Kessler News


West Orange, NJ - With the fall sports season about to kick-off, millions of college, high school and elementary school students are getting ready to take to the field. Among these young athletes who play football, soccer or other contact sports, more than 3.8 million will sustain some type of brain injury this year, according to the Centers for Disease Control (CDC), with football-related injuries being the most prevalent.

"Mild traumatic brain injury (MTBI), often referred to as a concussion, is the most common sports-related head injury, but it is also one of the most difficult to diagnose," explains Neil N. Jasey, M.D., staff physiatrist at Kessler Institute for Rehabilitation. "A brain injury occurs when a blow or jolt to the head or body disrupts normal brain function, typically causing a change in mental status or consciousness. While radiographic evidence of a brain injury may not be apparent, long-lasting cognitive and behavioral effects can result. That's why it's so important for people to understand the symptoms, the actions that should be taken after a concussion and when it's advisable to return to play."

Unlike physical injuries, such as a sprain or broken bone, the signs of a brain injury may not present themselves immediately. Initial symptoms may include confusion, disorientation, headache, nausea and extreme fatigue. Over time, other symptoms, including irritability, difficulty with memory or concentration, and even depression, may appear along with impaired judgment, behavioral issues and personality changes, which may be signs of "post-concussive syndrome."

"It is imperative that coaches, trainers, family members and players be aware of the serious after-effects of a concussion," advises Dr. Jasey. "Equally important, athletes need to be honest about any problems they may be experiencing. We often see that players will disregard their symptoms, tough it out and return to play too soon in an attempt to keep their competitive edge. However, this can result in serious complications and lasting problems."

In fact, despite the serious risk, it is estimated that 99 percent of football players, ranging from high-school level to the professional ranks, return to the game even when a concussion has been diagnosed.

Kessler Institute for Rehabilitation, one of only 14 federally designated Model Systems for the treatment and research of traumatic brain injuries in the nation, offers the following guidelines on recognizing and treating a concussion:

  • A cognitive assessment should be part of a pre-season physical. This important tool, which is increasingly being used at both the professional and school-age levels, helps to establish a baseline "point of reference" that can be helpful in diagnosing the extent of any brain injury.
  • An athlete suspected of sustaining a MTBI should be removed from competition immediately and examined by a trained professional. Coaches, trainers, parents and players should be on the lookout for symptoms including dizziness, loss of balance, confusion, headache, nausea and/or vomiting.
  • Any athlete who experiences loss of consciousness, even if just for a few seconds, should immediately be taken to the emergency room for a thorough neurological evaluation.
  • While there are no clear-cut guidelines for return to play, rest is critical. It takes time for the brain to recover and the athlete should limit physical activities and continue to be observed for several days. Adequate "cognitive" rest is also important, so television, video games and certain school work should be kept to a minimum.

"Most athletes recover spontaneously and completely from a concussion," says Dr. Jasey, "However, it is most important to remember that any injury to the brain is serious and requires immediate medical attention and appropriate treatment to avoid complications and optimize the health of the athlete."


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