When It's More Than a Headache: Delicate Adolescent Brains

The New York Times—September 20, 2009

Jordan D. Metzl, MD is a sports medicine physician at Hospital for Special Surgery in New York City and the author of The Young Athlete.

I was in my office last week when David, a 17-year-old high school football player, came in with his parents. David is a senior and has above average speed and receiving skills. He’s hoping to play college football next fall. The complication: he has had three concussions including one last year that kept him out of school for a week.

Despite widespread and ever increasing information that is available on adolescent concussion, there still is remarkably little information that a physician can give an athlete like David. Why are some athletes prone to suffering concussions? What makes their symptoms persist? Aside from stopping contact sports, what can be done to prevent these injuries?

Defined as a traumatic event to the brain that causes an alteration in mental status, much information on concussion has been gleaned over the past 10 years. In teen athletes, the data show cause for concern. Several studies have shown that the relative risk of suffering multiple concussions increases three to fivefold if an athlete has had one previously. Multiple concussions have been linked to memory problems and structural brain damage in studies involving adult football and rugby players. And lastly, the healing rate of concussion is slower in adolescents than in adults.

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