep. Ten days later he was able to pass a test in order to resume play.”

While most people know a youth who has suffered a similar head injury, pediatric experts say more attention in recent years has focused on concussion among professional athletes than kids and teens. They say youth concussions strike directly at a child's growing brain and can affect the child's ability to learn.

“We're paying more attention and are more aware of brain injury symptoms,” says Dr. Hossam AbdelSalam, pediatric neurologist and director of the Pediatric Brain Injury Clinic at Alexian Brothers Medical Center, Elk Grove Village, and St. Alexius Hospital, Hoffman Estates.

“Children and teens don't have to become unconscious to have a serious concussion,” notes Dr. AbdelSalam, who says concussion is a brain injury which can happen in just about any sport when collision happens. “It doesn't even have to be a direct blow to the head. Even a ding, getting ‘your bell rung' or what seems like a mild bump or blow to the head can be serious.”

According to the Centers for Disease Control, which recently mounted a Heads Up! campaign to increase awareness of pediatric head injury, children and teens are more likely to get a concussion and take longer to recover than adults.

Every year in the United States, emergency room doctors treat as many as 3.8 million children and teens with sports and recreation-related concussions.

“Concussion can occur in any sport, but more often in collision sports like football, rugby and ice hockey,” says Dr. AbdelSalam. “Hockey injuries top the charts for all amateur sports, while high school boys suffer the most concussions from football and high school girls from soccer.”

Brain rest, he says is imperative following injury. “A repeat concussion that occurs before the brain recovered from the first event can slow recovery or increase the risk for long-term problems and in rare cases can result in brain swelling, permanent brain damage and even death.”

Be on the lookout for concussion symptoms

“Pediatric concussions are fairly common,” admits Dr. Brian Babka, director of Sports Medicine for Cadence Physician Group at Central DuPage Hospital. “But because it's not a visual injury, children and teens can often look great but be seriously injured.”

Dr. Babka, who serves as team doctor for U.S. Soccer and several local college teams, cautions parents to look for signs including headaches, photo and noise sensitivities, nausea, dizziness, amnesia, behavioral changes, difficulties with balance and delayed word recall like forgetting a sibling or favorite pet's name.

“Today's local recreational program advisers do a great job protecting our kids, but with both organized and individual sports there is an inherent risk,” Dr. Babka states. “Individual sports like BMX bike racing, skateboarding, skiing, snowboarding, sledding, bicycling, rollerblading, jumping on a trampoline, and even a fall which results in a head verses ground or object hit, can cause a concussion.”

Since 2002, doctors no longer grade concussions with terms like mild, moderate or severe. “It's all symptomatic,” says Dr. Babka. “But the universal precaution is no same day return to play. Children must be symptom free for 24-48 hours, be evaluated by a medical professional trained in treating concussion injuries, and meet specific return to play criteria.”

New concussion legislation, passed in July 2011, now mandates specific return-to-play criteria for all grade school, middle school and high school athletes in Illinois.

A 20-minute computerized neurocognitive assessment tool such as ImPACT testing frequently is used by medical doctors, psychologists and athletic trainers to assist in determining an athlete's ability to return to play after suffering a concussion. The test can help evaluate a concussed athlete's post-injury abilities, and track recovery for safe return to play, preventing the cumulative effects of concussion.

For more information

Youth and high school sports coaches, parents, athletes and health care professionals can find free tools that provide important information on preventing, recognizing, and responding to a concussion at cdc.gov/concussion.

Concussion symptoms

Ÿ Appears dazed or stunned

Ÿ Is confused about assignment or position

Ÿ Forgets instruction

Ÿ Is unsure of game, score or opponent

Ÿ Moves clumsily

Ÿ Answers questions slowly

Ÿ Loses consciousness even briefly

Ÿ Shows mood, behavior or personality changes

Ÿ Can't recall events prior to hit or fall

Ÿ Can't recall events after hit or fall

Ÿ Headache or pressure in head

Ÿ Nausea or vomiting

Ÿ Double or blurry vision

Ÿ Sensitivity to light or noise

Ÿ Feeling sluggish, hazy, foggy or groggy

Ÿ Confusion

Ÿ Concentration or memory problems

Ÿ Just “not feeling right” or is “feeling down”

More information: <a href="http://www.cdc.gov/concussion/headsup/index.html">Centers for Disease Control “Heads Up!” campaign</a>