Sports Concussions: Know the Risks

An interview with Dr. Farhad Sahebkar, director of Sutter Pacific Medical Foundation Pediatric Neurology Division and the Headache Clinic at CPMC

Sports concussions have recently entered the medical spotlight, especially after last year’s tragic death of University of Pennsylvania football player Owen Thomas.

What’s a Concussion?

A concussion often follows a head injury and involves what doctors call altered mental status. “Initial confusion and amnesia are hallmarks of a concussion,” says Farhad Sahebkar, M.D. “And they can happen with or without loss of consciousness.”

Grade-one concussions are the least severe. Doctors assign a grade-two if a patient has symptoms that last longer than 15 minutes. When loss of consciousness occurs, whether it’s seconds or minutes, it usually signals a more severe, grade-three concussion.

Symptoms of concussion are generally divided into two categories. Immediate symptoms include headaches, dizziness, nausea, and vomiting. Children who suffer from concussions might stare, look vacant, slur their speech, or have delayed verbal and motor responses and difficulty following instructions. Often, they’re not sure what time or day it is. They may be disoriented and have trouble walking straight.

Other symptoms can start hours or weeks afterward. They include anxiety, irritability, low-grade headaches, sleep disturbance, dizziness, poor attention or concentration, difficulty at school, intolerance to light and noise, and low frustration. Memory problems can also occur.

“If you ask a concussion victim to memorize three objects and then repeat them in five minutes, he may not be able to do it,” Sahebkar explains. “On rare occasions the symptoms might last up to four weeks, so it’s important to observe athletes over a period of time to see how they’re doing.”

Multiple Impacts

If children sustain more than one concussion in a short period of time, serious complications can arise. Doctors believe Owen Thomas’ death was due to chronic traumatic encephalopathy (CTE), a progressive, degenerative disease in people who have suffered multiple concussions.

Although doctors don’t quite understand why it happens, they now know that multiple impacts can lead to depression, forgetfulness, personality changes, and cognitive impairment. In fact, some of the brain damage CTE causes looks similar to neurodegenerative brain disease. Symptoms are chronic, get worse with time, and appear months or even decades later.

“With another condition called second impact syndrome, patients suffer a single concussion and then go back to playing before they fully recover,” says Sahebkar. “If a second concussion occurs, it can cause devastating injury, sometimes even death.”

How do doctors determine when a child is well enough to return to the field? “It can be challenging,” muses Sahebkar. “A lot of athletes say, ‘I’m okay. I want to play.’ They may have major memory loss, but they’re so eager to return, that they’re not going to tell you about it.”

That’s why Sahebkar now uses a formalized neuropsychology evaluation called ImPACT™ testing to provide him with more objective feedback.

Get a Baseline

Even the safest sports can cause concussion, but that’s not to say that kids shouldn’t be athletic. There are measures parents can take to prevent neurological damage.

“It’s good for all parents of athletes to get their kids an ImPACT baseline test. If a head injury occurs, doctors then have an idea of how far along they are. Unless their condition goes back to baseline, we don’t recommend further sports activity,” says Sahebkar. The test takes less than 30 minutes and can be obtained at any certified center.

While your child should also wear a helmet when it’s appropriate, Sahebkar warns parents against relying on a helmet. “Wearing a helmet helps kids avoid fractures and lacerations, but it doesn’t protect against concussion. Even if you fall down, your head can still get an impact.”

If your child has suffered from a concussion, it’s important to talk to his or her doctor as soon as possible.

Immediate Concussion Symptoms

• Headache


• Dizziness


• Nausea


• Vomiting


• Staring, vacant look


• Slurred speech


• Delayed verbal and motor responses


• Difficulty following instructions