Originally created 10/13/03

Health officials: Sports head injuries need to be screened carefully



ATLANTA -- A Lawrenceville doctor is warning school sports coaches, trainers and parents that better on-field screening is needed for players who suffer head injuries in games or during practice.

Dr. Don Penney, a Lawrenceville-based neurosurgeon, said he is concerned because one-fifth of all pediatric head injuries come from collision-sports that include boxing, football, hockey and wrestling.

"You can suffer a concussion in any sport," said Penney, a professor of emergency medicine at the Medical College of Georgia. "This is a common problem - head injuries can be serious without a loss of consciousness."

Penney is working with other doctors to provide better education and guidelines for emergency room doctors, sports teams and parents. Penney wrote an article on the dangers of such injuries in the July issue of Pediatric Emergency Medicine Reports.

Each year, about 300,000 people suffer sports head injuries. About 19 percent of high school athletes have had at least one minor head injury and 70 percent of injured players have returned back to the same game where the injury happened. About eight football head injuries each year result in death, Penney said.

"I've seen parents bring in their sons saying, 'He was in the game Friday night and had this happen and he hasn't been right,"' Penney said. "This is someone who has had a concussion and it has not been picked up. If you let kids or adults go back into the game, their brain is vulnerable after they've had the immediate injury."

The Centers for Disease Control and Prevention warns of "second impact syndrome" - a repeat concussion not long after a first injury - that can cause rapid brain swelling, leading to coma or death.

"The popularity of contact sports in the United States exposes a large number of people to the risk of brain injury," the CDC said.

Players who have head injuries should be given a mental status exam, which includes asking them questions that challenges their memory ability - such as having them memorize three words and repeating them five minutes later or having to recite the days of the week backwards.

Those with a first-time concussion, if they do not appear to have suffered mentally, likely will recover normally, Penney said.

But second-concussion cases should wait a period of time - possibly a week - before playing, Penney said. Those who lose consciousness for longer than five minutes should be given a hospital CT scan, he said.

Head injuries are being watched more closely in professional sports.

"A lot of NFL teams do have neurosurgeons (on staff)," he said. "Now that concussions are recognized at the pro level as a serious consequence that can end your career, they are paying more and more attention to it."

On the Net:

CDC info: http://www.cdc.gov/ncipc/pub-res/tbi-toolkit/physicians/concussion-s ports.html