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In 1997, the American Academy of Neurology listed the following to assist individuals in dealing with concussions:
Symptoms of Concussions 
 Headache  Dizziness or vertigo (loss of balance)  Lack of awareness of surroundings  Nausea or vomiting  Pupils of unequal sizes  Persistent low grade headache  Light-headedness  Poor attention and concentration  Memory dysfunction  Easy fatigability  Irritability and low frustration tolerance  Intolerance to bright lights and/or loud noises  Anxiety and/or depression  Sleep disturbances
Frequently Observed Features of Concussions
 Vacant stare  Slow to answer questions or follow instructions  Easily distracted  Unable to follow through with normal activities  Disorientation (walking in wrong direction, losses track of time, date, place)  Slurred speech  Lack of coordination  Disproportioned emotional reactions to circumstances  Memory deficit (repeatedly asking same question)  Any period of loss of consciousness

Everyone in the concussed athlete's "neighborhood" has a role to play in his/her care
 
The Parents’ Role in the Neighborhood
 

Parents know their child better than any other neighbor in the neighborhood. You are best suited to pick up subtle changes in behavior, problem solving and organizational skills which may be associated with a concussion. 

*NOTE: The following information is designed to assist you in dealing with your child’s recent head trauma; it should not replace medical attention

Any head, face or jaw injury has the potential to be dangerous. The danger may not appear immediately. The first 24 hours are vital to determine possible severity.
To better care for your child in the first 24 - 48 hours, the following suggestions are offered:
• Do not leave them alone for long periods of time • Use only Tylenol or other ibuprofen medication for headaches • Avoid excessive eating and drinking • Avoid bright, loud and noisy environments • Be very aware of negative changes; any sign or symptom that seems to have gotten worse, indicating a need for immediate medical attention 
***Avoid large amounts of television, video games, text messaging and reading. These require mental activity and your child's brain needs to rest; this means mental rest as well as physical. 

Parents: if you see something in your child's behavior,demeanor, personality changes, eating or sleeping habits that you do not like do not hesitate to seek medical attention.
If parents have behavior, academic or performance questions resulting from their child’s recent concussion, they should also utilize the resources of the school and speak with the athlete’s teachers, school nurse and certified athletic trainer
If you have any doubts, seek medical attention immediately
From “Getting A-Head of Concussion-educating the student-athletes’ neighborhood” by Phil Hossler, ATC and Ron Savage, EdD; available from <A href="http://www.lapublishing.com">www.lapublishing.com</A> 
 

The Athlete’s Role in His/Her Neighborhood
 
 
Athlete’s responsibilities to himself or herself include:
1. You may not be thinking clearly, so do not dismiss anything that bothers you; tell someone 2. Tell someone if your headaches get worse or if you still have ringing in your ears 3. Talk to your teachers if school becomes difficult 4. Always report head injuries to your coach or certified athletic trainer; concussions add onto each other and may become more serious each time 5. Avoid returning too quickly; accept current concussion guidelines which say you may easily be out for a week or two with a mild concussion 6. Changes in your vision must be reported to someone; this may need further testing.
7. Avoid large amounts of television, video games, text messaging and reading. These require mental activity and your brain needs to rest; this means mental rest as well as physical.
From “Getting A-Head of Concussion-educating the student-athletes’neighborhood” by Phil Hossler, ATC and Ron Savage, EdD available from <A href="http://www.lapublishing.com">www.lapublishing.com</A> 
 
Second Impact Syndrome (SIS)
 
Receiving another blow can increase the severity and duration of symptoms. SIS can be very serious including seizures, long term memory loss and lifetime disabilities. Brain tissue needs time to recover; how much is based on how hard you were hit and how many hits you have received recently. The cumlative effects of concussion may not be obvious. It is wiser to sit out 3 days too long then to return 3 days too soon.
 Concussion and Taking Tests in School 
 
Tests taken while the student still has symptoms of concussion may affect class grades. For example, a student who is having headaches may have trouble concentrating in class. Fatigue after school may make it harder for the student to complete homework or pay attention in school. Difficulty with short term memory may make it harder for the student in classes such as history and science that require factual recall. A drop in the student’s grades may affect class standing and class selection. If a student has a poor run of 4 weeks at the wrong time; the counselor may alter next year’s schedule choices. If the GPA drops, the student-athletes may be rendered ineligible for the next season’s sports. 
 
Symptoms of a concussion usually resolve within days or weeks but in some situations may persist for months or longer. Parent and teachers must play an active role in the Neighbor Program and share information with and ask questions of other members in the athlete’s “neighborhood”.
East Brunswick High School has a program in which once the school nurse is notified that an athlete has a concussion, she will notify all your teachers. Teachers have been given a list of accommadations that they may make for the concussed student-athlete in their class.
 

