Dr. Bert Vargas on Concussion

Dallas sports neurologist Dr. Bert Vargas answers questions about concussion.

What happens to the brain during a concussion?

During a concussion, the brain experiences very complex structural, metabolic, and physiologic changes that lead to a disruption in its normal functioning. When given the proper amount of time to recover and return to its normal operating processes, the brain usually returns to normal.

But if frequent injuries occur, particularly during the vulnerable period after an immediately after an injury, longer-lasting problems, permanent damage, or death of brain cells can occur.

How are sports-related concussions different from other concussions?

There is probably little difference pathophysiologically, but the truth is that no one really knows for sure. The symptoms we see in patients after concussion from falls, motor vehicle accidents, or even blast injuries are very similar to the symptoms we see from concussions in sports. As the science develops, we may learn for sure whether there are any major differences.

Treatment, however, can be quite different. When treating athletes, I look to immediately evaluate them for more life-threatening or sinister underlying causes of their symptoms, then validate their concerns with a diagnosis; ensure they are removed from play to prevent further injury; and start them on a plan for eventual return to learn and return to play. Part of treating the athlete includes knowing what they are like at baseline and stratifying their risk for future injury based on their sport and their position. In many cases, my patients are student athletes, so the primary objective of their treatment is to make sure they return to the classroom.

What is supposed to happen when a student athlete gets hit in the head during a game or practice? What is he or she supposed to do?

At the moment – because the science hasn’t progressed as far as we need it to – in many cases, we are left to depend on the individual to reporting his or her symptoms. I do not recommend that athletes test themselves or make their own remove or return-to-play decisions as concussion can leave one with cognitive impairments that effect their ability to make rational, informed medical decisions.

If someone who knows the athlete well – like a parent or coach – sees the athlete not acting right, then we recommend that that person remove the athlete from play immediately and get him or her to a healthcare provider who can perform the appropriate evaluation and testing.

Things to watch out for include headache or neck pain, dizziness, nausea, blurred vision, ringing in the ears, confusion, and slowness in thinking, to name just a few.