Posted on 01/13/2021

Sue Tymkew, MS, LAT, ATC
Head Athletic Trainer, Chaparral High School

Concussion. Head injury. Traumatic brain injury. Whether it be through organized sport, recreational activity, military, or even every day activity, we all probably know someone who has sustained one of the above categorized injuries, from mild to catastrophic.

Research continues to evolve in all aspects of this unfortunate injury. As the seriousness of trauma to the brain is realized there is a frenzy of research dedicated to prevention and diagnosis.

On the prevention front: education and early recognition, best practice coaching/technique strategies, rules/policy changes, and equipment/helmet improvement/redesign are just a few solutions.

In recent years the Centers for Disease Control and Prevention (CDC) has committed to funding 3.3 million dollars to study ways to prevent brain injuries. The research focuses on effecting behavioral and social change in youth sports as well as encouraging more young athletes, parents, coaches, and others to take head trauma more seriously.

The studies show that there are certainly some best practice methods for the prevention of head injury. The literature continues to emphasize the utmost importance of recognizing when there is a potential head injury, removing the individual from play and following up with an evaluation by a healthcare professional. “When in doubt sit them out” is a good rule of thumb for a head injury or any type of injury for that matter. For some, this often is ignored. The immediate moment and insistence to continue the activity, at times, is deemed more important to the individual than long term brain health.

Although any blow to the head warrants careful consideration, there are a variety of encouraging diagnostic methods on the horizon which may assist quickly in “making the call” to return to activity or sit it out. Currently many baseline and sideline tests are utilized in determining the next steps. They all have merit yet there is no single test that has been deemed the “standard” for diagnosis. Sport Concussion Assessment Tool (SCAT) and Standardized Assessment of Concussion (SAC), King-Devick (K - D) Test and ImPACT Test for Concussion Assessment are the most common practices. They are not perfect yet are excellent resources for the evaluator in the direction/determination of a potential concussion/head injury. There are Concussion Quick Check apps available via Google Play and iTunes as examples. They are advertised to “help evaluate if someone may have a concussion and needs to see a neurologist”. Ideally, a multi-faceted approach is best and more accurate in the determination. Symptoms, memory, reaction time, balance and coordination along with pupillary response and tracking are all considered important factors.

As technology develops, studies are now underway using smartphone apps to detect pupil response and potential diagnosis of concussion. The PupilScreen app and an app by Brightlamp are two such examples of concussion detecting software. They are being touted for quick determination by any layperson. Clearly it is encouraging, exciting, and cutting edge. It is natural to assume that in the very near future this may be a useful tool for the masses. More research is needed before this is the “tool” of choice and/or used for the sole determination of concussion. Caution is urged in sole reliance on any single test in diagnosis and management of any head injury.

In the meantime, keep a watchful eye for potential blows to the head. Look out for that individual by removing them from activity and see that they get the proper care until fully healed.

  1. https://www.cdc.gov/headsup/youthsports/index.html

  2. https://www.aan.com/tools-and-resources/practicing-neurologists-administrators/patient-resources/sports-concussion-resources/

  3. https://www.newsweek.com/new-app-detects-concussions-just-looking-your-eyes-663218

  4. https://www.ncbi.nlm.nih.gov/books/NBK185341/
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