Concussions require serious attention

Jenna Haviland sensed something wasn't quite right after she headed a soccer ball nearly a year ago, during a preseason tournament she played in Pennsylvania.

But the then 12-year-old tried to shake it off, wanting to continue playing with her teammates.

"Right after it happened I was in a daze and was dizzy," she said. "It was odd, but I just wanted to keep playing, because I didn't want to be out."

A couple of minutes later, Haviland was hit in the head with another shot, and she knew what she was feeling really wasn't right.

"I thought, 'I'm going to pass out. I think I have a concussion,'" said Haviland, now 13, and in eighth grade at Wall Intermediate School in Wall, Pennsylvania.

With an increased number of concussions happening in the fall because of sports seasons, experts say it's the time of year that parents, coaches and especially young athletes educate themselves about the signs, symptoms and potential long-term effects of of the traumatic brain injury.

"The takeaway is the concussion education," said Dr. Kristine Keane, a clinical neuropsychologist and clinical director of Ocean Medical Center's Concussion Program. "Be aware of the signs and symptoms and that they are properly cared for."

Each year, U.S. emergency departments will treat an estimated 173,000 youths ages 19 and younger for traumatic brain injuries, including concussions, according to data from the Centers for Disease Control.

Younger people at greater risk

Children and teens are more likely than adults to suffer concussions, and it will take this younger age group longer to recover, the data shows.

And during the past decade, emergency departments have seen a 60 percent increase in traumatic brain injuries among children and adolescents related to sports and recreational activities, according to the CDC.

The increased numbers may be happening because kids are playing more sports and are playing or training for them year round through travel leagues, Keane said.

And the concussion risk in children is believed to be greater than adults because of their size and development: They tend to have a smaller head mass, weaker neck muscles and their brains are still rapidly developing.

There's also more attention being placed on concussions, Keane said. A big part of her concussion program includes outreach to the community, offering lectures on sports concussions in schools.

New Jersey's law also requires high school athletes suspected of suffering a concussion to immediately come out of the game and not return to play until they've been seen by a doctor or medical professional.

How concussion happens

Concussion is caused by a direct blow to the head or a hit to the body that causes the brain to hit or twist within the skull.

The sudden movement of the brain can cause stretching and tearing of brain cells, starting a "neurometabolic cascade of events," Keane said.

The brain goes into a hypermetabolic state, where it's metabolic activity speeds up, then into a hypometabolic state, where it slows down.

That causes decreased cerebral blood flow and decreased glucose, which contributes to the fatigued feeling a person feels after suffering a concussion.

The most obvious symptoms of a concussion are loss of consciousness or post-traumatic amnesia, forgetting about the play that caused the concussion or where they are, Keane said.

But the symptoms can also be less apparent — feelings of dizziness, lightheadedness, double vision or nausea.

It's critical for athletes to be evaluated because studies show student athletes tend to minimize their symptoms in part because they want to continue playing, Keane said.

"When in doubt, sit them out," she said.