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Westchester Pediatricians Discuss New Concussion Guidelines with Northern Westchester Hospital

Posted on: September 12, 2012

Protecting the Student Athlete

An Interview with Dr. Louis Corsaro and Dr. Elliot Barsh

Concussion Guidelines

You don’t really have to be a sports fan to have heard about the concern over concussions. Every few months, it seems, the national news carries another report about a former professional football player or boxer and their career filled with head trauma. But according to Northern Westchester Hospital pediatricians Elliot Barsh, MD, and Louis Corsaro, MD the damage these athletes suffered as professionals most likely began much earlier—when they were just youths playing in town and school sports programs.

We sat down with these leading Westchester pediatricians to understand the toll these school sports programs can take.

“I’ve seen very serious concussions in athletes as young as 12 and 13,” says Dr. Corsaro who, like Dr. Barsh, serves as a school physician for local Westchester County school districts. “We really need to educate youth coaches, trainers, parents, and athletes in all sports—football, soccer, lacrosse, basketball, hockey, baseball—on how to recognize the signs of a concussion and the steps to take to prevent lasting damage to the brain.”

The problem, says Dr. Barsh, is that the signs of a concussion can be maddeningly vague—especially when you consider that loss of consciousness is rarely one of the symptoms. “In 90% of concussions, the patient doesn’t lose consciousness,” he says. “And the other signs, such as headache, nausea, dizziness, fatigue, can be caused by any number of things.”

Wearing a snug helmet offers necessary protection for the skull, but it won’t prevent concussions, the doctors say. “If you think of the brain as a gelatinous-like organ,” says Dr. Corsaro, “you can picture how a sharp blow can cause a wave to pass through the brain. That wave can destroy neurons, and it will take time for the body to repair.”

The doctors both praise recently released New York State Concussion Guidelines that address concussions. The guidelines recommend that any athlete who takes a hit to the head and feels woozy immediately head for the sidelines. “Once you’ve suffered one concussion,” says Dr. Barsh, “you’re much more vulnerable to subsequent concussions, and to further cognitive consequences.”

“The guidelines help us manage the recovery process.” The athlete should rest quietly—no cell phones, video games, television, or schoolwork for 3-5 days following the injury. “Any cognitive strain or stimulation can delay the recovery,” shared Dr. Barsh. When the athlete is symptom-free for one week, he or she can begin a gradual return to play.

Dr. Corsaro also likes the idea of preseason cognitive testing of healthy athletes so that coaches and parents have a baseline measure. “If there’s an injury, we can do testing and compare it to the baseline to get a clear idea of the potential damage.” Several districts have already implemented such testing, he says.

Both doctors have met resistance to the new guidelines. “Parents, coaches, and kids really don’t like taking time off,” says Dr. Corsaro, “but that’s the only way to heal.” And the consequences of not respecting the downtime are severe: Memory loss, increased irritability, poor impulse control, increased risk of substance abuse, and depression are just a few of the potential outcomes. “Some parents can’t understand why I’m preventing their kids from playing,” says Dr. Corsaro. “I want that athlete out of play because I’m thinking about their future.”

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