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How dangerous are sports-related concussions?

Will Smith at the premiere of “Concussion,” which highlights the work of Bennet Omalu on concussions in the NFL. (PopularImages)

Ninety-five percent of people who suffer an uncomplicated concussion recover in three months

With “Concussion,” the Will Smith-led movie showcasing the work of Bennet Omalu, M.D., opening this week, sports-related brain injuries are top of mind. And, obvious pun notwithstanding, with good reason. According to the Centers for Disease Control and Prevention, there are between 1.6 to 3.8 million sports- and recreation-related cases of concussions in the United States every year. Dr. Omalu even penned an op-ed for the New York Times earlier this month arguing that children shouldn’t play football because of the concussion issue.

A concussion, defined as a mild traumatic brain injury as a result of a blow to the head or body which causes the brain to move rapidly within the skull, causes alterations in brain function due to physiologic and chemical changes in the brain. This can result in a variety of symptoms, including brief loss of consciousness, nausea, vomiting, dizziness, vision changes, headaches, light or sound sensitivity, loss of balance, mood and personality changes, poor concentration, lethargy and changes in sleep patterns.

New attention regarding the evaluation, management and prevention of these injuries has increased awareness of the problems associated with concussions. Media reports tend to highlight the worst-case scenarios (think former NFL players Andre Waters, Junior Seau and Dave Duerson, all of whom committed suicide and were discovered to suffer from CTE, caused by repetitive brain injury). And the reports are scary. A recent report from the Department of Veterans Affairs and Boston University revealed that 87 of 91 (a whopping 96 percent) deceased NFL players tested positive from brain disease caused by concussions.

But experts say the sometimes overly dramatic examples draw attention away from the positive recovery trajectories that typically occur after these injuries. Guidelines for how to handle concussions have become much more conservative in recent years. And while repeated concussions from longtime play can add up to traumatic brain injury, a single concussion is not thought to have long-term neurological consequences. Not everyone will experience every symptom after a concussion, and it is important to note that only 10 percent of people with a concussion experience a loss of consciousness.

The signs and symptoms can vary in severity and duration, but for most people, a gradual pattern of recovery happens over a period of several weeks to two to three months. Research shows 95 percent of people who suffer an uncomplicated concussion fully recover in three months or less.

Key to a successful recovery, however, is proper management, including a brief period of rest followed by a gradual return to activities as symptoms improve.

Physicians trained in the evaluation and management of concussion are critical to determining the best recovery process for people who sustain a concussion. Early intervention is important so appropriate education, support and medical interventions can be provided. No athlete should return to athletic activities until he or she has fully recovered from a concussion. Returning to play prior to complete recovery increases the chances for prolonged post-concussive symptoms and additional, possibly catastrophic, injury.

Of course, prevention is the most important step in reducing the frequency and severity of injuries. So far there’s no product that eliminates the risk of concussion in sports, but the use of certified helmets in football, lacrosse, hockey and other sports is vital. In addition, teaching and coaching proper tackling, checking, heading and other contact activities is imperative, along with general fitness training. Education and training for coaches, athletic trainers, athletes and parents for all age levels helps in the early identification of potential risk factors and injuries on the field.

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