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Making Sense of Head Injuries in Young Athletes

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Making Sense of Head Injuries in Young Athletes

The Consequences of Concussion


There has been a recent increase in awareness regarding the effects of chronic or repeated concussion. Significant neurological and cognitive deficits as a result of concussive injuries are the primary associated risk. It has long been known that the acute cognitive effects of concussion generally resolve. There are, however, a pattern of underlying cognitive deficits that tend to appear over long periods of engagement in sports that involve repeated head trauma, even in the absence of diagnosed concussion.

For instance, studies have found that soccer players with long histories of heading the ball, in cases without diagnosed concussion, manifest physical changes to their white matter on magnetic resonance imaging (MRI) examination. This finding is likely from the accumulation of subclinical injuries over long periods. The possibility of long-term injury as a result of repeated, often undiagnosed, trauma reinforces the need to properly diagnose concussion in young athletes.

Second impact syndrome (SIS) is potentially the most serious short-term consequence of concussive injury. The evidence for its occurrence comes from a variety of reports of acute cerebral edema that occurs when an individual sustains an injury within the first week of a primary concussive injury. Perhaps most notably, the sort of catastrophic injury seen in SIS is more common among young players because of their engagement in activities that predispose them to re-injury. While the actual prevalence of SIS remains unknown, its possibility remains a very important component of decisions regarding return to play (RTP).

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