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S u m m e r 2 0 1 2  
H E A L T H b e a t
of patients hospitalized
with head injuries are
younger than 25.
Once a concussion
occurs, an athlete becomes
four to six times
more likely to sustain a
second concussion.
Headlines about concussions
in athletes
of all ages have made their way into the national spotlight
over the last several years—and for good reason. Amid
the stories of professional athlete fatalities and young,
high school athletes suffering lifelong damage linked to
concussions, numerous research studies have surfaced
showcasing the devastating and life-altering effects of
untreated concussions.
The statistics are alarming. According to Health Care
Communication News, each year athletes suffer 1.6 mil-
lion to 3.8 million sports-related concussions, and half
of patients hospitalized with a head injury are less than
25 years old. Unfortunately, proper diagnosis is difficult—
less than 10 percent of concussions result in loss of con-
sciousness. In addition, getting a second concussion while
still having symptoms from the first can be lethal.
A movement for change
The subject of concus-
sions made its way through the Texas Legislature in the
form of House Bill 2038, which was put into effect imme-
diately after approval. The bill focuses on the prevention,
treatment and oversight of concussions affecting public
school students participating in interscholastic athletics.
Requirements stemming from the bill include es-
tablishing a concussion oversight team at each school
and ensuring that concussions not only continue to be
managed but receive treatment as medical conditions.
The concussion oversight team enforces “return to play”
protocols and recommends treatment that may also be
implemented at home.
“Concussions have been managed for years, but
nowwe need the treatment aspect to coexist with the man-
agement and on an individualized level,” says Mark Dun-
can, licensed athletic trainer, Shannon Sports Medicine.
“Students must be 100 percent recovered before we send
them back into play, or they could suffer severe damage.”
How Shannon is helping
In order to help ensure
that the proper care and treatment are administered to
San Angelo and West Texas student athletes, Shannon
neurologists and the sports medicine department have
implemented the Shannon Concussion Clinic and a
universal treatment regimen for concussions among all
Shannon providers.
Each medical professional administering concus-
sion treatment has received ImPACT (Immediate
Post-concussion syndrome
Although the majority of
athletes who experience a
concussion are likely to re-
cover, an unknown number
of these people may experi-
ence chronic cognitive and
neurobehavioral difficulties
related to recurrent injury.
Symptoms may include:
Chronic headaches.
 Sleep difficulties.
 Personality changes
(such as increased
irritability or emotionality).
 Sensitivity to light or
Dizziness when standing
Deficits in short-term
memory, problem solving
and general academic
This constellation of
symptoms is referred to
post-concussion syndrome
and can be quite disabling
for an athlete. In some
cases, these difficulties
can be permanent.
In addition to post-
concussion syndrome, ex-
periencing a second blow
to the head while recover-
ing from a concussion can
have catastrophic conse-
quences, as in the case of
second-impact syndrome,
which has led to approxi-
mately 30 to 40 deaths
over the past decade.
Source: ImPACT
Concussion Clinic makes an ImPACT
Signs observed in athlete
Symptoms reported by athlete
Appears to be dazed or stunned
Is confused about assignment
Forgets plays
Balance problems or dizziness
Is unsure of game, score or opponent
Double or fuzzy vision
Moves clumsily
Sensitivity to light or noise
Answers questions slowly
Feeling sluggish
Loses consciousness (even temporarily)
Feeling “foggy”
Shows behavior or personality changes
Change in sleep pattern
Forgets events before hit
(retrograde amnesia)
Concentration or memory problems
Forgets events after hit
(anterograde amnesia)
Common signs and symptoms of a concussion
Post-Concussion Assessment and Cognitive Testing)
certification. James Williams, MD, a Shannon family
practice physician and medical director of the Shannon
Concussion Clinic, has been an ImPACT-certified phy-
sician since 2006. Before joining Shannon in 2011, he
served as the head team physician at Ripon College in
Wisconsin and supervised the ImPACT testing program
for seven rural school districts in Wisconsin.
Before school sports begin this fall, Shannon Sports
Medicine will ask area junior high and high school
athletes to take the ImPACT test. The test, which takes
approximately 20 minutes, measures multiple aspects of
cognitive function in athletes, including:
Working memory.
Sustained and selective
attention time.
Response variability.
problem solving.
Reaction time.
At the end of the test, a baseline is reported. If an
athlete later sustains a head injury, an ImPACT-certified
medical professional administers a follow-up test and
a f e t y
then compares the outcome to the baseline result. From
there, a treatment plan is established on an individualized
basis. The plan is then shared with the school district.
Treatment involves eliminating certain activities that
stress the brain, Duncan explains. This can include no
texting, television or video games, along with modifica-
tions in the classroom setting. He says it is up to parents
to make sure these rules are enforced at home as well.
“We want to prevent the long-term effect of concus-
sions and ensure the health of the student athletes in our
area so they may go on to lead a bright future beyond the
field or court,” Duncan says.
Reach out
Shannon Sports Medicine provides
on-site injury assessment when the team is present
at sporting events. Parents may also seek concussion
evaluation or treatment for their children by calling the
Shannon Concussion Clinic at