Sports Medicine: Mild Concussions Have Serious Impact

Lisa C. Routh, M.D.

Brainwaves Newsletter, 2007

Ask almost anyone to define “head injury” and they will describe someone who is “knocked out” or unconscious. People do not think a head injury is serious unless they are unconscious. These are some of the most common and frustrating misconceptions faced by doctors who work with head injured adults and children.

Minor head trauma is a very common occurrence in the United States. Concussion is an example of minor head trauma. A concussion is any transient change in cognitive (thinking) functioning. Concussions that cause only a few moments of dizziness or disorientation are significant and may lead to long term serious problems.

Children and teenagers are extremely vulnerable to minor head trauma. About 62,000 concussions and mild traumatic brain injuries occur during high school sports events every year. These mild brain injuries trigger changes in brain metabolism and disrupt the normal mechanisms through which brain cells communicate with each other. Since the brain is still developing into early adulthood, children and young adults may be much more vulnerable to injury.

The symptoms of minor head trauma or concussion usually resolve within 24 hours and cognitive functioning and thought processes return to normal within one to three weeks. However, post-concussion syndrome can also occur. Symptoms may affect any area of functioning—physical, mental and emotional—and include headache, dizziness, memory problems, difficulty paying attention, irritability or personality change.

Pre-existing conditions such as learning disabilities, moodiness or ADHD are frequently worsened by minor head trauma.

Anyone who has suffered even a very minor head injury needs time to recover from the injury. Studies have shown that children who are not fully recovered from a concussion is two to six times more likely to have a second head injury. Even though athletes and coaches have become much more aware of the seriousness of even minor concussions, there is great pressure on young athletes to return to sports prior to full recovery. The pressure may come from the team, coaches, the athlete or parents, but no matter the origin it has the same long term consequence.

Recent studies have focused on the cumulative and long term damage that occurs after multiple minor head injuries. These long term effects include behavior problems, personality changes, learning difficulties and mood disorders.

Any child or adult who has suffered even a very minor head injury should see a professional who is experienced with the diagnosis and management of concussion and the after effects of brain injury. Early treatment and adequate recovery time will maximize the chance for recovery and minimize long term damage.