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HEAD INJURY Heed pain caused by injuries

Tuesday, February 24, 2004

It's not a good idea for athletes to play through the pain, experts say.
In hockey star Eric Lindros' contemplation of retirement after experiencing his eighth "known" concussion in a game against the Washington Capitals last month, neurologists and other brain experts see a teachable moment.
First, they say, the common view of concussion as involving loss of consciousness reflects only the most severe type. Many lesser injuries go unrecognized, even by victims.
Their second point has particular relevance for young athletes tempted to emulate their millionaire heroes: Playing through the pain can be a really bad idea.
"If they have symptoms [which may include headache, fatigue or sleep disturbance, among others], they shouldn't ignore them," says James Stevens, an associate professor of neurology at Indiana University. "When athletes do that, they're playing a little game of Russian roulette."
What can happen
In about 90 percent of cases, Stevens says, subsequent concussions will result from less severe impacts. People who suffer such injuries before recovering are at particular risk. And not just for headaches.
"You have to understand that in addition to controlling all of your cognitive functions, your brain controls all of your behavioral functions as well," says Barry Jordan, director of the brain-injury program at Burke Rehabilitation Hospital in White Plains, N.Y.
Near-term effects, experts say, can range from cognitive, emotional and motivational difficulties to vertigo.
Stevens notes that concern about such effects prompted the American Academy of Pediatrics to adopt "very conservative" practice guidelines for dealing with young victims -- including permanent bans from some contact sports -- and Jordan suggests those rules should apply more broadly.
"Professional athletes should not be the gold standard for dealing with head trauma," he says. "Young athletes should be the standard."