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Concussion danger cited in the young; Incomplete recovery shown to be high risk

A new study highlights the heightened danger to young athletes who suffer concussions and sustain new blows to the head before they've fully recovered.

The study, published today in the journal Pediatrics, comes on the heels of efforts across the country -- including in New York State -- to bar athletes with concussions from returning to athletics until they have fully recovered.

The study dug into the National Registry of Sudden Death in Young Athletes, a database maintained by the Minneapolis Heart Institute Foundation, to focus on deaths from blunt trauma among players 21 and younger. Previous studies from the data focused on deaths from cardiovascular problems.

A key finding was a worrisome number of prep football players who died of head and neck blows after they had already recently suffered, one of the study's authors, Dr. Barry J. Maron, said in an interview. Maron said the new data comes at a time of growing awareness about concussions, including the dangers of "second-impact syndrome."

The registry listed 1,827 sudden deaths among young athletes from 1980 to 2009. More than 14 percent of them, or 261, were caused by trauma-related injuries. Trauma fatalities were most frequent in football, at 148, including 17 high school players who died of head or neck injuries after they had already suffered concussions a few days to four weeks beforehand.

In general, the authors wrote, trauma deaths among young athletes are relatively uncommon, and they're four times less common than cardiovascular deaths. The average has remained relatively constant at about nine per year.

"Nevertheless, these catastrophic events remain an important public health issue with a devastating effect on families, communities, and physicians," the study says.

According to the study, most of the deaths were preventable and showed the importance of better equipment, better protocols for when injured athletes should return to action, and possible changes in blocking and tackling rules.

Dr. Joel I. Brenner, incoming chairman of the American Academy of Pediatrics' Council on Sports, Medicine and Fitness, said the study contains important new information.

"It gives credence to everything we've been trying to do to make it safer for young athletes out there with proper treatment of concussions," said Brenner, medical director of the sports medicine program at Children's Hospital of the King's Daughters in Norfolk, Va.

Last week, the New York State Legislature gave final approval on a bill requiring student-athletes suspected of suffering concussions to be immediately benched, and kept sidelined from sports or gym classes until they're symptom-free for at least 24 hours and obtain written authorization from a doctor.

If signed into law by Gov. Andrew M. Cuomo, the bill would go into effect July 1, setting standards for all 700 public schools in New York in an effort to reduce the number of concussions in contact sports. Such injuries can lead to adverse health effects on students for years after they were injured.

Given recent moves across the country to bar athletes with concussions from playing until they've fully recovered, the study also hit home for Jon Almquist, head of the athletic training program for Fairfax County Public Schools in Virginia. He said the 17 deaths cited in the study were probably preventable.

"Maybe that catastrophic number can take a dip because of the changing awareness and changing concussion protocols," said Almquist, chairman of the secondary school athletic trainers committee of the National Athletic Trainers Association.

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