Is It a Concussion?

A serious talk about helmet safety

That’s what trauma educator Donna Grather, R.N., engages in regularly with area school children. Her “model student,” Elizabeth, is from Macungie.

Your brain is well-protected naturally, covered in a hard skull and surrounded by fluid that acts as a shock absorber for the minor bumps and bruises of life. But when that fluid can’t handle the force of a hard blow, you lose awareness. It’s called a concussion.

“Concussions usually result in a brief loss of consciousness, and/or amnesia regarding the accident that caused the injury,” says trauma surgeon Michael Pasquale, M.D., of Lehigh Valley Hospital and Health Network. “In most cases, there are no serious effects. It takes a more traumatic head injury or repeated concussions to cause long-term damage to
the brain.”

The symptoms of a concussion may appear right after the injury or in the hours and days following, Pasquale says.

Immediate signs include headaches, ringing in the ears, drowsiness, nausea and/or vomiting, dilated pupils, slurred speech and convulsions.

Lingering symptoms include trouble with coordination, persistent headaches, irritability, depression, fatigue, sensitivity to light and sound, and trouble sleeping and concentrating.

When to call the doctor

“If an adult or child loses consciousness, vomits, acts clumsy or confused, or is irritable or inconsolable after a head injury, call the doctor or 9-1-1,” says Pasquale’s colleague, family physician Suzanne Widmer, D.O. “We may want to do a CT scan or MRI to check for damage.”

After any concussion, it’s a good idea to keep an eye on the victim overnight and call the doctor if you have any concerns, Widmer says. With more severe injuries, bleeding and swelling may continue inside the head even after initial symptoms seem to have passed. That’s why parents often are advised to wake and check their child in the middle of the night.

Older adults, especially those on blood-thinning medications, need special attention, she says. “Call the doctor right away even if the head injury seems mild. There may be slow bleeding inside the head that is not readily apparent.”

How to prevent a concussion

Motor vehicle accidents, sports injuries and falls are the most common causes of head injuries, and many of these can be prevented, says pediatric intensivist Kerrie Pinkney, M.D., of Lehigh Valley Hospital and Health Network. Here’s how:

Wear a helmet. “There is an alarming increase in serious head injuries involving people riding motorcycles and all-terrain vehicles (ATVs) without using helmets,” Pinkney says. Wear a properly fitted helmet on these vehicles and also when rollerblading, bicycling, skiing, snowboarding or doing any recreational activity where falls are possible.

Avoid multiple sports concussions. Concussions are common in contact sports, especially football and ice hockey, and more than one can put the victim at risk for long-term effects such as memory loss. If you or your child suffers more than one concussion, talk to your doctor about the advisability of dropping that sport.

Prevent falls. Many falls, especially involving young children and older adults, can be prevented. For toddlers, be careful to block off stairways, unsafe places to climb and hard edges. Elderly people should “fall-proof” their homes to remove tripping hazards such as loose rugs or dim lighting.

Buckle up. You can’t avoid all car accidents, but you can reduce your risk for serious injury by wearing your seatbelt. l

Want to Know More about preventing head injuries? For guidelines on helmet safety and preventing falls, call 610-402-CARE.

Giving the Brain Room to Heal

Traumatic brain injuries last year caused dangerous brain swelling in Kara Coder, 10, of Royersford, and Kevin Flynn, 14, of North Catasauqua. To save their lives, neurosurgeon Christopher Lycette, M.D., temporarily removed half of each child’s skull.

Both wore specially fitted helmets for several months until the swelling went down and Lycette reattached the skull segments. They’re back in school now and doing well. You can read the stories of these and other local people whose lives have been touched by Lehigh Valley Hospital in our 2005 Report to the Community.

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