November 1st, 2010
01:42 PM ET

Docs seek to better ID concussions' 'invisible injury'

It is hardly a comforting sight when an athlete's body lies splayed and twisted on the field after an injury. Doctors can splint a broken arm or X-ray a twisted knee. But when a concussion occurs, diagnosis is not so simple.

"The athletes don't appear injured," said Dr. Jeffrey Kutcher, assistant professor at Michigan NeuroSport at the University of Michigan. "Concussion is an invisible injury in a lot of cases, therefore there is no awareness of the injury."

It is a dangerous paradox: Concussion, an injury where the brain is jostled so hard that can cause brain damage, is invisible - almost impossible to accurately diagnose.

Against that backdrop, the American Academy of Neurologists is releasing updated guidelines today designed to make diagnosing concussion at sporting events easier. According to an AAN statement, "catastrophic results can occur and the long-term effects of multiple concussions are unknown."

The guidelines issued by AAN echo what has been discussed at recent congressional hearings, and at the state level, where laws are being shaped to address youth concussion. There are five tenets to the new AAN guidelines:

1) Any athlete who is suspected to have suffered a concussion should be removed from participation until he or she is evaluated by a physician with training in the evaluation and management of sports concussions;

2) No athlete should be allowed to participate in sports if he or she is still experiencing symptoms from a concussion;

3) Following a concussion, a neurologist or physician with proper training should be consulted prior to clearing the athlete for return to participation;

4) A certified athletic trainer should be present at all sporting events, including practices, where athletes are at risk for concussion;

5) Education efforts should be maximized to improve the understanding of concussion by all athletes, parents, and coaches.

According to the Centers for Disease Control and Prevention, there are 3.8 million sports-related concussions concussions each year in the U.S. That amounts to nearly 4 million invisible injuries every year.

Kutcher stresses that managing a suspected concussion on the playing field is not merely about rote adherence to guidelines, but taking into consideration an athlete's family history and previous injuries. As understanding of concussions' long-term effects grows clearer, a clear set of guidelines for coaches and parents is important, said Kutcher.

"We are starting to understand more and more that concussions may have some very serious long-term consequences," said Kutcher, chairman of the sports neurology section of the AAN and lead author of the concussion guidelines. "As that understanding grows and develops we can't wait for all the science to tell the complete story. We need common sense reccommendations that should be followed."

soundoff (514 Responses)
  1. jonathan

    Can this be used to help identify fibromyalgia. I'm still sick of trying to get this treated. Screw the athletes, let's deal with real people not making millions of dollars, to go out and hurt themselves anyway.

    November 2, 2010 at 00:26 | Report abuse | Reply
    • JFT

      Jonathan, I can understand your frustration, having suffered from fibromyalgia almost all my life. It's a frustrating disease and sadly, despite lots of evidence to the contrary, far too many physicians discount is as "all in your mind". However, it's important to remember that professional sports figures are not the only people who suffer injuries like concussion, and the information being gained in treating athletes can be used to help people who suffer concussion in falls, automobile accidents, industrial accidents, etc. Concussion is no joke and can be as hard to identify as fibromyalgia.

      November 2, 2010 at 00:50 | Report abuse |
    • AD

      Lets not forget that not all concussions are people making millions of dollars. Most of these injurys are high school kids playing spots. These kids are not fitted for the right protective equipment like college and pro athletes are. This is a very serious issue and I don't think the answer is to just "forget about these people and focus on something more important" as you suggest Jonathon.

      November 5, 2010 at 13:50 | Report abuse |
  2. anon

    I think the medical industry has a vested interested in continuing to pretend 'environmental' diseases are "all in your head" to maximime profits, extend the study of unwitting victims without compensation (recall tuskegee), or both. and in the rare case there is a blatant show of seeking direct profits on doctor's part after dismissing the patients' claims of environmental injury ( see Invisible Killers toxins in our environment) telepathy101, airfreshener411 blog

    November 2, 2010 at 03:27 | Report abuse | Reply
  3. Katie

    As a mother of a fearless son; who by the time he was 10 had already had 3 concussions; would love to know the long term effects or what it actually does. He was fine and I did restrict his activity for longer then probably necessary but wanted to be sure all was fine. There have also been a lot of recent deaths of celebraties that have died for tramua to the head. So please continue to do the research – make the athletes making millions you guinea pigs if necessary but please continue to study the effects.

    November 3, 2010 at 09:52 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.