Multiple Concussions in High School Athletes Linked to Lasting Health Issues
Repeated concussions suffered by college and professional athletes have been a growing concern in recent years because of their potential long-term impact on the brain. Now a study finds that the damage may begin much earlier -- in high school.
Researchers from St. Joseph's University in Philadelphia looked at more than 2,500 teens in three states who played contact sports.
They found that some high school athletes who'd experienced two or more prior incidents of head trauma were already showing signs of "post-concussion syndrome." Symptoms can range from headache and balance problems to memory loss and other cognitive impairment.
"It appears that youth athletes who sustain multiple concussions experience a variety of subtle effects, which may be possible precursors to the future onset of concussion-related difficulties," wrote lead author Philip Schatz and his colleagues in the Neurosurgery study.
Dr. Michael A. DeGeorgia, the director of the Center for Neurocritical Care at University Hospitals in Cleveland, called the findings "scary" because they deal with children.
"This is very, very important, especially with our kids playing all these sports," he told AOL Health. "It may be related to the sheer aggressiveness of today's sports. I recognize it in my own kids. ... It's all kind of ratcheted up to a pre-professional level that may contribute to the higher incidence of injuries."
Previous studies have found a dramatic jump in the number of sports-related injuries in children, including those to the head. They've also discovered a heightened risk of developing dementia and Alzheimer's for professional athletes under 50.
"This is serious stuff," DeGeorgia said. "We haven't really been taking it as seriously as we should be in the past."
The Philadelphia research team examined the standard pre-season evaluations the students filled out about possible concussion symptoms. The group was divided into those with one previous concussion, those with two or more and those with no prior head injuries. None of the teen athletes had had a concussion in the four months preceding the research.
The high school students with past concussions, especially those who'd sustained two or more, had a higher rate of concussion-related symptoms of three types: cognitive or intellectual impairment, such as difficulty remembering or feeling "mentally foggy;" sleep changes, including sleeping more or less than usual; and physical symptoms, including dizziness, trouble balancing and headache.
There wasn't a marked difference between teen athletes with no history of concussion and those who'd had just one, the findings showed. There was also no significant increase in the level of emotional symptoms that can crop up after head trauma, including depression and irritability.
Schatz, who also works at the Sports Concussion Center and the International Brain Research Foundation, said the results indicate "subtle, yet significant increases" in concussion-related symptoms among high school athletes who'd had two or more head injuries.
But he cautioned that the analysis didn't draw a definitive cause-and-effect relationship. Teens who've had multiple concussions, he theorized, may just be "more sensitive to physical, cognitive and emotional fluctuations."
One well-publicized condition tied to repeated head trauma is known as chronic traumatic encephalopathy, or CTE. The degenerative brain disorder, which normally afflicts professional athletes, has been identified as a possible factor in several of their suicides and in that of an 18-year-old college football player whose brain scan showed signs of the disease. It can cause depression, psychotic thoughts, erratic behavior and loss of impulse control, as well as symptoms mirroring those of Alzheimer's.
"These troubling findings beg the question of whether high school athletes with a history of repeated concussions may also be exhibiting the reported cognitive, emotional, physical and behavioral symptomatology as seen in retired professional athletes with CTE," the study authors wrote.
DeGeorgia believes linking CTE with players' suicides is "a big jump to make." But the condition is a very real concern.
"Repeated concussions can lead to structural brain changes, and you can have a whole range of symptoms mimicking Alzheimer's/dementia," he told AOL Health. "Whenever you get hit in the head, your brain tries to repair itself. Part of that repair process is the laying down of proteins, including [those] known to be associated with Alzheimer's/dementia."
An athlete can also have small brain hemorrhages that don't show up on a scan, but can be very dangerous, he said.
"One manifestation can be disinhibition, or loss of self control," leading a person to do things he or she wouldn't normally do, DeGeorgia said. "If you're a teenager, you're already struggling with that issue, so then this can be very troubling."
In a child who is still developing, the ramifications of repeated head trauma can be frightening, as it can interfere with the proper formation of neurological pathways to the brain.
So what is a parent or young athlete to do? DeGeorgia advises taking precautions and seeing a specialist if there are lingering side effects after a head injury.
"We need to take every concussion seriously," he said. "Any player that has any type of confusion or suspicion of a concussion needs to at least be evaluated by a school physician. And if there are any more complicated symptoms, he or she needs to be seen by a neurologist."
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