A concussion is an injury causing abnormal function of brain cells caused by a blow to the head or body that slams the brain tissue against the inside of the skull. The potential for concussion is greatest in sports where collisions are common, but concussions can occur in any environment. Common warning signs include: appearing dazed or stunned; confusion about assignment or position, game score or opponent; forgetting sports plays, moving clumsily; answering questions slowly; losing consciousness (even briefly); showing behavior or personality changes; inability to recall events prior to or after a hit or fall; or experiencing a headache or "pressure in head;" nausea or vomiting; balance problems or dizziness; double or blurry vision; sensitivity to light or noise; feeling sluggish, hazy, or groggy; concentration or memory problems. These signs and symptoms can last several minutes to several months. Symptoms may not appear for days or months after the injury.

As a former high school football player and wrestler, I understand the temptation or pressure to tough it out after an injury and stay in the game; the glory of the moment can be very powerful. But a concussion is not just any injury, and can be far more life changing than a sprain, bruise or even a broken bone. As a doctor, I have repeatedly seen the life changing effects of multiple concussions. With the popularity of motor cycles and ATV's, these injuries are more common than ever.

This dangerous situation is worsened by the fact that 50-75% of all concussions are undiagnosed. The public wrongly assumes that concussions involve at least a temporary loss of consciousness when actually only 10% result in any lapse of consciousness. The odds of long term brain damage go up dramatically with repeated concussions. Research links repeated concussions to premature dementia, memory loss and depression.

To help recognize a concussion, parents and coaches should watch for a forceful blow to the head or body resulting in rapid movement of the head and any resulting change in behavior, thinking or physical functioning. If concussion is suspected, the athlete should be removed from play. A person suffering from this condition is more likely to receive a second concussion until total healing has taken place. Health care professionals should evaluate the condition and decide when it's safe to return to play or other activities.

Coaches and parents can help by recording the following information: cause of the injury and force of the blow, any loss of consciousness and for how long, any memory loss immediately following the injury, any seizures immediately following the injury, and number of previous concussions.

Proper protective equipment should be worn and properly fitted and maintained. Although helmets don't eliminate concussions, they do dramatically reduce the frequency and severity.

Remember, after the first concussion, reaction time may be slowed and the brain may be vulnerable to much less forceful blows. Even practicing at half speed may be an unacceptable risk. The risk of permanent brain damage goes up with each concussion, possibly causing memory loss, depression, and even reduced brain function to the point of inability to carry on with normal activities. It's one thing to have a limp or arthritic shoulder as a badge of honor to remind you of glory days. It's a whole different thing to not remember them.