What are the risks of concussions recurring?

Louis Bell, MD, Chief of the Division of General Pediatrics, shares the latest in medical thinking on an important topic: concussions. Nicholas was 13 when he was checked into the boards during an ice hockey game and suffered a concussion, a form of mild traumatic brain injury caused by a blow to the head or body that results in injury to the brain.

Nicholas’ concussion was so severe, he was out of school for more than three months and didn’t return to classes full time for nearly six months. Rehabilitation exercises prescribed by his physicians at CHOP got him back to full function.

A year later, Nicholas was fooling around in the school hallway and banged his head on a locker. A return visit to CHOP revealed he had suffered another concussion. Thankfully, this one was much milder. After two weeks of cognitive rest, he was able to return to all his usual activities.

One in six children

A recent study from CHOP’s Center for Injury Research and Prevention (CIRP) and the Centers for Disease Control and Prevention found that Nicholas’ experience is not unusual. Roughly one in six children ages 5 to 15 who had a concussion experienced a repeat concussion within two years. Children with many symptoms or a long recovery were more likely to have a subsequent concussion. These injuries can have a big impact on a young person’s health and development.

“Knowing a child’s increased risk for repeat concussions can help families make informed decisions,” says study author Christina Master, MD, co-lead for CIRP’s concussion research program and a sports medicine pediatrician at CHOP.

With more children participating in year-round sports at younger ages, concussions have become a public health issue. Dr. Master is pioneering research that promises to greatly improve diagnosis and management of concussions.

I asked Dr. Master to share some tips on preventing concussions and caring for them properly if they do occur:

• Play it safe. Teach children to be “body aware” when they play sports, paying attention to where they are in relation to other players and to the ball, so they can protect themselves.
• Anywhere, any way. Sports account for 60% of concussions, but they can also happen in other ways, such as car accidents. Practice everyday safety measures like always using seat belts or age-appropriate child safety seats in a car.
• Know the symptoms. Along with headaches, symptoms include feeling foggy or slow, dizziness and visual problems.
• Rely on experts. Consider seeing someone with special expertise as soon as possible. “Proper evaluation and management by experienced professionals can aid in recovery,” says Dr. Master.
• Take rest seriously. Continuing to play in a game after sustaining a concussion will increase time out from the sport.
• Nourish the mind. It’s important to have proper nutrition (including hydration) after a concussion, as the brain requires extra energy to heal.

For more information, visit chop.edu/concussion.

A link to President and CEO Madeline Bell’s podcast featuring Dr. Master is at chop.edu/madeline.