Health

The basic foundation in the treatment of a concussion is to rest the athlete. Limiting physical exertion while the athlete is symptomatic is very important. Since it is the brain that is injured in a concussion, it is equally important to limit cognitive exertion by allowing modifications in school for tests and homework assignments as well as restricting other popular activities such as playing video games. Once the athlete is asymptomatic, a graduated increase in exertion is recommended. There are recommended protocols for this gradual increase in activity. The athlete should progress through lighter aerobic levels of activity and gradually increase to more sport-specific exercise on a day-to-day basis as long as there is no recurrence of symptoms. Reassessment with the computerized cognitive test should be performed during this phase to verify there has been no setback in brain function. If there is no setback in terms of symptoms or performance on the computerized test, the athlete may then return to play in the designated sport. If an athlete remains symptomatic, he or she should not be allowed to return to the sport under any circumstance. Treatment with specific medications may be used to help alleviate some of the symptoms, but the symptoms must remain absent when the athlete is taken off of the medication before clearance to resume participation in sports is given.

An athlete who ignores the signs or symptoms of a concussion is at much greater risk for a repeat concussion injury. In fact, the athlete is 4 to 6 times more likely to suffer another concussion while playing with symptoms from a previous injury. The phase where symptoms are still evident is recognized as the "period of vulnerability." If a second concussion occurs within a short time frame, the athlete is likely to have a much longer recovery, be prone to persistent or permanent symptoms, or even develop a severe catastrophic event known as "second impact syndrome." In this case, the brain's ability to appropriately control blood flow and swelling is lost, and severe elevation in brain pressure can occur. Although uncommon, second impact syndrome has a high mortality rate and even in best cases causes severe disability.