Dr. Bruce Douthit: Diagnosing and Treating Sports Concussions

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Last night’s PBS FRONTLINE documentary on the evolution of high school football included new findings by researchers that concussions and their negative effects are becoming more prevalent in players at a younger age.

According to the Concussion Clinic at Nationwide Children's Hospital in Ohio, approximately 400,000 concussions occurred among 7.5 million student athletes who participated in high-school sports during the 2008-2009 school year.

The Sports Concussion Institute estimates that 10 percent of athletes suffer a concussion each season. Football players suffer the most brain injuries of any sport, but other sports including baseball, basketball, hockey, rugby, soccer and softball also have moderate to high incidences of concussion.

VYPE Editor-In-Chief Tim Polzer asked Dr. Bruce Douthit, an orthopaedic surgeon on the medical staff at Baylor Medical Center at Frisco and a Baylor SportsCare physician, about the diagnosis and treatment of sports concussions.

VYPE: What are some symptoms or danger signs of a possible concussion involving an athlete?

Dr. Douthit:

A concussion is the disturbance in the function of the brain caused by a direct or indirect force to the head. Symptoms can include a headache, pressure in the head, neck pain, balance problems or dizziness, nausea or vomiting, vision or hearing problems, drowsiness, fatigue, irritability and loss of memory.

VYPE: What steps or tests are involved in diagnosing a concussion?

Dr. Douthit:

Diagnostic tests for concussions can include memory testing, cognitive assessment such as recall or reciting months in reverse order and testing balance. Neurologic screening can test speech pattern, gait assessment and Romberg testing the athlete’s ability to balance with eyes closed and arms extended straight out in front.

VYPE: What are short-term and long-term cumulative dangers involving undiagnosed concussions?

Dr. Douthit:

Short-term effects can include sadness, nervousness, anxiety or a sensitivity to light and noise. An athlete might also vary his or her sleep pattern, suffering insomnia or sleeping longer than usual.

VYPE: What steps are involved in managing a concussion?

Dr. Douthit:

An athlete suffering a possible head injury should immediately be removed from play. A medical evaluation should be performed to determine the severity of the injury. The athlete should get physical and cognitive rest while being monitored for the next 24 to 48 hours. If any concussion symptoms reoccur, the athlete should immediately be taken to the emergency room.

VYPE: What are some common misconceptions about concussions?

Dr. Douthit:

Besides the fact that an athlete doesn’t have to lose consciousness to suffer a concussion, there is also a misconception that the severity of a concussion is apparent immediately after impact.

VYPE: What are the criteria for determining when an athlete can return to action?

Dr. Douthit:

Athletes should not return to action until signs and symptoms of concussion no longer appear. If there is no reoccurrence, the athlete should gradually return to activity. Neuropsychological testing of an athlete’s return to a baseline pre-concussion level is also a determining factor.

VYPE: Why do some high school athletes recover from a concussion in a day or two and others take months?

Dr. Douthit:

It depends on the severity of the trauma to the brain. The greater initial damage sustained, the longer the recovery of healing time required for the brain tissue.

VYPE: Does Baylor Health Care System work with high school teams and trainers in diagnosing and treating concussions among athletes?

Dr. Douthit:

Baylor SportsCare is in the developmental stages of working with school districts using the ImPact program. It is designed to provide a more scientifically based approach to returning athletes safely to play after a concussion.