After spending 12 years as the Director of the Division of Sports Medicine in the Department of Emergency Medicine at the Warren Alpert Medical School at Brown University, Dr. Raukar joined the Department of Emergency Medicine at the Mayo Clinic in 2018 as full-time faculty.
In this fascinating talk, she explores what happens to those children we see every weekend in the emergency department. Whether it is a clash of elbow versus head on the footy oval, or a punch to the face at karate practice or something as innocuous as a simple fall from the monkey bars, we don’t give these head injuries the attention they deserve.
The Prevalence of Concussion
Concussion is not an isolated issue; it is a pervasive concern in the medical and sports worlds, with an estimated 20% of youth athletes experiencing this injury annually. However, this figure likely underrepresents the true incidence, as many athletes choose not to report their symptoms, often driven by the desire to continue competing.
Boys vs. Girls
Dr Raukar’s research reveals a noteworthy gender difference. While both boys and girls suffer concussions, a surprising 70% of girls and nearly 80% of boys who know they have a concussion continue to play. This reluctance to report symptoms is rooted in various factors, including a fear of appearing weak, parental pressure, or a lack of understanding about concussions.
Diagnosing concussion is a unique challenge. Unlike many other medical conditions, there is no biomarker, blood test, or imaging study that definitively confirms a concussion. Instead, we must rely on self-reporting by athletes, who may not always be forthcoming about their symptoms.
The definition of concussion is complex, but in essence, it involves a direct blow to the head or body, resulting in rapid, short-lived neurological impairment. This impairment manifests in four categories of symptoms: emotional, somatic, cognitive, and sleep-related. However, each individual may experience these symptoms differently, making diagnosis a detective-like process.
Concussion as a Process
Concussion is not an isolated event but rather a process that unfolds over time. Unlike a broken bone, where the injury is immediately visible, concussion symptoms may not appear immediately. This distinction underscores the need for careful observation and monitoring.
Treatment and Recovery
Goals of Treatment
The primary goal of treating concussions is to protect the vulnerable brain. Rest is a crucial aspect of this treatment plan, as it allows the brain to recover by accumulating symptom-free periods, akin to “tokens in the bank.” While complete isolation or “cocoon therapy” was once advocated, Dr. Raukar emphasizes the importance of striking a balance between rest and gradual reintegration into daily life, especially school activities.
Factors Affecting Recovery
Several factors can influence the duration of concussion recovery:
- Age: Younger athletes may take longer to heal.
- Concussion History: Those with a history of three or more concussions often experience more severe symptoms.
- Sex: Female athletes have a lower threshold for concussion and may require more extended recovery periods.
- Comorbid Conditions: Mental illness or migraine history can prolong recovery due to decreased “tokens” in the recovery “bank.”
Concussion is a critical issue, and its effects extend beyond the playing field. Dr. Neha Raukar’s talk underscores the need for medical professionals to be well-versed in the diagnosis, treatment, and recovery processes associated with concussions. By understanding the complex nature of this condition, we can better support young athletes and ensure they have the opportunity to recover fully and participate safely in sports and academics.
As we continue to delve into the intricacies of concussion, we aim to strike a balance that prioritizes the well-being of our youth athletes, both in their academic and athletic pursuits. The journey towards comprehensive concussion care is ongoing and requires a collaborative effort from medical professionals, educators, and sports authorities alike.