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When children and teens participate in contact sports, concussions can seem like just part of the game. But new research says that even one concussion can set teens off course for the rest of their lives.
Every year, millions of students play high school sports. According to the National Federation of State High School Associations, over 1 million student athletes participated in high school football in the 2014-15 school year alone.
The need for traumatic head injury screening in every contact sport has become an issue of national concern. From the NFL on down, coaches are wondering how to protect their players. One tactic has been to remove student athletes at the first sign of concussion, to protect against repeated injury.
Now a new study from Sweden says that one concussion may already be too many. The study, performed by scientists from Oxford University, Indiana University, and the Karoliska Institute in Stockholm, was published in a report in late September 2016, by health insurer Blue Cross Blue Shield. It surveyed the medical records of all Swedes born between 1973 and 1985, looking for those who suffered a head injury before age 25. More than 104,000 people qualified. The study compared those records with the general public, and with a sibling who had never been diagnosed with a head injury.
The results were concerning, to say the least. Young people who had suffered a single diagnosed concussion – a mild traumatic brain injury – were much more likely than then national average or their own siblings to be medically disabled as adults. They were also significantly more likely to need mental health treatment and much less likely to have graduated from high school or attended college. And they were about twice as their uninjured siblings to die prematurely.
The outcomes were worst for teens who suffered head trauma between the ages of 15 and 25, probably because the brain is less resilient during this period than earlier in childhood. The risk of lingering physical or psychological problems also went up significantly with a second or more severe brain injury.
Having a concussion did not automatically lead to problems. The majority of the people surveyed did not experience adverse outcomes. But there is no way to know at the point of impact who will, or won’t, face lasting effects from the concussion.
Dr. Seena Fazel, a professor of forensic psychiatry at Oxford, and the study’s senior author says that while “there are lots of benefits from sports,” schools and coaches need to consider changing the rules or equipment in contact sports to try to reduce the number of head trauma cases. When a concussion does happen, Fazel encourages more and longer-lasting monitoring to pick up on decreases in psychosocial performance including dropping grades or changes in personality. These changes can continue into adulthood, so careful monitoring is essential long after the initial hit.