SPORTS CONCUSSION BASELINE: A Small But Highly Preventative Investment In Your Cognitive Future

In the winter of 1997, I received a call from a colleague in Buffalo, NY asking if I would be interested in evaluating the Buffalo Sabres Hockey Team.  Their top-scoring player had sustained two concussions within a week and was sidelined.  The team physician wanted guidance on how to decide if and when a player should return to play.  I accepted the request and agreed to conduct baselines on all players.  My contract, after the baseline cognitive measures were obtained, was to serve as the team Neuropsychologist (a friend and colleague was just commissioned to do the same with the NY Jets).  If a Sabre sustained a concussion, I agreed to evaluate the player within 24 hours of the concussion, and compare data to the baseline; advising whether or not he should return to play.

Fast forward to 2015.  Sideline sport coaches of soccer, snow boarding, Lacrosse, football, field hockey, baseball, softball, and all youth contact sports, are all concerned about potential player concussions and how to evaluate.  Yes, there are Apps to assist coaches and trainers in assessment of readiness to return to the field, but they are not scientifically based.  Typically, the individuals using these tools are not qualified to make such clinical decisions. A brief neuropsychological battery of cognition, conducted by a Board Certified Neuropsychologist, captures baseline data and compares results in the unfortunate event of a concussion.   The data serves to determine when a player should return to play, or what length of time is needed for recovery. Without this data, predictions of future cognitive potential are not possible.

As a Board Certified Neuropsychologist, I have conduced hundreds of evaluations of children, adolescents, and adults to determine clinical status after a concussion or multiple concussions in a short period of time.  The data speaks for itself.  If an athlete evidences a significant decline from baseline, the clinical data is provided to the family with recommendations for treatment and/or sideline healing.  Years ago, without such data, decisions were based on whether an athlete sustained loss of consciousness or not.  Neurologically, that is no longer a benchmark in the world of concussions.  Concussions are not additive; they are multiplicative, particularly if sustained within a short period of time. In other words, a second concussion sustained in a short period of time can change a minor problem to a major complication.  If intervention is not initiated, long-term cognitive consequences can be detrimental and permanent, especially in a young athlete    whose brain maturation is incomplete.  The media is now reporting the long-term effects for football players who sustain multiple concussions over their careers, and the increased potential for early dementia and brain deterioration.

The best form of prevention of cognitive deficits, is baseline evaluation and immediate re-evaluation following trauma.  Baseline data is compared with post-injury data, to determine the most appropriate course of action (medically, educationally, and psychologically).  Prognosis improves dramatically with immediate intervention, while it declines after a concussion which has not been cognitively evaluated to determine one’s suitability for continued participation.

Fortunately, a baseline exam takes a mere 30-45 minutes conducted by a Board Certified Neuropsychologist with experience and training in sports concussions.  If a concussion occurs, the Neuropsychologist evaluates the athlete within 24 hours, and triages his/her care with the primary care physician, team coach, and family.  “An ounce of prevention is worth a pound of cure.”  I have been conducting these evaluations regularly since being commissioned by the Buffalo Sabres to assist with sports medicine.  If interested in further information, please contact me at www.drsorman.com and submit a request for a consultation.