Magazine article The Exceptional Parent

Education on All Aspects of a Concussion: In the End, It All Comes Back to Those That Are Concussed Understanding How Truly Important It Is to Report Symptoms Accurately and Honestly

Magazine article The Exceptional Parent

Education on All Aspects of a Concussion: In the End, It All Comes Back to Those That Are Concussed Understanding How Truly Important It Is to Report Symptoms Accurately and Honestly

Article excerpt

In November 2013, Ryan Barcelona, a 14-year-old from Berkeley Heights, New Jersey was playing a fierce soccer game for his club team when he suffered a hard body-to-body collision and was whipped around. He was taken out of the game, but since he showed no signs of headache, nausea, memory loss, fogginess or fatigue, his coaches put him back in to finish the game. That night, his parents, Christie and Kevin, saw that there was something wrong. Ryan began acting erratic and extremely overtired. His mother Christie noticed he was covering his eyes and had sensitivity to light and sounds. They brought him to the Saint Barnabas Medical Center Emergency Department and it was confirmed he had sustained a concussion.

"I wasn't able to do the things I loved ... sports, spending time with friends. Some things I could always remember I would forget so easily," stated Ryan. After months of close monitoring and management through the Matthew J. Morahan III Health Assessment Center for Athletes at Barnabas Health, Ryan's road to recovery continued to face many obstacles. He worked with therapists to gradually return to play through several stages of progressive exercise and was closely monitored by his team of physicians, therapists, family and friends. It was not until several months later that he became symptom-free and could finally set foot back out on the soccer field. He now speaks about his concussion to other children his age, in hopes of educating them on the understanding and importance of reporting signs and symptoms honestly and allowing the brain the time it needs to heal.

Over 4.5 million Americans live with traumatic brain injury (TBI) related disabilities. 500,000 TBI's occur under the age of 14. The word concussion means to shake violently. A concussion or traumatic brain injury can be caused by a blow to the head, face, jaw, neck or body. A common misconception is that a blow to the head must occur for a person to be "concussed." Like Ryan, who sustained a hard hit to the body, any hard impact which causes the brain to move in the skull can cause a concussion. The mechanisms causing a TBI do vary from the more common blows to the head (minor TBI's) to the more serious traumatic head injuries where the skull is compromised and brain tissue is structurally damaged (IED--major TBI's). In a minor TBI, there is a chemical reaction in the brain that can impact the way it normally functions. There is a specialized protein in the brain called the "Tau protein," which is responsible for holding the nerve cells in the brain together and helping them communicate with each other. When a concussion occurs, the Tau proteins undergo a chemical change. They become "tangled" and can no longer hold the nerve cells together, causing a miscommunication to occur in the brain. This overall reaction can cause symptoms such as headache, nausea, vomiting, sensitivity to light and noise, fatigue, exhaustion, sleep changes, behavioral changes, blurred vision, concentration or memory problems, fogginess and slowed reaction time.

A safe and conservative approach to allowing brain rest and healing is crucial towards preventing a second impact. The days of "getting your bell rung" and counting fingers to see if someone is ready to go back in the game are a thing of the past. Today, seven to 10 days of being symptom-free is the minimum timeline many physicians use before considering clearance for a gradual return to activity. Unfortunately, there is no specific imaging test available that will show a "concussion" because the changes occurring in the brain during a concussion are not structurally seen. The changes are chemical and will not appear on any present day imaging studies.

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In the last five years, the way in which we manage concussion has evolved more than in the last 20 years combined. State legislature has had a large hand in creating a proactive approach to awareness. …

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