Concussion Information


Head injury is continually a topic that provokes much debate among sports medicine professionals.  While there is a large body of knowledge that continues to grow through scientific research, concussions are not fully understood.  There are many proposed definitions, diagnostic criteria, and management techniques, but a singular definitive standard of care continues to elude the sports medicine community.  Consequently, it is of utmost importance to formally address the issue of head injury in athletics at the institutional level.  Connecticut College Sports Medicine has developed a concussion management plan for the care of athletes with suspected head injury that is in agreement with current sports medicine best practices.  A copy of our Concussion Management Plan may be obtained by members of the College community upon request.  It is our goal to provide the highest level of care possible to all of our student-athletes.  

What is a Concussion?

Sport related concussion (SRC) is a traumatic brain injury induced by biomechanical forces. Several common features that may be utilized in clinically defining the nature of a concussive head injury include: 
  • SRC may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an impulsive force transmitted to the head.
  • SRC typically results in the rapid onset of short-lived impairment of neurological function that resolves spontaneously. However, in some cases, signs and symptoms evolve over a number of minutes to hours.
  • SRC may result in neuropathological changes, but the acute clinical signs and symptoms largely reflect a functional disturbance rather than a structural injury and, as such, no abnormality is seen on standard structural neuroimaging studies.
  • SRC results in a range of clinical signs and symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive features typically follows a sequential course. However, in some cases symptoms may be prolonged.
Education

Student-athletes and coaches are educated about concussions annually.  This education includes signs and symptoms of concussion, what to do in the event of a suspected concussion, and the potential consequences of not reporting suspected concussions to a member of the sports medicine staff.  

After receiving this education, student-athletes must sign a statement in which they acknowledge that they have received, read, and understand the educational material regarding the signs and symptoms of concussions and that they have a responsibility to report concussion-related injuries and illnesses to the sports medicine staff as required by the NCAA.

Lastly, head coaches must acknowledge they understand our concussion management plan, their role within the plan and that they received education about concussions.

Signs and Symptoms

Headache, nausea, vomiting, dizziness, visual disturbances, balance problems, sensitivity to light or noise, feeling slowed down, feeling "fuzzy", feeling "in a fog", "don't feel right", "pressure in head", difficulty concentrating or remembering, fatigue or low energy, confusion,  drowsiness, trouble falling asleep, more emotional, aggression/irritability, sadness, nervous or anxious, lightheadedness, post traumatic amnesia (PTA), tinnitus (ringing in ears), seizures, and loss of consciousness.

Baseline Testing

Sway Medical concussion assessment software is used to record a baseline cognitive and balance assessments for every intercollegiate student-athlete at Connecticut College.  When a concussion is suspected, follow-up tests may be administered to compare to baseline scores.  

Concussion Management at Connecticut College

Connecticut College is dedicated to providing comprehensive care for students suffering from a concussion. We strive to deliver integrative care by employing a holistic interdepartmental approach in caring for the whole person. 

Sports Medicine Department: 
The sports medicine department oversees medical care and serves as a liaison between other health care providers and the students’ dean. The sports medicine staff manages concussions according to the department’s concussion management plan, under the direction of the team physician and neurological consultant.

Deans:
The Deans of the College advocate for students that require academic modifications due to their injury. The student’s dean is advised of medically necessary academic modifications by the sports medicine staff, and then communicates these needs to the student’s professors. The deans also refer students in need of academic assistance to the Academic Resource Center.

Academic Resource Center: 
The Academic Resource Center provides academic support by deploying strategies to assist students in completing their academic work within the parameters of the academic accommodations and return to learn paradigm. The Academic Resource Center will also communicate with Student Accessibility Services to arrange long-term academic accommodations (> 6 months) when necessary.


All suspected head injuries must be reported to a member of the Sports Medicine Staff. If a student-athlete experiences, or a coach or teammate witnesses any signs or symptoms of concussion after an athlete receives a blow to the head or body, the athlete shall be removed from practice or competition, and the Sports Medicine Staff notified immediately so that the athlete can be evaluated as soon as possible.

If a concussion is diagnosed, a graduated return to cognitive and physical activity protocol is administered under the direction of the team neurologist to safely return the student-athlete to normal activity levels. 

Team physicians have the final authority to determine when a student-athlete is removed or withheld from participation. In addition, clearance for that individual to return to activity is solely the responsibility of the team physicians or their designated representatives.

Second-Impact Syndrome

Second-Impact Syndrome is a rare but usually fatal condition that occurs when an athlete sustains a second concussion while still suffering symptoms of the first concussion.  The second injury, which may be caused by a much lesser force, causes a disruption of the regulation of blood flow to the brain.  This disruption results in a massive intracranial bleed, and most often death.  The only cure for this condition is prevention! This condition develops rapidly after sustaining the second injury and the athlete's condition deteriorates fast, usually resulting in death within one hour.

Post Concussion Syndrome

Post concussion Syndrome is a condition in which the symptoms of a concussion persist for weeks or even months following the initial injury.  It is most often characterized by the following signs and symptoms: depression, dizziness, drowsiness, fatigue, headache, irritability, memory deficits, nausea, poor balance, and difficulty concentrating.

Unfortunately, there is no known cure for this condition.  Often times, the student-athlete must simply wait until the symptoms resolve.  Pharmacological interventions may be implemented by a physician to manage symptoms, and there is some evidence that low-level cardiovascular exercise can aid in recovery.  Additionally, some medical practices specializing in concussion care have begun classifying post-concussion patients by symptom profiles and attempt to hasten recovery by creating treatment plans that target patients' specific symptom subsets.

Chronic Traumatic Encephalopathy (CTE)

 Chronic Traumatic Encephalopathy is a progressive neurodegenerative disease whose pathologic hallmark is abnormal tau deposition, with clinical manifestations of mood disorder, neuromuscular incoordination, dementia and death that may occur as a consequence of repetitive mild traumatic brain injury. However, it is not possible to determine the causality or risk factors of CTE with any certainty.  As such, the speculation that repeated concussion or subconcussive impacts cause CTE remains unproven.


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