Head Injuries

• Confusion
• Vacant stare
• Delayed verbal and motor responses
• Inability to focus attention
• Disorientation
• Slurred or incoherent speech
• Incoordination (balance problems)
• Heightened emotions (Irritability)
• Memory deficits
• Nausea
• Visual changes (blurred vision)

Treatment of concussions is very serious. The brain must have time to recover from the traumatic impact. The athlete must be 1 week symptom free before being tested for returning to play. This criteria includes IMPACT testing (http://www.impacttest.com/index.php), cardiovascular testing, and sport-specific drills before full return to play status can be determined.  

Second Impact Syndrome:
If an athlete is returned to athletics before the concussion has completely resolved, there is an increased chance of sustaining a second blow to the head, leading to second impact syndrome. If this occurs, the athlete displays symptoms of a mild concussion, but quickly collapses into a semicomatose state. Even in the best-case scenario where the athlete is immediately treated, there is a 50 percent mortality rate. This is why the athlete must be 1 week symptom free before consideration of pre-participation testing even occurs. It is important to have the cooperation of the athlete and the athlete's parents as well as the athletic training staff and coaches to monitor the athlete's symptoms.  

Homecare Instructions:
It is very important to monitor your symptoms following a concussion.  If your symptoms begin to worsen or do not decrease, inform your physician or athletic trainer.  Aside from the common symptoms listed above, some red flags include clear fluid or blood from the nose or ears, decreasing levels of consciousness, uncontrollable eye movements, vomitting, difficulty breathing, tremors, and unequal pupil size.  Be sure to follow instructions given by your physician and athletic trainer.  Drink plenty of fluids and get plenty of rest, keep the computer, television, video games, and cell phone use to a minimum, and eat a well balanced diet.  

Academic Modifications:
Following a concussion, the brain needs rest, just like an ankle needs rest after a sprain.  Working the brain too hard following a concussion can worsen symptoms and delay the healing process.  Academic work demands focus, memory, and concentration and the brain must be properly healed before it can return to normal.  Some modifications to consider include avoiding computer use, extended time on assignments, elimination of certain assignments, excessive reading, longer time to take tests and quizzes, longer time to complete assignments and projects, and a quiet area for test taking when necessary.  This can gradually decrease as symptoms decrease and protocol depends on the athlete's progress.  

Concussion Paperwork:

Concussion Injury Information
Classroom Accommodations  
Physician Concussion Evaluation Form  

Links to useful information:

-Center for Disease Control and Prevention: http://www.cdc.gov/ (Click on T and find link for traumatic brain injury)  
-Athletic Trainer's Society of New Jersey: http://www.atsnj.org/ (Click on the link for information for athletes, parents, or coaches and there will be a link for concussions)
-National Athletic Trainer's Association: http://www.atsnj.org/documents/pdf/NATA_Concussions_Position_Statement.pdf  
-Warren Hospital Concussion Center: http://www.warrenhospital.org/concussioncenter
 -Somerset Hospital Concussion Center: http://www.somersetmedicalcenter.com/body.cfmid=799&action=detail&ref=617