Doctors know little about concussions, inquest told

What the medical profession knows about concussion is still “the tip of the iceberg,” CHEO emergency physician and concussion specialist Dr. Roger Zemek told an Ottawa inquest Monday.

Zemek, who led a team that produced concussion management guidelines for the medical profession, parents and caregivers, said CHEO is seeing the equivalent of two to three concussion cases a day and that between 2003-2010 the number of cases doubled.

Star athlete power has also had an impact, he said.

Statistics haven’t been analyzed beyond 2010, but Zemek said it’s likely that since NHL star Sidney Crosby’s much-publicized 2011 concussion, the number of cases reported at hospitals and doctors’ offices has likely increased significantly.

Zemek was testifying at the inquest of Rowan Stringer, the 17-year-old John McCrae High School student who died of “second impact syndrome” four days after hitting her head during a high school rugby game in May 2013.

Stringer, who was apparently suffering from a concussion before her final game, had complained of chronic headaches in the final days of her life.

While as many as one-third of concussion victims still have symptoms one month after their initial injury, statistics are skewed by the reality that many students do not report concussions and will simply play through them.

If the injury is not obvious, or the injured player “self-identifies,” the invisibility of the brain injury makes it almost impossible for coaches and parents to know whether a child needs to be withdrawn from play — a move young athletes know is the consequence of admitting to concussion symptoms.

Coaches don’t need to be concussion experts, but they do need basic knowledge that would allow them to raise suspicion when they see a player who is possibly concussed, said Zemek. All 50 U.S. states have legislated policies on concussion that require sports coaches to have taken a course in “concussion competency,” he noted.

Prior to Rowan Stringer’s death there were no concussion policies in place at area schools.

The inquest continues Tuesday.