New Program Needed to Track Concussions in Youth

A new report from the Institute of Medicine (IOM) calls for a national surveillance program that will help create enough data on concussions in young athletes to counter the lack of information on the phenomenon, as well as resist what the agency calls “a culture of resistance” pervading youth sports.

While the attention paid to concussion has centered on professional and college sports, awareness of the problem has not yet been raised in youth sport leagues, the IOM report noted.

The number of visits to the emergency department for concussion and other nonfatal sports- and recreation-related traumatic brain injury (TBI) among patients aged 19 and under rose from 150,000 in 2001 to 250,000 in 2009. Thus, the IOM believes it is time for a nationwide surveillance program on the incidence of those injuries in youth between 15 and 21 years of age.

The report calls for the US Centers for Disease Control and Prevention (CDC) to carry out the surveillance program, which the IOM believes should include demographic data, pre-existing conditions, concussion history, use of protective equipment, impact of monitoring devices, and the qualifications of those making the diagnoses of concussion.

The IOM found some data on youth concussions in high school sports injuries, but very little on younger children. The panelists said better studies are needed to compile data on vulnerability timelines and potential differences in biomechanics of concussion at younger ages. There is a critical need to educate parents, players, coaches, and others on the risks of head impacts, including those which don’t result in concussion.

Other key findings of the report include:

• Confusion and controversy persist in many areas, despite growing awareness of sports-related concussion.
• Current sports helmet designs may reduce the risk of concussion, but they only address linear impact and do not prevent rotational injuries.
• The interval between concussions may be an important factor in the risk and severity of subsequent concussions; it remains unclear whether repetitive head impacts in youth lead to long-term neurodegenerative diseases.

The highest rates of reported concussions for US male high school and college athletes occur in football, ice hockey, lacrosse, wrestling, and soccer. For female high school and college athletes, soccer, lacrosse, and basketball are associated with the highest rate of concussion.