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New concussion guidelines for young athletes include stronger precautions

High school football players are seen in this undated file photo.
March 14, 2013 12:00:00 AM PDT
Previous head injury guidelines indicated young athletes could return to play if they were symptom-free, but new guidelines will include stronger precautions. Players will be required to sit out games even if they have a suspected concussion. New evidence supports these recommendations.

High school junior Brian Heintz knows a lot about tracking and tackling. As a linebacker for Flintridge Preparatory School, he takes a lot of hits. But a year and a half ago, it appeared he had taken one too many.

"I came out of the game because I actually had bleeding in my back as well as my head, so my legs, I had really sharp intense leg pain," said Heintz.

Dr. Gabriel Zada, a neurosurgeon with Keck Medical Center of USC immediately put Heintz on the sidelines.

"Brian had slightly more than what we just call a normal concussion, because he actually had a very tiny rim of bleeding around the brain," said Zada.

Zada points to new evidence showing the significance of a single hit to the brain.

"Even just one concussion or just one mild traumatic brain injury can cause long-term anatomical effects that we can see on the right kind of MRI," said Zada.

A report in the Journal Radiology compared people with minor head injuries to those without. Those with the head trauma had nearly twice as much brain mass loss as the healthy volunteers and a higher incidence of mood disorders a year after the event. Zada says that includes anxiety, depression or problems with concentration.

Interestingly, the head injury patients performed at the same level on cognitive tests both pre and post injury. Zada attributes that to neuroplasticity.

"We know the brain can adapt, especially in younger people, to any kind of physical or structural changes and we have an amazing ability to do that," he said.

After more than a year of careful monitoring, Heintz is back in the game. But after high school, he may pursue other things.

"I was thinking about playing college football, maybe, and now with this happening, I don't think I will, because they do talk about cumulative hits. I wouldn't do that to myself," said Heintz.

Heintz says his coaches at Flintridge Prep have been training him to look up when he tackles, don't lead with his head and to avoid helmet to helmet contact. Under new guidelines, players cannot return to play without the approval of a licensed healthcare professional trained in concussions.


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