- Vacant stare (befuddled facial expression)
- Delayed verbal expression (slower to answer questions or follow instructions)
- Inability to focus attention (easily distracted and unable to follow through with normal activities)
- Disorientation (walking in the wrong direction, unaware of time, date, place)
- Slurred or incoherent speech (making disjointed or incomprehensible statements)
- Gross observable incoordination (stumbling, inability to walk tandem/straight line)
- Emotionality out of proportion to circumstances (appearing distraught, crying for no apparent reason)
- Memory deficits (exhibited by patient repeatedly asking the same question that has already been answered or inability to memorize and return three of three words and three of three objects for five minutes)
- Any period of loss of consciousness (coma, unresponsiveness to stimuli)
How many concussions are safe? The short answer is the fewer the better with none being optimal The importance of the brain cannot be overstated and should be protected from injury. The long answer is well... long. The lack of data and research makes clinicians hesitant to state a number. Some sport teams have set limits but mostly out of fear of a lawsuit than from research. It is difficult to compare concussions because no two are alike. Complete recovery from a concussion is important to avoid cumulative injury from repeated concussions. Current guidelines focus of symptom resolution before allowing athletes to return to play
It's interesting that sports teams have set limits on concussions mostly out of fear of being sued than the actual safety of their athletes. As I do agree that the fewer number of concussions are better, there should not be a definite limit to the number of concussions an athlete can endure simply because no two concussions are alike. Athletes need to be evaluated individually before they are cleared to play. By setting a limit, you are encouraging athletes to lie about their symptoms to avoid being benched (something that I could see myself doing in such a situation).
ReplyDeleteWhile randomized trials give the most reliable data, for things like concussions they are not really possible. So perhaps some light could be shed upon this topic by doing some retrospective studies looking at some non-optimal end points (even looking way down the line in degenerative brain diseases in old age) and seeing if there is any trend to how many head injuries (and the degree of injury) these same patients had throughout their lives. While correlation doesn't prove causation, maybe they would provide some fresh insight into this debate.
ReplyDelete