Recently more than one magazine cover has pictures of athletes talking about head injury. Hot topic, but, unfortunately not new.
In the last 3 weeks (written 10/31/2010) I have seen 4 children with Grade 3 Concussions (the highest grade) - half of them with repeated prior concussion. I was the first neurologist to see each. The children with repeated concussion stated that coaches sent them back into play because either 1) it was not clear that they had a concussion or 2) the child didn't want to look weak so he/she shrugged it off 3) it was a big game/met and the child was key to the team.
No matter how key to the team a person (of any age) is, I kinda think that their ability to think will be key to them for a longer time than the met or the game .... just saying....
That being said, their are ways to tell if you are ready to be "cleared" again. Once way is with an EEG - EEGs can show slowing from a concussion even when MRIs or CTs do to show physical signs of injury. (EEG is function based, MRI is a picture of the structure.) We do EEGs and know how to interpet them in regards to head injury. The other useful means to give appropriate recommendations for return to activity is through a careful history, full physical exam, experienced neurologist (such as Dr. Stein) and use of Practice Parameters.
The American Academy of Neurology has a Practice Parameter for Neurologists regarding exactly this issue. Feel free to ask your doctor about the contents of this practice parameter.
If your team or school or group would like a presentation on head injury and concussion by Dr. Stein, please call the office at 949-743-5678.
Be Well and Safe
Diane Stein MD