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B renna Hughes, team leader lan- guage pathologist for acute care speech, examined a 16-year-old boy named Sam at Community Regional Medical Center in downtown Fresno. He was suffering from a spinal cord injury and a concussion that he sustained while playing football. As Hughes conducted the cognitive examination she asked Sam and his mother if he had ever sustained a concussion before. Their answer was no. However, once Hughes explained what a concussion really was and some of the ef- fects of a concussion, it became explicitly clear that Sam had indeed suffered from at least one and possibly as many as six in his past, including two less than a week apart. While Hughes was concerned about Sam's concussion, she was more alarmed that everyone involved had little under- standing of traumatic brain injury and seemed oblivious to the fact that athletes and others in high risk situations suffer from concussions all the time. "We are in the stone age when it comes to brain injury awareness," Hughes said. "I think here in the central valley in par- ticular we are 20 years behind where we should be." For Hughes, the realization that there is a severe lack of education in identifying concussions and traumatic brain injury came eight years ago. Already an advo- cate for concussion education, Hughes was serving as a member of the sports injury prevention committee at Valley Children's Hospital in Fresno when she discovered that the seriousness of brain injury was not fully understood, even by local trauma surgeons. While the focus of the committee was to discuss return-to-play policies for youth athletes who had suffered from a concussion, Hughes voiced her concerns about how the kid was going to perform in the classroom. One of the head trauma surgeons dismissed her concern imply- ing that she was overreacting to what amounted to a bump on the head. "There are so many different layers to this problem when it comes to the lack of awareness and education," Hughes added. In Sam's case, he was cleared to re- enter the game by a licensed medical professional while he was still displaying symptoms from his last concussion. Whether it is a blow to the head or a jerking motion that causes the brain to bounce off the inside of the skull, a con- cussion causes a metabolic crisis within the brain. Axons, which form electrical and chemical currents throughout the brain, are torn from their neurons, releas- ing high levels of potassium and other chemicals into the body resulting in head- ache or dizziness. The effect gets worse the longer the injury goes untreated, and leaves the patient more susceptible to ad- ditional concussions. "When you have a concussion, the brain is trying to piece itself back together," Hughes said. "It is the repeated trauma while the brain is still trying to heal that t e x t b y pat r i c k d i l l o n Despite protocols and preventative measures, experts say there are still too many con- cussions in youth sports due to a lack of understanding and attitudes about sports Bring down concussions? Are we doing enough to MINERAL KING PUBLISHING INC | FSGNEWS.COM | 19 Mental HealtH

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