The Cumulative Effects of Concussions

A concussion can happen during falls, contact sports, car accidents, and fighting. Really any event that results in a blow to the head. Symptoms may appear immediately or even days after the injury. There may be physical symptoms like pain or others like coordination problems, and mental and emotional symptoms, such as memory loss, confusion, and difficulty concentrating. In most cases, a concussion can be treated with rest. A doctor will give the okay to return to normal activities once symptoms have passed. It is important to allow enough time to heal. It is equally important to avoid another blow to the head. Multiple concussions increase the risk of long term damage.

Athletes who participate in contact sports are at higher risk for repeat concussions. A repeat concussion has a higher risk of complications like edema, permanent brain damage, and death. It can also result in dementia-like symptoms that can occur many years after the injuries.

Repeated concussions are linked to a degenerative disease of the brain known as chronic traumatic encephalopathy (CTE). CTE causes changes in the brain that lead to memory loss, impaired judgement, depression, aggression, and dementia. If you are a fan of American football, you’ve likely heard about professional players who have suffered from repeat concussions. For example, linebacker Junior Seau suffered from years of depression and severe sleep disorder. He committed suicide at the young age of 43. An autopsy determined he had CTE. It can only be diagnosed after death.

In addition to football, professional fighters also suffer from similar symptoms due to the repeat blows they sustain in the ring. Sugar Ray Robinson, for example, developed dementia after fighting 198 professional bouts between 1940 and 1965.

Many sporting organizations now recognize the dangers of concussions and repeat concussions. Most are taking steps to prevent them. For example, major pro sports leagues and NASCAR have developed concussion policies detailing what should be done after an injury and who decides when the player can return to play. In most cases, the organizations now leave the decision up to the team medical staff rather than up to the coaches who do not have the medical training to make such decisions.

The pros are not the only players who need to take care when it comes to concussions. Concussion action plans can also be found at the local and state level, in schools and sport organizations. Most of these laws state that an athlete who is believed to have a concussion should be removed from play right away. They will need permission of their doctor before they return to play. There is also a 24 hour minimum waiting period before they return to sport. Many contact sports also engage in safety training and planning. This includes making sure the right equipment is available and avoiding actions that have a high risk of concussion.

A concussion is often the result of an accident, which can be difficult to prevent. To decrease the chance of severe injuries during an accident:

• Always use seatbelts, shoulder harnesses, and child safety seats when traveling in vehicles.
• Learn about the air bags in your car. Young children should not be placed in front of air bags.
• Wear a helmet when participating in high risk activities, such as:
  • Riding a bike or motorcycle
  • Playing a contact sport, such as football, soccer, or hockey
  • Using skates, scooters, and skateboards
  • Catching, batting, or running bases in baseball or softball
  • Skiing or snowboarding

If you or a loved one has a concussion, follow your doctor’s instructions on when you can return to normal activities, including sports. A repeat concussion may take longer to heal and result in greater long-term effects.

Revision Information

• Reviewer: Michael Woods, MD, FAAP
• Review Date: 11/2018
• Update Date: 03/11/2019