"There is no safe blow to your head. Just like there is no
safe cigarette." These words, spoken by Dr. Bennet Omalu, the
now-famous physician and forensic pathologist who first discovered
the debilitating effects of multiple concussions in National
Football League players, mean that any time an athlete suffers a
head injury it is a serious injury which could have concussion
Nature, Causes, and Symptoms
The Canadian Concussion Centre explains that a "concussion
is a brain injury caused by a swirling movement (rotational
acceleration) of the brain within the skull, either by a direct
blow to the head or body, or by a whiplash effect." A person
does not necessarily lose consciousness as a result of a
concussion. Concussions are also known as "mild traumatic
Sports-related concussions are typically associated with contact
sports such as football and hockey. But, basketball and soccer have
also become known for concussions. Concussions can be sustained in
any sport as a result of collisions with an opponent, teammate, the
playing surface, a piece of equipment, or an object in the playing
If an athlete sustains a concussion, they will likely experience
mental and physical symptoms, including: an inability to
concentrate; memory loss; headaches; and fatigue and drowsiness.
For most individuals, the symptoms usually dissipate in
approximately 10 days, but in some cases, physical, mental,
emotional and behavioural issues persist. This is commonly referred
to as "post-concussive syndrome." As well, if one
sustains repeated concussions in short succession, the individual
may also suffer from "second impact syndrome" which can
be life-threatening if not treated properly.
Evaluation and Assessment
Medical evaluation and treatment should be provided to an
individual immediately following a concussion in order to determine
vital signs, consciousness level and other potential injuries. In
cases of minor concussion, athletes are evaluated on-site during a
"sideline assessment." In severe cases, evaluation and
treatment must be sought from a hospital emergency department.
A neurological assessment can detect impairment and disturbances
in brain function and consists of neuropsychological testing
related to attention, memory and information processing speed. Such
testing is repeated at regular intervals to determine whether an
athlete has returned to baseline level performance. A person who
experiences persistent post-concussive symptoms must undergo a more
thorough neuropsychological evaluation which includes physical
testing and medical imaging.
Prevention and Treatment
A key preventative measure is to change the rules for contact
sports, but before such a drastic change occurs, prevention of
concussions can include: advanced helmet design; improved physical
conditioning with an emphasis on strengthening neck muscles;
developing heightened awareness of the playing area and potential
hazards and stricter rules to avoid contact that can lead to
contact with the head.
In addition to prompt medical assistance, treatment of a
concussion may also include the following: a description of
symptoms (indicative of worsening brain injury and common
post-concussive symptoms); education of player and coaches;
cognitive rehabilitation and psychological support.
Don't Just 'Play On'
Mario Manningham, an NFL wide receiver for the San Francisco
49'ers, once said concussions were "part of the game ...
until it's you." Although attitudes in the sports world
are changing, more education is needed to warn athletes about the
severity of concussion, how they can take precautions to prevent
them and to ensure anyone who receives a blow to the head receives
immediate medical attention and be monitored afterwards. Don't
just shake it off! Be diagnosed and follow through with proper
In Irwin v. Alberta Veterinary Medical Association, 2015 ABCA 396, the Alberta Court of Appeal found that the "ABVMA" failed to afford procedural fairness to a veterinarian undergoing an incapacity assessment.
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