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King: Test for concussion is simple

Posted: October 3, 2012 - 8:05pm

LITTLE ROCK — Described by a co-worker as the only city-born male in Arkansas, The Associated Press rookie was assigned the year-end story on agriculture in the state.

Two questions into a suggested interview, a man with a huge cotton farm in the northeastern Arkansas bluntly encouraged the reporter to research about yields per acre and subsidies and call back.

Another potentially embarrassing moment surfaced recently. The assignment was to discuss the test for concussions with the chairman of the Department of Neurosurgery in the College of Medicine at the University of Arkansas for Medical Sciences and there was relief when I first missed phone connections with Dr. J.D. Day. In the imagined phone interview, the first question provoked a flood of medical jargon from a man who has authored textbooks on skull base surgery.

To prepare, a medical dictionary was located online. There, brain concussion was defined as “a clinical syndrome usually due to head trauma, characterized by immediate but transient impairment of cerebral function, principally alternation of consciousness, but also disturbance of vision and equilibrium, without any detectable structural brain damage.”

The test had to be complicated; I reviewed the definition in preparation for the call-back.

It turns out the test is simple, although there is the possibility that Day dumbed down the answer:

• Pupils are examined to make sure they react.

• Eye movements are monitored to make certain the eyes track with each other.

• Various muscle groups are tested for strength.

• Coordination is tested with finger to nose and such.

This year, quarterback Tyler Wilson was among Razorback football players who suffered concussions, described by the UA as an “above the neck injury.” Last week, senior cornerback Kaelon Kelleybrew was hurt making a tackle and vomited on the field.

Nausea, headaches, and amnesia are among the symptoms. On the sideline, a player is questioned to determine the status of his short-term memory.

“They may not even remember they got knocked out,” Day said. “They might not remember the score, who they were playing. The longer it takes to get rid of the amnesia, the more serious the concussion. Typically, amnesia is gone in 24 hours or less.”

Wilson still suffered from headaches and other symptoms days after the concussion in the first half against Louisiana-Monroe and was held out of the Alabama game the following week. Generally, Day said, major college athletes are checked 72 hours after suffering the concussion and again near the end of a week.

The NCAA’s 2011-2012 Sports Medicine Handbook says that from 2004 to 2009, the rate of concussion during games per 1,000 athlete exposures was highest for football at 3.1.

The handbook requires NCAA member institutions to have a concussion management plan on file with specific components, including:

• Student-athletes exhibiting signs of concussions must be evaluated by a medical staff member with experience in the evaluation and management of concussions before they can return to play.

• Student-athletes diagnosed with a concussion must be cleared by a physician or a physician’s designee before they can return.

Day’s preference is to test an athlete after exercise.

“The important thing is that a player has to be free of symptoms for a week,” Day said. “Either you’re perfect or you’re not.”

He has told a couple of high school kids who have suffered concussions that they must give up football.

A quarterback who once suffered a concussion in high school in Idaho, Day abandoned the game for another reason. “I was always upset that I was not 2-3 inches taller and that I didn’t run 4.6 instead of 4.8,” he said.

Thirty-plus years ago, he played behind an offensive line that was pretty big for the time with tackles who weighed 250 and 210 and guards in the 195-pound range. Today, everybody is bigger and the collisions are more violent than ever.

Harry King is sports columnist for Stephens Media’s Arkansas News Bureau. His e-mail address is hking@arkansasnews.com. Readers also can follow him on Twitter @harrykingsports.

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