13 July 2005

Headache alert for athletes

Don't dismiss headaches among high school athletes who suffer concussions.

Don't dismiss headaches among high school athletes who suffer concussions.

Your brain telling you something
"If someone who suffers a sports-related concussion has a post-concussion headache - just a headache - they probably should not return to play until they've had a more detailed neuro-cognitive evaluation," says Dr Melvin Field, co-author of the Pittsburgh study on concussions among high school athletes.

That message goes unheeded far too often in high school sports, says the study, reported in the March-April issue of the American Journal of Sports Medicine.

Headache traditionally not a criterion
Multiple concussions can lead to permanent damage that reduces some brain functions. In rare cases, high school athletes who suffer a concussion before recovering from an earlier one can suffer "second-impact syndrome," which has resulted in at least 20 deaths to date, Field says.

The research study
The Pitt researchers reviewed the cases of 109 high school athletes who had concussions in the 2000-2001 school year. Most of the athletes were male football players, but the study also included female players and other sports such as basketball, soccer, hockey and lacrosse.

Neuro-cognitive performance impaired
All the athletes with headaches a week after concussions performed significantly worse than those without headaches on a computerised test measuring neuro-cognitive functions such as reaction time, memory, attention, and speed of processing information, the study found.

The question of grading scales
"Probably 90 to 95 percent of all team physicians and trainers and primary-care physicians will use concussion scales to determine when athletes should return to play," Field says. "And this data suggests that athletes who suffer mild concussions with persistent headache will often have neurological abnormalities ... despite the fact that many grading scales would allow the athlete to return to play."

Importance of taking headaches seriously
Dr Gerard Varlotta, director of sports rehabilitation at the Rusk Institute of Rehabilitation Medicine at New York University Medical Centre, says the Pitt study highlights the importance of taking post-concussion headaches seriously.

A-Z of concussion
When a bump is serious


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Dr Elliot Shevel is a South African migraine surgery pioneer and the founder and medical director of The Headache Clinic in Johannesburg, Durban and Cape Town, South Africa. The Headache Clinic is a multidisciplinary practice dedicated to the diagnosis and treatment of Primary Headaches and Migraines. Dr Shevel is also the main author of all scientific publications generated by his team. He recently won a high level science debate in which he was able to prove that the current migraine diagnosis and classification is not based on data. Tertiary Education - Dr Shevel holds both Dental and Medical degrees, and practises as a specialist Maxillo-facial and Oral Surgeon. Follow the Headache Clinic on Twitter@HeadacheClinic.

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