What’s a Baseline Concussion Test and Does My Child Need One?

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Concussions are common sports-related injuries, especially among high school students. Most of the time, when a child hits his or her head, the impact is low and only a hematoma (a swelling of clotted blood) forms outside of the skull causing that goose egg we see and feel. This eventually absorbs, and there are no further complications. Sometimes the structures inside of the skull are involved, including the brain, blood vessels, or skull bones. When these structures are injured, children can have mental and neurological symptoms that occur at the time of the injury or develop in the future. This is a concussion.

Many sports programs are requiring students to have a preseason, baseline concussion test to assess an athlete’s balance and brain function, including learning and memory skills, ability to pay attention or concentrate, and how quickly he or she thinks and solve problems, as well as for the presence of any concussion symptoms. If a student sustains a concussion during play, the health care professional and athletic trainers can compare symptoms with the baseline testing to determine the severity of the concussion, and follow the healing process to make safe decisions about when to return to school and return to play.

During baseline testing, the health care professional asks questions targeting aspects in the student’s medical history that can be affected by concussion severity. This includes previous head injuries, learning disorders, psychiatric disorders, ADHD and migraines. A neurologic physical exam looks for problems with movement, sensation, balance and coordination. Neuropsychological testing can be performed on paper or a computer program such as IMPACT – a standardized computer test specific to concussion evaluation – that examines cognitive functions, such as memory, problem-solving skills, processing speed and intelligence.

The mainstay of concussion treatment is brain rest in a low-stimulation environment, so it is important to give adequate time for the brain to rest and heal before resuming school and sports. Returning too soon may hinder the brain’s ability to heal properly and quickly, thus prolonging concussion symptoms, including headache, dizziness, sleep problems, vision problems, behavior changes, learning problems, and movement and coordination problems.

Baseline testing can be helpful when performed properly. However, some students are purposefully underperforming on baseline testing in order to return to play sooner after a concussion. This practice is strongly discouraged by health care providers and sports programs due to a significant increase in risk of major head injury when a child sustains a hit while recovering from a previous concussion.

Find more information about IMPACT testing at impacttest.com.

Dr. Kristine Uyesugi is a graduate of the pediatric residency program at Levine Children’s Hospital at Carolinas HealthCare System, and Dr. Shivani Mehta is a board-certified pediatrician at CHS Myers Park Pediatrics.