Protect That Brain. You Only Get One!
Edwin Shepherd III, D.C.
Concussion, which now is termed mild Traumatic Brain Injury (mTBI), has been a hot topic in the past two years. The exposure to this topic has been primarily in the area of professional sports. But there is evidence that the problem extends well beyond professional sports. According to the Centers for Disease Control the age groups at highest risk for mTBI are: Infants and children (ages 0 to 4), Children and young adults (ages 5 to 24) and Older adults (ages 75 or older). The American Academy of Neurology (AAN) deﬁnes mTBI as a biomechanically induced brain injury resulting in neurologic dysfunction. The activities most commonly associated with mTBI include bicycling and football; followed by playground activities, basketball, and soccer. In addition, traumatic events such as exposure to blasts (this includes military personnel returning from war zones) can cause mTBI.
In the area of youth and adolescent sport injuries the chances of an mTBI going unreported can be high. Youths and adolescents may not understand the seriousness of even seemingly minor head injuries that may occur in a practice session and go unnoticed by coaches. The tendency is to minimize these injuries, not reporting them to coaches or parents. Yet these minor head injuries can have far reaching effects. And even worse is the repeat occurrence of an even seemingly minor injury.
A good line of communication with young athletes is key. And knowing what to look for as signs and symptoms of mTBI is equally as important. Observable signs of mTBI may include one or more of the following: personality or behavioral changes, increased irritability, answering questions slowly, clumsy movements. Signs that a young athlete might report are: headaches, concentration difficulty, memory lapses, nausea, double vision or changes in sleep patterns.
Cervical spine injury should also be considered due to a similar mechanism of injury. The biomechanical injury to the neck may become a causative factor in headaches and neck pain following mTBI. Chiropractic care as part of the plan of care for an injured athlete is an important consideration.
The CDC website, www.cdc.gov/traumaticbraininjury/ is an excellent resource for families, parents and coaches. U
 J. Gilchrist, K. E. Thomas, L. Xu, L. C. McGuire, and V. G. Coronado, “Nonfatal sports and recreation related traumatic brain injuries among children and adolescents treated in emergency departments in the United States, 2001–2009,” Morbidity and Mortality Weekly Report, vol. 60, no. 39, pp. 1337–1342, 2011.
 Concussion Management, Heads Up, Centers for Disease Control
Consensus guidelines, Zurich, The 3rd International Conference on Concussion in Sport. 2008