Children's Health

When It’s Time to Stop

Sports Related Concussions Can Impact Student Athletes for a Lifetime

Alizabeth Dumez, 17, loves sports. Liz, as she is known to family and friends, is a passionate athlete. That is why, three years ago when she was kicked in the back of the head during a soccer game, after some rest and ibuprofen, she was soon back participating with her team.

“The doctor told Liz to be very, very careful,” remembered her mother, Lisa Dumez. “She is not a very careful player.”

Liz’s latest sports passion is rugby. So she kept playing in a rugby match last March when she was tackled and hit in the head again. And then again. According to her mom, after the third time she injured her head, she was pulled to the sidelines.

At this point, Liz had an extreme headache, pressure behind her eyes and “triple vision” – meaning she saw three of everything.

“Her eyes were dilated so bad that there was no color left in them – just black,” said Lisa.

The family sought emergency treatment at Helen DeVos Children’s Hospital, a member of Spectrum Health. Liz returned home later that evening after undergoing scans that indicated a severe concussion. Five days later, with symptoms increasing, rather than decreasing, Liz’s family sought further treatment.

“She wasn’t thinking clearly and she didn’t understand what words to use sometimes. Her headaches and nausea were terrible,” said her mom.

Liz, who missed 20 out of 40 school days last spring, would require speech, occupational and physical therapy to help her deal with the impact of the concussion.

When the nausea wouldn’t go away, the family turned to their pediatrician for medication. He referred the Dumez’s to his colleague, Michael Lawrence, PhD, a neuropsychologist and concussion expert with Spectrum Health Medical Group.

“Dr. Lawrence asked why we were there to see him and I said I don’t know,” admitted Lisa. “I wasn’t sure why our doctor thought we needed to see a neurology specialist.”

With Dr. Lawrence, Liz underwent neurocognitive testing – mandated at the professional sports level to measure the impact of head injuries – which she “failed miserably.” Dr. Lawrence also conducted a detailed clinical interview and assessed Liz’s balance and visual tracking abilities. 

“This is important because concussions can affect patients differently based upon the brain system involved,” said Lawrence. “Every concussion is a brain injury and young people’s brains are more vulnerable than adults. They are more likely to suffer concussions and often take longer to recover.”

Based upon his evaluation, Dr. Lawrence recommended a detailed plan of action tailored for Liz. The family was referred to a neuro-ophthalmologist because of a potential vision problem known as convergence insufficiency which can cause symptoms of fatigue, headache and nausea. 

The family was concerned that Liz was becoming depressed because she was not allowed to be active. Dr. Lawrence recommended that Liz ease her way back into activity. School was still a concern given the visual demands of learning. Lawrence predicts that Liz will need numerous school-related accommodations in order to successfully navigate her academic career.

Liz was thrilled to learn that she could engage in some exercise – walking, running, even machine workouts at the gym – after six months of being prohibited from any activity. However, the high school senior will have to forgo impact sports and even activities like bike riding – which can aggravate her visual system – for the immediate future and possibly for the rest of her life.

Dr. Lawrence says that parents, coaches and athletic trainers need be educated about the risks and the consequences of playing with concussion. He has the following suggestions for parents whose children play contact sports:

• Wearing proper, well-fitting equipment is a must.
• If an athlete sustains a concussion during play, they should not be allowed to return to the game and should not be allowed back to activity, until cleared by a medical professional.
• Know the common symptoms of concussion. Headache, dizziness and fatigue are common. Vomiting and prolonged loss of consciousness are uncommon symptoms and may suggest more severe brain injury. If any of these symptoms occur, seek prompt emergency medical care.
• Learn from Liz. With rest and proper treatment most athletes quickly and completely recover. However, repeated concussions in close proximity can have devastating effects and can lead to prolonged and intractable symptoms.

Lisa Dumez has succinct advice for other parents of enthusiastic young athletes:

“Pull them out after any head injury. Don’t take the chance; take precautions.”

Spectrum Health is a not-for-profit health system in West Michigan offering a full continuum of care through the Spectrum Health Hospital Group, which is comprised of nine hospitals including Helen DeVos Children’s Hospital, a state of the art children’s hospital that opened in January 2011, and 190 service sites; the Spectrum Health Medical Group and West Michigan Heart, physician groups totaling more than 700 providers; and Priority Health, a health plan with 600,000 members. Spectrum Health is West Michigan’s largest employer with more than 18,000 employees. The organization provided $176.5 million in community benefit during its 2011 fiscal year.