The Brain Injury Association of New Jersey's Concussion in 
Sports Committee has developed the following consensus statement:
<UL>
<LI>A concussion is a mild traumatic brain injury (MTBI), induced by mechanical forces that immediately disrupt the normal functioning of the brain. </LI>
<LI>When playing sports, if there is any doubt that a player might have sustained a concussion, the player should be removed from the game or practice. Never participate in physical activity if any sign or symptom of MTBI is present.</LI>
<LI>All concussions should be evaluated by knowledgeable health care professionals to measure severity, monitor progress over time and properly manage the injury. Resolution of clinical and cognitive symptoms often occurs spontaneously, typically following a sequential course.</LI>
<LI>The mechanical trauma that causes a concussion may be either a direct blow to the head, face, and neck or an indirect blow elsewhere on the body that transmits an “impulsive” force to the head.</LI>
<LI>Concussion symptoms usually appear immediately, although they can present later, and affect a wide array of mental functions. A stunned, confused state is a hallmark of MTBI. Loss of consciousness is proof of a concussion; however, most concussions do NOT involve loss of consciousness. Memory loss, dizziness, emotional instability, disturbances of equilibrium, vision, and cognitive functions, as well as headache, nausea and vomiting are common symptoms.</LI>
<LI>Concussion results in immediate chemical changes within the nerve cells of the brain, which usually return to normal over several days or weeks. Neuroimaging studies typically show grossly normal anatomic structures, reinforcing the temporary and non-structural component of mild traumatic brain injury.</LI>
<LI>Like all injuries, a concussion may have widely varied clinical consequences (from mild to severe) , however, it is imperative that the injured body part be afforded adequate time to heal. Resting the brain must not only involve ceasing physical activity for a period of time, but also should include a break from challenging cognitive activity as well.</LI>
<LI>Concussions are not simply “a blow to the head”; as brain injuries, concussions must always betaken seriously.</LI></UL>
This definition has been developed by a committee of professionals as part of an on-going effort to bring together a statewide partnership on concussion awareness and prevention in youth sports. Revised June 2005
-------------FOR MORE CONCUSSION INFO GO TO 
<A href="http://www2a.cdc.gov/podcasts/media/mp3/mmwr5_072707.mp3">http://www2a.cdc.gov/podcasts/media/mp3/mmwr5_072707.mp3</A>
<A href="http://www.momsteam.com/alpha/features/health_safety/matthew_colby_foundation.shtml">http://www.momsteam.com/alpha/features/health_safety/matthew_colby_foundation.shtml</A>
<A href="http://www.cdc.gov/ncipc/tbi/CGToolKit/A_Fact_Sheet_For_Parents.htm">http://www.cdc.gov/ncipc/tbi/CGToolKit/A_Fact_Sheet_For_Parents.htm</A>

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<TD class=SWFilesNameSize height=1><A href="http://www.delranschools.org/939201170536187/lib/939201170536187/_files/Concussion_and_Depression.pdf" target=_blank border="0"><IMG border=0 alt="Click here to download the file." align=absMiddle src="http://www.delranschools.org/939201170536187/FileLib/images/pdf.gif" target="_blank"></A> Concussion_and_Depression.pdf, 70.50 KB, 2/20/2008 </TD></TR>
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<TD class=SWFilesNameSize height=1><A href="http://www.delranschools.org/939201170536187/lib/939201170536187/_files/Hard-Knock_Lessons.pdf" target=_blank border="0"><IMG border=0 alt="Click here to download the file." align=absMiddle src="http://www.delranschools.org/939201170536187/FileLib/images/pdf.gif" target="_blank"></A> Hard-Knock_Lessons.pdf, 106.87 KB, 10/5/2007 </TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>
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<TD class=SWFilesNameSize height=1><A href="http://www.delranschools.org/939201170536187/lib/939201170536187/_files/Head_Injury_Study.pdf" target=_blank border="0"><IMG border=0 alt="Click here to download the file." align=absMiddle src="http://www.delranschools.org/939201170536187/FileLib/images/pdf.gif" target="_blank"></A> Head_Injury_Study.pdf, 75.03 KB, 10/5/2007 </TD></TR></TBODY></TABLE></A></DSFCONTENTTITLE>
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<TD class=SWFilesNameSize height=1><A href="http://www.delranschools.org/939201170536187/lib/939201170536187/_files/Hard-Knock_Lessons.pdf" target=_blank border="0"><IMG border=0 alt="Click here to download the file." align=absMiddle src="http://www.delranschools.org/939201170536187/FileLib/images/pdf.gif" target="_blank"></A> Hard-Knock_Lessons.pdf, 106.87 KB, 10/5/2007 </TD></TR>
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<TD class=SWFilesTitle height=1><DSFCONTENTTITLE id=286933 uuid="395BB3B7-6F6E-4A00-A4CD-38673BF83332">Hard Hitting in the NFL</A></DSFCONTENTTITLE></TD></TR>
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<TD class=SWFilesNameSize height=1><A href="http://www.delranschools.org/939201170536187/lib/939201170536187/_files/Hard_Hitting_Career_in_NFL.pdf" target=_blank border="0"><IMG border=0 alt="Click here to download the file." align=absMiddle src="http://www.delranschools.org/939201170536187/FileLib/images/pdf.gif" target="_blank"></A> Hard_Hitting_Career_in_NFL.pdf, 99.92 KB, 10/5/2007 </TD></TR>
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<TD class=SWFilesTitle height=1><DSFCONTENTTITLE id=286912 uuid="B5928032-DFBD-423E-84D6-EA157988A435">Concussions Tied to Depression</A></DSFCONTENTTITLE></TD></TR>
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 FOR ADDITIONAL INFORMATION ON HOW ADULTS AND YOUTH DIFFER, CLICK THE NEXT LINE 
<A href="http://www.cnn.com/video/#/video/health/2009/01/29/am.gupta.athletes.concussions.cnn">http://www.cnn.com/video/#/video/health/2009/01/29/am.gupta.athletes.concussions.cnn</A>
<A href="http://teacherweb.com/NJ/EastBrunswickHS/EBBearCare/ConcussioninYouthversusAdults.doc">http://teacherweb.com/NJ/EastBrunswickHS/EBBearCare/ConcussioninYouthversusAdults.doc</A></TD></TR>
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<TD class=SWFilesNameSize height=1>Athletes: be honest with yourself. Your brain is too important to gamble with; when in doubt, sit out !</TD></TR>
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