Seeking Proper Treatment for Concussions Keeps Children, Athletes Healthy and Safe

By Malorie Burkett and Sathya Achia Abraham

Whether a child has suffered a concussion on the playground or on the playing field, physicians, parents, schools and legislators are working together to raise awareness about the importance of recognizing and responding to this serious injury, according to Charles Dillard, M.D., assistant professor in the Department of Physical Medicine and Rehabilitation, Children’s Hospital of Richmond.

A concussion is a traumatic brain injury (TBI) caused by any sort of shock or blow to the body or head that may result in neurologic change. It can interfere temporarily with memory, judgment, reflexes, speech, balance, attention, coordination, fine motor skills and even behavior. Traumatic brain injury is a major cause of death and disability in the United States. Dillard said that seeking proper treatment is vital to helping a child recover from the injury.

“What you’re really worried about is a kid who goes back to play too soon, who hasn’t really recovered from the first brain injury,” said Dillard, who treats patients with concussions and other TBIs. “You can get what’s called Secondary Impact Syndrome. The brain has not completely finished healing from the first injury, sustains a secondary injury and that could lead to pretty severe disability and long-term on-going symptoms.”

Dillard noted that evidence of a concussion is not often visibly apparent.

“Unfortunately it’s not like a broken-ankle where a patient is not going to be able to walk or you’re going to be in a cast,” Dillard said. “A kid who has had a brain injury is going to look like a normal kid – he may just act differently, so it’s important for the coaches and parents to be aware of the signs and symptoms of concussion and to be aware that the best thing for them is cognitive rest and time to heal. That allows those kids to heal from the first injury and possibly to avoid having the second injury, which would become even more debilitating than the first injury.”

Concussions in student-athletes are of growing concern among medical and educational professionals, as well as parents, and also a focus of new Virginia legislation to become effective this July regarding risks of re-injury and medical clearance to return to play.

“I think there’s been a significant increase in awareness in the community about brain injuries and concussions as we’re seeing players in the NFL and other sports that we watch as we were growing up, now get to be older and realize they’ve had multiple concussions or having long-term disability from those injuries,” said Dillard. "So what this legislation primarily is doing is trying to standardize throughout the state, if a child does have an injury during a sport, that they’re cleared by some medical professional before they go back onto the playing field.”

Dillard and a comprehensive team of caregivers at the CHoR TBI/Concussion Clinic made up of physical medicine and rehabilitation physicians, neuropsychologists, rehabilitation therapists, social workers and education consultants are taking a multidisciplinary approach to helping children and families manage the recovery process with their extensive history of treating TBIs.

According to the Centers for Disease Control, there are half a million emergency department visits due to TBI for kids ages 0-14 annually, and one in every 20 emergency department visits is for TBI. Twenty-five to 75 percent of kids with TBI will demonstrate some school failure or require special education services afterwards within the first five years of injury.