Preventing second concussions a priority for AGH Concussion Center
Playing with symptoms caused by a head injury is
not a smart choice for athletes — no matter what
their age or skill level. It is well known that once a
concussion has occurred, an athlete is three to five
times more likely to have a second concussion. If
a second concussion occurs while the athlete is
still recovering from the first concussion, its effects
may be compounded. In rare situations, a second
concussion (also known as the Second Impact
Syndrome) may even lead to death.
“Concussions account for more than 20 percent of all
injuries suffered in competitive athletics and appear
to be rising in virtually all sports,” said Edward
Snell, MD, director, Division of Sports Medicine,
Allegheny General Hospital (AGH), and director,
AGH Concussion Clinic, both a part of Allegheny
Brendan Donovan (left) and Edward Snell, MD
Health Network (AHN). “This increase has raised
concern regarding the potential cumulative effects
“One of our goals is to make testing simpler to administer and
of multiple concussions in athletes. Pennsylvania’s ‘Safety in Sports
interpret by creating portable testing systems so that athletes
Act’ is helping to address this problem by establishing standards
can be assessed without needing to leave the playing field,” said
for managing concussions and other brain injuries. Players who
Kevin Kelly, MD, PhD, director of the Center for Neuroscience
describe symptoms or demonstrate signs of a concussion must be
Research at AGH. “C3 Logix is taking concussion assessment to
removed from play immediately and cannot return to play until
the next level.”
they have been cleared by an appropriate medical professional.”
However, physicians, athletic trainers and other medical
professionals often have to play a guessing game when
determining if an athlete has suffered a concussion, Dr. Snell
added. “Many athletes will not discuss any or all of their symptoms,
because they do not want to be taken out of the game,” he
said. “As a result, many concussions go undiagnosed, putting
the athlete at greater risk for permanent neurological damage
with subsequent head injuries. This issue requires expert clinical
evaluation to determine the likelihood of concussion and focused
decision-making regarding whether the athlete should return to
play. Many times, just knowing the athlete and how they react
normally can help make the decision. It is important to note
that diagnosing a concussion is based on clinical information.
Concussions are not detected by a CT scan or an MRI.”
AHN is using a new mobile technology that could revolutionize
the way concussions are diagnosed and treated. Working with
i-COMET Technologies, a Cleveland Clinic Innovations spinoff
company, AHN is testing “C3 Logix,” a concussion evaluation tool.
The tool features a new battery of tests that effectively measure
motor skills and balance by a unique iPad® application. When the
iPad is strapped to a patient’s lower back, the app collects data
that helps medical professionals to make a quick, objective and
scientifically accurate assessment of athletes who have suffered a
head injury.
Athletes who are recovering from concussions can find specialized
treatment at the AGH Concussion Center. Unlike many other
healthcare providers that treat concussions, the AGH Concussion
Center includes the specialties of Sports Medicine, Neurosurgery
and Neurology. A physician from one of these three disciplines
is the first to assess an athlete who has suffered a concussion
and subsequently coordinates care. After undergoing a
comprehensive initial neurological and cognitive assessment at
the AGH Concussion Center, the patient is given an individualized
treatment strategy. When appropriate, other specialists may see
the patient, including neuro-ophthalmologists, neuro-otologists
(hearing and balance specialists), neuropsychologists, physiatrists
or physical therapists.
A blow to the head should be a wake-up call for every athlete.
“More and more, we are hearing tragic stories about athletes who
played through concussions, only to suffer severe neurological
problems later in their lives,” said Dr. Snell. “Hopefully, better
educatio