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Head Trauma
All coaches and trainers are familiar with the player
who has had his 'BELL RUNG'. This player has usually
been hit with a heavy check, which may or may not
cause a minor blow to the head. This type of injury
is very often improperly assessed and is far too
often dismissed as just a 'DING'. The player is then
allowed to return to the game in a very short period
of time with little follow up or consideration given
to the potential outcome.
These are head injuries that can become serious even
if not first very debilitating. Brett and Eric Lindros,
Jeff Beukaboom and Pat Lafontaine are examples of hockey
players who have continued to suffer from the cumulative
effects of concussions and head trauma.
In reality, the DING, injury is a minor or grade 1
concussion. It is the most common yet the most difficult
form of concussion to recognize and according to current
literature is potentially the most dangerous form of
head injury. Brain imaging studies show that brain
tissue trauma occurs following mild head injury, even
without loss of consciousness (a grade 1 concussion).
Repeated concussions appear to impart cumulative damage,
resulting in increasing severity and duration with
each event. The Second Impact Syndrome, although rare,
can result in catastrophic brain swelling from a second
minor head injury in individuals who still show symptoms
from a prior concussion. It is also documented that
the chance of having a second concussion is four times
greater than the chance of sustaining the first concussion.
The literature further shows that 25% of those athletes
with 3 minor head injuries, 33% of those with four
and 40% of those with five show persistent neuropsychological
abnormalities six months after the injury. In view
of this information, it is imperative that coaches,
trainers and parents be familiar with the signs and
symptoms of head injury. They should have the ability
to grade the injury and to understand the appropriate
follow up to the injury.
In all cases PARENTS SHOULD be informed of the injury
and given the signs and symptoms to look for in case
of developing intracranial trauma.
CONTACT YOUR DOCTOR
OR REPORT TO THE EMERGENCY DEPARTMENT IF ANY OF
THE FOLLOWING OCCUR:
stiff back, unconsciousness or fainting,
personality changes, numbness, persistent nausea
or vomiting, difficulty speaking, slurred speech,
ringing or unusual sounds in the ear, shortness of
breath, breathing difficulties, dizziness, trouble
walking, confusion, unusual drowsiness, loss of memory,
bleeding or clear fluid drainage from the ears or
nose, inability to wake up completely, excessive
sleeping, severe, persistent or worsening headache,
unequal pupils (the dark portion of the eye), fever
or shaking chills, blurred or double vision, sensitivity
to light.
Soon we will further discuss neck and shoulder injuries
and the treatment and rehabilitation that can get you
back in the game faster and stronger.
If you have any questions regarding any hockey related
injuries, please call Dr. Lawrence Micheli or Dr. Joe
Pelino at the Soft Tissue Institute at 416-815-0388
or email hockeyinjury@softtissue.com.
Larry Jusdanis, SST Director
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