An athlete may consult a doctor about a concussion. A couple pain pills might help remedy the headaches.
Treatment, though, starts at home.
“The most important treatment is rest,” said Dr. Mohammad Sajed, Medical Director of Neurocritical Care at the Edward Neurosciences Institute. “Rest as much as possible.”
Sajed and his colleague Dr. Henry Echiverri were the featured speakers at a public seminar on concussions Wednesday evening in the Edward Hospital Auditorium in Naperville.
In the near future Edward plans to open a “concussion clinic” to help treat the thousands of young athletes afflicted by traumatic brain injury annually. According to researchers from Hasbro Children’s Hospital in Rhode Island, concussions among 14- to 19-year-olds playing organized team sports jumped 200 percent from 1997 to 2007, with more than 500,000 ER visits for concussed children from 2001-2005.
When Sajed says he recommends rest after a concussion, he doesn’t just mean from physical activity. He says a kid should get 8-10 hours of sleep after a concussion while drinking plenty of fluids. Tylenol, two tablets every 4-6 hours, is the preferred medication for headaches resulting from a concussion.
To get back up to speed, the brain needs downtime. That means no texting and other media many kids crave.
“Don’t overstimulate the brain with video games and movies,” Sajed said.
“Overstimulating the brain after a concussion is like revving an engine that needs a tuneup,” Echiverri said.
Echiverri admitted that there is not much that can be done to prevent the first phase of traumatic brain injury, other than wearing a protective helmet and avoiding getting hit. The second phase is when most injuries occur, causing a cascade of events. Confusion and amnesia are the hallmarks of concussions, either immediately or several minutes later.
There are three grades of concussions, Grade 1 being the most common yet also the most difficult to recognize. Commonly referred as being “dinged” or having one’s “bell rung”, an athlete may be confused yet suffer no loss of consciousness. In a Grade 2 concussion symptoms or mental status abnormalities last longer than 15 minutes. Grade 3 concussions are easily the most recognizable, where the athlete loses conciousness for any period of time. Should that be the case the athlete should immediately be sent to the ER.
Sideline evaluations test mental status in orientation, concentration and memory. In a concentration test, for example, an athlete may be asked to recite the months of the year in reverse order. An injured athlete should be removed from a contest, examined immediately and at five-minute intervals for developments of mental status abnormalities or post-concussive symptoms.
“If a kid passes all three tests, you can send them back in,” Echiverri said.
A second Grade 1 concussion in the same contest, though, should eliminate the player from competition that day.
Echiverri’s recommended follow-up after a concussion included going to the ER after the injury; consultation with the athletes’ primary doctor; if an athlete has not improved within seven days, they should see a specialist. If nothing is revealed in a test such as a CT scan, the athlete should be treated symptomatically.
Echiverri has a test to see if an athlete is ready to return. After one week of showing no symptoms he will have them walk on a treadmill for 30 minutes. If there are no symptoms — headaches, cloudy head — the athletes is cleared for non-contact drills. If they pass through that and show so signs in scrimmages, then the athlete can be cleared to return full contact.
“It’s very important to note that each patient is different,” Echiverri said. “You approach them patient by patient and evalulate as they go along. The best advice I give — use your head.”
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