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Repeat Concussions Repeat Concussions

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So how are we doing with regards to sports concussions nationally? And the answer is horrible. And the reason for that is multifactorial, and one of it is--we don't have the resources to provide the types of guidance for coaches or trainers or even parents about what a concussion is. And we are only now beginning to get to the outreach where we can actually train high school coaches or trainers or parents about--This is what a concussion is, and this is how you recognize it. And there's this underlying problem, which is a wonderful problem to have in young people, but it's--you know-- athletes and young soldiers, they all lie. So I'm fine, I want to go back in. So they will do every trick in the book in order to manipulate the situation. And I'm not saying that in a bad way, I'm just saying it in a way that they don't want to leave their buddies in a lurch. And generally speaking, the concept of a second impact syndrome, which was described years ago-- I think by Cantu and others-- where you have a second head injury or a second concussion and that results in a devastating head injury. Those are rare, they do happen, but they're much rarer than what we thought. What I have been more concerned about is the repeat concussions that can add to somebody's cost at the end of life or their ability to excel in school or the--or--depriving them of what their capacity is for plasticity for learning and memory. Those things, I think we need--we need to be more attentive to. That doesn't mean that we should stop young people from playing sports. I mean there are wonderful things that young people learn about themselves and about working with others in playing sports. I for one played football, and I'm sure got my bell rung many times. And--But it taught me a lot about who I was and how I could work with other people and the--those benefits far outweigh those risks. But you know when you--when you sprain a knee or you sprain an ankle or you put somebody on crutches, you have a visible injury that the coach can see and that the parents can see and everybody can see, and there's no pressure on the kid. When you have an invisible injury with a concussion, all you see is an individual that looks normal and kind of walks and talks normal and wants to get back in. That's--That's the danger sign, because they're more susceptible to being-- being exposed again for a second injury. We now have, I think, 15 states in the United States that actually have a law on the books that follows the Washington-- The State of Washington law, the Lystedt law. And I was part of that testimony to get that law passed in Washington. And we don't know how much we are sacrificing young people in terms of their future. Now it may be that it's only a small percentage of the people that are participating in sports. And I would probably--I would guess that without any good epidemiological data to date that it probably is a small percentage. But you know one young person that we are going to deprive of a quality of life, or we're going to condemn to early dementia, or to traumatic cerebral encephalopathy, that's 1 too many.

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Playing sports has many benefits for kids, but there needs to be more awareness of the potentially life-changing effects of repeat concussion.

Produced by Noel Gunther, Ashley Gilleland, and Brain King, BrainLine.

David A. Hovda, PhDDavid A. Hovda, PhD, David Hovda, PhD is the director of the UCLA Brain Injury Research Center. He is past president of the National Neurotrauma Society and past president of the International Neurotrauma Society.  He has served as chair of study sections for the National Institute for Neurological Disease and Stroke.

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