Study: Kids Competing Too Soon After Concussions

ENLARGE PHOTO+

Fancy / Veer / Corbis

• Share

(2 of 2)

Why is playing sports with concussion symptoms so risky? During a concussion, arteries constrict, slowing blood flow to the brain. At the same time, calcium floods the energy-producing portions of brain cells. That calcium plays a mean defense, blocking oxygen- and glucose-rich blood from replenishing neurons' energy supply. Brain cells get sluggish, and a concussed athlete who can't focus or suffers from slower reaction times is left more susceptible to a slew of other injuries, including another concussion. A second blow to the head could lead to more arterial constriction and more calcium infusions. "Concussion produces an energy crisis in the brain," says David Hovda, director of the Brain Injury Research Center at UCLA's David Geffen School of Medicine. "A second concussion will cause such an energy demand that it will overwhelm the survival capability of the brain." (See the Year in Health, from A to Z.)

That's why caution should be the name of the game. Robert Cantu, a neurosurgeon and concussion expert, insists that even after a mild first-time concussion, athletes must be free of all symptoms for at least a week, both at rest and during exertion, before returning to the field. Cantu's mantra: "When in doubt, sit them out."

But coaches, parents and medical personnel should expect resistance from athletes and remain on the lookout for those trying to downplay or hide less visible symptoms like headaches. What if a college scout was at the game you sat out because you got your bell rung? "For these kids, their goals in life sometimes revolve around athletics," says Todd Lipe, Waller's coach at J.H. Rose High School, who has promised to be more vigilant in detecting and managing concussions. (The school district did not blame any individual for Waller's death, though the first responder who examined him was relieved of his duties.)

Waller's death helped prompt an athletic-safety task force in North Carolina to recommend that all public high schools in the state be required to employ a full-time certified athletic trainer by August 2011. Meanwhile, after a high school student in New Jersey died of a brain injury suffered while playing football in October, New Jersey Representative Bill Pascrell introduced legislation in late 2008 that would set aside federal funding for computerized preseason baseline and postinjury neurocognitive testing for student athletes. This is a tough time to be asking for money, he says, but "when you compare this to the other injuries and ailments that we've responded to, it's embarrassing we haven't done more about concussions."

Given that concussions can be difficult to spot, the trickiest aspect may be getting kids to bench themselves after they're thumped. "You don't want to miss out," says Ryan Williams, a senior at Cibola High School in Albuquerque, N.M., who suffered two concussions this season and one last season. "You want to help your brothers." Of course, you can't help them, or yourself, if you don't know when to stay out of the game.

See pictures of Super Bowl entertainment through the ages.

See pictures of teens and how they would vote.