Efforts to prevent, treat concussions gain momentum

In late 2011, Paige Havens needed a constant reminder that she could find some good in what had happened. Her daughter Rachel had recently suffered a concussion playing soccer. It sent their world into a tailspin.

Rachel and another player collided; Rachel’s head bounced off the ground. Rachel had a headache that lasted for months. She was highly sensitive to light. She had problems concentrating. She started having seizures.

Havens grabbed a blue dry erase marker and scrawled the following words on her mirror: “The seeds I receive I will sow.”

A Peachtree Ridge High School freshman at the time, Rachel had taken a knock to the head the previous spring and had never really healed. Rachel’s first concussion had been underestimated, and as a result, the damage from that November 2011 blow was far worse.

Since then, mother and daughter have been on a mission to help raise awareness about concussions and ensure steps are taken to make playing sports safer for young people. Momentum is building.

Last year, Gov. Nathan Deal signed “return to play” legislation requiring Georgia’s youth athletes who suffer concussions to be cleared by a health professional before returning to the field of play. Georgia is now one of 46 states with such laws.

And Thursday, CNN chief medical correspondent Dr. Sanjay Gupta headlines a conference called “Finding Solutions to the Public Health Crisis: ‘Mild’ TBI / Concussion in Youth.” Organized by the Sarah Jane Brain Foundation, about 150 people — primarily doctors, clinicians and coaches — will gather in New York City to address a wide variety of issues surrounding concussions. Those will include ways to better recognize concussions when they happen as well as measures to help students transition back to school gradually.

Concussions are a type of brain injury that is caused by a blow to the head or another injury that causes the brain to shake inside the skull.

Dr. Ronald Savage, a New York-based rehabilitation psychologist who specializes in pediatric brain injuries, said more attention needs to be placed on assisting children with their return to school, little by little, after a concussion. Children may need days, even weeks, of brain rest, he said.

In 2010, the most recent year available, 12,198 Georgia children ages 5-18 sustained non-vehicle-related head injuries, according to the Georgia Concussion Coalition. Many of those injuries occurred during athletic competition or practice, the group believes, putting them at risk. But many experts believe the number is much higher because concussions often go unreported.

Gupta said it’s critical to have someone — whether it’s an athletic trainer or someone educated about concussions — on the fields. Football players, he said, need to have baseline exams and have cognitive exams at the beginning of the season.

“The word ‘concussion’ has the connotation of not being that serious,” Gupta said. “But if you call it a brain injury, everyone responds differently. If someone had a badly sprained ankle, they wouldn’t go back in the game, and they would get time to heal, but since it’s a brain encased in the skull and you don’t see it, and the symptoms can be masked, the brain can be injured — and then injured again.”

Gupta said the keys to concussion safety include safer tackling such as not leading with the head; keeping kids who suffer a concussion out of the game until they fully recover and are symptom-free; and recognizing symptoms of concussions in the first place.

Cassie Bruce of Duluth knows the symptoms of concussions aren’t always easy to spot. Her son Caleb, now 17, got right back up after a big tackle in the fall of 2012.

"I should have known something was wrong when my 200-pound football player wasn't hungry for dinner," Bruce said Monday. (She also was interviewed by The Atlanta Journal-Constitution last year for a story about concussions; see www.ajc.com/news/lifestyles/health/concussion-victims-urge-legislation/nWsjQ/). "And then, the next day I couldn't get him up in the morning. I thought he was up late texting his girlfriend."

And his irritability? That just seemed like typical cranky teenager behavior.

But knowing what she knows now and after several months of her son unable to attend school, suffering seizures and having episodes of uncharacteristically aggressive bouts, she believes that hit to the head should have put her on high alert.

Little by little with the help of therapy sessions and strong support of family and friends, Caleb is doing much better. He is back at school full time and getting good grades.

He recently started an eBay business.

“He is determined and driven,” said Cassie Bruce. “We have seen great progress because he has not given up. He kept climbing. He is determined to go to the University of Georgia.”

Meanwhile, after Rachel’s November 2011 injury, she couldn’t complete simple tasks at school and could barely make it through two hours of classes. Two-and-a-half years later, she is back at school again and making all A’s. But the impact will be with her always. Rachel has permanent scarring on the frontal lobe of her brain, and she now takes daily medication to prevent seizures.

Paige Havens (also interviewed last year by the AJC) became an advocate for more awareness, education about concussions, as well as an advocate for better care. She helped raise funds for the opening of Gwinnett Medical Center Duluth’s Concussion Institute, a comprehensive care center for concussions. Paige Havens also recently assumed the role as executive director of the Georgia Concussion Coalition.

Rachel, now 16, has a passion for health care and is doing two internships, including one at a physical therapy office.

“My concussion completely changed my life and flipped my world,” Rachel said. “I never thought about or realized how delicate the brain is … but this injury has also affected me in a positive way. It has allowed me to appreciate each and every day, and it has made me more health-conscious and positive about life.”


The Georgia Concussion Coalition offered this guide to the warning signs of a concussion, prepared by the Centers for Disease Control and Prevention. Coaches, teachers and parents should watch to see if the student:

  • Appears dazed or stunned.
  • Is confused about assignment or position.
  • Forgets an instruction.
  • Is unsure of game, score or opponent.
  • Moves clumsily.
  • Answers questions slowly.
  • Loses consciousness (even briefly).
  • Shows mood, behavior or personality changes.
  • Can't recall events prior to hit or fall.
  • Can't recall events after hit or fall.

Student athletes should monitor their own symptoms as well, added the CDC, and watch for:

  • Headache or "pressure" in head.
  • Nausea or vomiting.
  • Balance problems or dizziness.
  • Double or blurry vision.
  • Sensitivity to light.
  • Sensitivity to noise.
  • Feeling sluggish, hazy, foggy or groggy.
  • Concentration or memory problems.
  • Confusion.

For more information: www.cdc.gov/concussion/sports/recognize.html

ExploreSee video of Dr. Sanjay Gupta explaining the physiology of concussions here.