This past week in sports medicine we watched learning videos about concussions in sports. The videos discussed that concussions result in a functional impairment, not a structural impairment, therefore, a CT would be normal for these individuals.
Research has found that the brief excitation period following a concussive impact is followed by a widespread neuronal suppression known as “spreading depression,” leading to symptoms such as cognitive deficits, amnesia, emotional lability and fatigue. The most common concussion symptoms are headache and dizziness. As a doctor that may be working with a sports team, it is important to remember that the following are contraindications to return to play: symptoms lasting more than 15 minutes, prior concussion within the same season, loss of consciousness, amnesia, development of complications such as post-concussion syndrome and recurrence of symptoms on exertion.
The biggest concern with a concussion is a cervical injury; it has been found that contracture of the neck stabilizing muscles prior to impact does reduce the risk of a concussion. Second, impact syndrome is a complication of a concussion, and has a 50% mortality rate. Second impact syndrome happens when the brain swells rapidly after an individual suffers a second concussion before symptoms from an earlier concussion alleviate. Return to play is contraindicated in these individuals. If an athlete with a concussion presents with a severe worsening headache, seizures, two or more episodes of vomiting, an unsteady gate or slurred speech, or weakness/numbness in the extremities, referral is indicated. As a future chiropractic physician, it is important to be aware of concussions and their possible presentation, as many of us may work with a sports team in the future.
Did you know that NUHS offers preceptorship opportunities for DC students? Read more here. And, for additional information about NUHS’ commitment to sports medicine, check out this web page: Sports Medicine Excellence.