Love of the Brain

Published 10:53pm Monday, November 8, 2010

Athletes of all ages who are suspected of suffering a concussion should be evaluated by a specialist before they return to sports, a major doctors group said Monday in the latest sign of concern over potential lasting damage from head injuries.

The statement by the American Academy of Neurology follows rules already adopted in college sports and pro football aimed at preventing and better treating blows to the head in competition. Research involving NFL players has suggested repeated concussions may have long-term consequences, such as dementia and Alzheimer’s disease.

Doctors want to get the message “to the athletes, their parents and their coaches that a concussion is not just a ding, or getting your bell wrung, but it is an injury to the brain,” said Dr. Mark Halstead of Washington University.

Concussions “need to be treated as if they are a big deal. The brain is pretty important.”

The neurology academy is the most authoritative medical group when it comes to concussions. And its new advice sweeps across all ages and types of athletes. The academy also calls for a certified athletic trainer at every sports event and even practices where there is risk of concussion, something that would be a dramatic change in youth sports.

Major U.S. sports leagues, meanwhile, have gained attention for their recent efforts to cut down on head injuries and improve treatment for concussions.

Dr. Jeff Kutscher, chair of the academy’s sports neurology section, said the academy’s current guidelines on managing concussions and when to return to play were written in 1997, and experience since then has shown they are inadequate. Experts hope to publish new guidelines by 2012, following a careful review of published studies, he said.

The group’s new statement released Monday is meant to offer guidance in the meantime for child and adult athletes, he said. Key points include:

4An athlete suspected of suffering a concussion should be removed from competition until evaluated by a doctor trained in assessing and treating sports concussions. Symptoms like unconsciousness, unsteadiness, problems with memory or concentration, dizziness or headache are warning signs, Kutscher said.

4 No athlete with symptoms should be allowed to take part in sports.

4After a concussion, a neurologist or another physician with proper training should be consulted before the athlete is allowed to return to sports.

4A certified athletic trainer should be present at all sports events, including practices, where athletes are at risk for concussion. This recommendation is especially crucial for middle school and younger children, for whom such trainers are rarely used, Kutscher said.

Certified athletic trainers now work at about 40 percent of the nation’s high schools and are rarely provided for athletes in younger grades, said Kevin Guskiewicz of the University of North Carolina, Chapel Hill.

It would be a struggle to find enough of them to cover high schools and also programs for younger athletes, he said.

For Selma High School head football coach Leroy Miles, the first sign of a player having a concussion is grounds enough to remove him from a game, and seek immediate medical attention.

“It’s serious business,” Miles said. “If we see a player a little dizzy or that player complains just a litte — he’s done. And he cannot come back until he is cleared by a physician.”

Miles said coaches in Alabama were required to complete a concussion course over the summer and had to pass that course before even coaching this season.

“We are taking it very seriously,” Miles said. “That young man cannot come back until he is cleared. I can’t clear him, his parent’s can’t clear him. A doctor must clear him.”

- Times-Journal editor Tim Reeves contributed to this report.

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