Amid increased awareness of the long-term damage that head-knocking sports collisions can inflict, many student-athletes are taking computer-based tests to examine their memory, reaction time and attention skills.

The exams are used to help determine whether athletes have suffered concussions, and if they have recovered. The Washington Post reports that an estimated 2 million U.S. athletes, students as well as others, have been evaluated by the best-known exam, ImPACT, which stands for Immediate Post-Concussion Assessment and Cognitive Testing.

Many student-athletes are given a baseline test at the start of a season. If they suffer a possible concussion in a game, they are tested again to determine whether if they can return to play. The growing use of tests is fueled partly by laws passed over the last two years in 33 states and the District of Columbia requiring medical clearance before an athlete who has suffered a concussion can re-enter the game.

The reliance on ImPACT, as the Post put it, also “reflects growing public unease about the state of our kids’ gray matter. News stories about brain-damaged former NFL football players and reports from Afghanistan and Iraq, where 200,000 U.S. service members have suffered head injuries over the past decade, have also raised concerns about concussions, which almost seem routine in some sports.”

Yet ImPACT’s boom has drawn critics. Some contend the tests are less reliable than widely assumed,  and that they are administered mainly for legal protection.

“A lot of school districts think they’re running liability risk if they’re not doing something,” said Christopher Randolph, a clinical professor of neurology at Loyola University in Chicago. Randolph contends that the danger of concussions is overblown, and that the most severe sports head injuries are caused by internal bleeding and swelling of the brain lining, not concussions.

Concussions typically are the result of a collision that causes the brain to be shaken inside the skull, causing such symptoms as difficulty thinking clearly, headaches, dizziness and mood changes.  Medically, not much can be done to treat a concussion beyond resting athletes so that second concussions don’t occur while they are recovering.

On occasion, athletes have suffered “second impact syndrome” — an instance of severe brain damage sustained while a person is healing from initial injuries.

Given that danger, and the frequency of the injuries —  according to the Centers for Disease Control and Prevention, 1.7 million concussions and other traumatic brain injuries occur in the U.S. each year — tests such as ImPACT have many supporters.

“We don’t want crippled 13-year-olds because they were put back into a sporting event they should have been left out of,” said Dr. David Milzman, an emergency physician in the Washington area who has championed the use of ImPACT at local schools. “It’s not that complicated. Enough of this ‘Shake it off, kid,’ stuff.”


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