Response to concussions in schools

At the semi-final game of the National High School Basketball Invitational Tournament (Winter Game 2015), held on December 27, the captain (3rd year) of Oka Gakuen High School of Nagoya collapsed and was unable to rise for a while due to a brain concussion.

The press report stated that “Due to the brain concussion in a scramble near the goal line, Endo was unable to stand up.” What shocked us was the description that followed. “The coach, Shinichi Inoue (69), immediately requested a time-out because ‘We can’t continue the game without Endo’. While there was concern, Endo soon returned to the game, increasing the lead to 15 points.”
Endo commented after the game that “When I had the concussion, I heard people cheering and knew I had to play.”

The athlete collapsed 2 minutes and 20 seconds into the 3rd quarter, allowing him to play about 18 minutes until the game ended.
The people shuddered when they read the article and were glad he was well after the game.

If we hit our head hard and people around us ask, “Are you all right?” we will usually answer “Yes, I’m all right,” regardless of the pain. Many of you must have responded the same, and so will the athletes playing in competitions. An athlete will think, “I want to keep playing. I don’t want to let them down,” resulting in a response of “I’m OK.”
Coaches, therefore, are responsible for stopping the athletes from returning to the game. They must protect their health.

In Nagoya, in May 2015, a first year high school student (16) had an acute subdural hematoma during practice in the boxing club of Kikuka High School. His life was saved, but he suffered permanent side effects on the left side of the body.

Subdural hematoma is not an “unexpected accident”; the side effects are extremely serious. Has the school conducted an investigation? What were the measures taken to prevent repetition of the same injury?
While the press report ended with a short story of senior club members encouraging the victim, the event must not be described as a heartwarming story.

In Nagoya, on December 9, 2015, a second year student (19) of the American Football Club of Nagoya University developed fatal acute subdural hematoma. With a helmet and pads, the student was hitting his body against another club member in practice. “I have a banging headache,” he said, then he went into convulsions and collapsed.

The American Association of Neurology (AAN) made an announcement of “Evidence-based guideline update: Evaluation and management of concussion in sport” in 2013. The following points are included:

    ・Athletes suspected of having concussions should be immediately prohibited from returning to play/practice.
    ・Athletes of high school age or younger should be managed more conservatively than older athletes because it takes longer for younger athletes to recover.
    ・Athletes should be gradually allowed to play only after acute symptoms have disappeared based on evaluation by a trained and qualified medical person.

The athlete from Oka Gakuen High School was lucky that he did not have any harmful side effects. However, for him and many athletes, serious injury was possible, and therefore the world is focusing on brain concussions. We must not take concussions lightly.

Reference to concussion on the website of JJAVA

Original article in Japanese language(December 29, 2015)

24/04 2016

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