Helpline could be lifeline for holiday rough and tumble
As children gear up for holiday fun — from cycling, soccer and dancing to horse-riding and water sports — parents should watch out for concussion after blows to the head, specialists advise.
— By: Claire Keeton —
Dr Jon Patricios, a sports physician who runs the Johannesburg Concussion Clinic, says symptoms are not always physical and may show up as emotional, cognitive or sleep disturbances.
He said: “All of these rely very much on a child to tell you what is happening. If in any doubt, parents should take their children to a doctor, ideally a sports physician or neurologist.”
Patricios is a co-founder , with Dr Ryan Kohler, of Sports Concussion South Africa, a programme set up to manage children and amateur athletes with concussion.
Kohler, a sports physician and Stormers team doctor, said signs of concussion are often missed. “Scientific evidence shows it is definitely under-reported. The key is to recognise it and tap into the resources for managing it — to know where to go.”
Sports Concussion South Africa has a network of doctors in eight towns, and a 24-hour emergency number.
Concussion does not strike only school rugby players, although they make up most of the patients Patricios treats.
“My worst case of prolonged cognitive injury this year was after a hockey player ran into another player and hurt his head,” he said.
Patricios has treated 322 cases of concussion since 2006. About two-thirds of these (221 cases) were rugby-related, while nearly a third (113) of patients had suffered previous concussion, the South African Sports Medicine Association Congress in Pretoria was told last week.
Patricios said : “One of the rugby players had had concussion 10 times by the age of 17.
“We are learning that children and adolescents are more susceptible to concussion.”
Kohler agreed that adolescents were more vulnerable to concussion. “We know the developing brain is a lot more susceptible and their recovery time might be more prolonged.
“We are also finding there may be a genetic basis and there might be differences between men and women. This year is the first year we are looking at gender differences and finding that women may take a bit longer to recover from accidents.”
People with the gene APOE4 may be more susceptible to suffering from concussion, said Patricios . Levels of a protein in the blood, known as SB100, may also indicate the severity of a person’s concussion and rate of recovery.
Sports Concussion SA has a detailed protocol, following international guidelines, on how to diagnose a concussed patient — including computer brain-function tests — and how to manage recovery.
Patricios said: “If a person has a hamstring injury we tell them to stop running. If they have a mild traumatic brain injury … they should be pulled out of a learning environment for a short time.”
He said it might be harder to identify concussion in infants and toddlers , and, although brain scans are not that sensitive in picking up micro-trauma, scans may be a safeguard against bleeding or fractures.
Sister Lilian Leistner, an author and specialist in babycare , writes: “Bumps to the head and falls that injure the upper body need to be monitored carefully in the first 24 hours, although mostly there will be no reason for concern … Worrisome symptoms after a bump on the head include lethargy, weak and/or high-pitched crying, vomiting, confusion, irritability, unequal focus and reaction of the pupils of the eyes, dizziness, abnormal sleepiness and a lack of interest in or refusal of milk and food.”
• If you are unsure about concussion, call 084-BRAIN24 or 084-272-4624
