Definition of a Concussion
“Concussion is a brain injury and is defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces. Several common features that incorporate clinical, pathologic and biomechanical injury constructs that may be utilized in defining the nature of a concussive head injury include: (2013 – 4th International Concussion in Sport Conference)
1. Concussion may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an ‘‘impulsive’ force transmitted to the head.
2. Concussion typically results in the rapid onset of short-lived impairment of neurological function that resolves spontaneously. However, in some cases, symptoms and signs may evolve over a number of minutes to hours.
3. Concussions may result in neuropathological changes, but the acute clinical symptoms largely reflect a functional disturbance rather than a structural injury and, as such, no abnormality is seen on standard structural neuroimaging studies.
4. Concussions result in a graded set of clinical symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive symptoms typically follows a sequential course. However, it is important to note that in some cases symptoms may be prolonged."
Recognition of Signs and Symptoms
The presentation and discussion of signs or symptoms can be brought up by anyone who observes the player – meaning - parent, guardian, teammate and/ or coach.
Signs Observed by Others:
• Appears dazed or stunned
• Is confused about assignment or position
• Forgets an instructions
• Is unsure of game, score or opponent
• Moves clumsily
Symptoms Reported by Athlete:
• Headache or “pressure” in head
• Nausea or vomiting
• Balance problems or dizziness
• Double or blurry vision
• Sensitivity to light or noise
• Answers questions slowly
• Loses consciousness (even briefly)
• Shows mood, behavior or personality changes
• Can’t recall events prior to hit or fall
• Can’t recall events after hit or fall
• Feeling sluggish, hazy, foggy, or groggy
• Concentration or memory problems
• Does not “feel right” or is “feeling down”
Any athlete exhibiting signs and symptoms of a concussion will be removed from play immediately and require an evaluation by a healthcare provider. Any athlete who is suspected to have evidence/signs or symptoms of a concussion shall not return for the remainder of that day and be referred to their parent/guardian and physician. A brief screening tool assessing symptoms, cognitive function and balance (e.g. SCAT3) may be used by the healthcare provider. The type of evaluation is decided upon by the individual physician. Assessment of the athlete will be conducted at appropriate time intervals as determined by his or her physician or appropriate healthcare provider. The athlete will not be permitted to return to activity until cleared by an appropriate healthcare provider as defined by individual state legislation.