Q&A with Dr. Barrow: Concussion and the Student Athlete

Getting Back in the Game – but Not Too Fast

Michael W. Barrow, MD, Samaritan North Family Physicians, Inc., specializes in sports medicine and family practice. Dr. Barrow is head team physician for Northmont High School and assistant team physician for the University of Dayton. He is board-certified in both sports medicine and family practice.

What is a concussion?

A concussion is a brain trauma resulting from a direct blow to the head or from whiplash to the head or neck. Concussions usually cause a temporary alteration in mental status but not necessarily a loss of consciousness. This disturbance in brain function occurs at the cellular/chemical level and is generally not a structural problem that can be seen on an MRI or CT scan.

Why should family physicians be up to date on the latest research on concussion management?

According to the Centers for Disease Control and Prevention, for young people ages 15-24, sports are second only to motor vehicle accidents as the leading cause of brain injury. While concussion symptoms may seem minor, concussion injuries are cumulative and can result in permanent loss of brain function.

With the field of concussion diagnosis and management evolving rapidly, treatment guidelines have changed. We are now far more cautious with the developing brain and skull. A study from the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio, found that 40.5% of high school athletes with a concussion return to play prematurely, putting them at risk for conditions that will limit their academic ability in the future. Since it can be difficult to determine if a concussion has healed, it is important to work with a physician who has expertise in concussion management.

What are some of the symptoms of a concussion?

Athletes who demonstrate any of following may have a concussion:

• Headache
• Feeling “in a fog”
• Emotional ups and downs
• Amnesia
• Irritability
• Slowed reaction times
• Drowsiness

What is the best treatment for the student athlete with a concussion?

In the past, we used a variety of grading systems to determine how serious a concussion was and to develop a management plan. Recently, however, experts gathered at the third annual International Conference on Concussion in Sport recommended that all concussions be managed individually with a physician examination including consideration of a computer-based assessment (or other neuropsychologic test) that measures brain function, such as memory and reaction time.

Parents, coaches, athletic trainers, physicians – and, of course, injured athletes themselves – need to work together to ensure a concussion is recognized and treated according to the latest scientific guidelines, which include a appropriate rest for the brain and a slow return to the field of play.