Concussion in Sports
Brain Injury Lawyers

Concussion is defined as a traumatically induced alteration in mental status, not necessarily with loss of consciousness, and is a common form of sports-related injury.

Traumatic brain injury is common in contact sports, with an estimated 250,000 concussions and an average of eight deaths due to head injuries occurring every year in football alone. Twenty percent of football players suffer concussion during a single football season, and some more than once. Repeated concussions can lead to brain atrophy and cumulative neuropsychological deficits. Repeated concussions occurring within a short period can be fatal.

Unfortunately, many physicians, coaches, athletes, and athletic trainers trivialize and dismiss the dangerous possibility of a traumatic brain injury and allow a hurt young person to continue to play.

Repeated concussions can pre-dispose the brain to vascular congestion from autoregulatory dysfunction. The congestion leads to elevation of pressure and brain swelling.

Amnesia and confusion following an impact to the head are the hallmarks of concussion. Amnesia associated with concussion can be instantaneous, or delayed by several minutes. The delayed onset of amnesia or post-concussion symptoms demonstrates a pathological process occurring gradually. This entire process is missed entirely if the athlete is returned to the event too early.

The Colorado Medical Society has set forth guidelines for the management of concussions in sports. Categorizing severity of concussion into three grades, recommendations regarding treatment and continuing participation attach to each grade. These guidelines are set forth below:

"Grade No. 1: Confusion Without Amnesia, No Loss of Consciousness. Remove from contest. Examine immediately and every five minutes for the development of amnesia or post-concussive symptoms at rest and with exertion. Permit to return to contest if amnesia does not appear and no symptoms appear for at least twenty minutes.

Grade No. 2: Confusion With Amnesia, No Loss of Consciousness. Remove from contest and disallow return. Examine frequently for signs of evolving intercranial pathology. Re-examine the next day. Permit return to practice after one full week without symptoms.

Grade No. 3: Loss of Consciousness. Transport from field to nearest hospital by ambulance (with cervical spine immobilization if indicated). Perform thoroughneurologic evaluation emergently. Admit to hospital if signs of pathology are detected. If findings are normal, instruct family for overnight observation. Permit return to practice only after two full weeks without symptoms.

Prolonged unconsciousness, persistent mental status alterations, worsening post-concussion symptoms, or abnormalities on neurologic examination require urgent neurosurgical consultation or transfer to a trauma center."

The overwhelming concern is that those sustaining concussion during sports activity are immediately and promptly treated. The risk of second impact syndrome is significant and its consequences severe. In "second impact syndrome" the victim is thought to have sustained a second concussion while still symptomatic from an earlier concussion. The victim often suffers cerebral vascular congestion leading to malignant brain swelling and marked increase in intercranial pressure. Brain swelling is many times difficult, if not impossible, to control.