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Josh loved to play soccer. While normally a quiet nine-year-old, his competitive nature came out in full force when he hit the field. During a regular season game, he collided with an opposing player on the field. Despite the concerns of his coach, he insisted on staying in the game.

Later that evening, Josh’s mom noticed he was struggling to answer simple questions, and she knew the situation was more serious. A trip to the emergency room confirmed a mild concussion.

What is a concussion, and why is it so serious?

The Sports Concussion Institute defines it as a “complex pathophysiological process that affects the brain, typically induced by trauma to the brain. It can be caused either by a direct blow to the head or an indirect blow to the body, causing neurological impairment.”

According to the Center of Disease Control and Prevention, approximately 1.6 million to 3.8 million concussions are estimated to occur each year.

In essence, a concussion is considered a brain injury. Under normal circumstances, the human brain floats within the skull surrounded by cerebral spinal fluid. This fluid acts as a shock absorber for minor impacts.

When the brain is forced to one side of the skull and makes contact with the hard surface of the skull as a result of a strong impact, a concussion has occurred. The danger of a concussion is that delicate neural pathways in the brain could be damaged by that impact, thus resulting in neurological damage or disturbances.

“When a brain injury has occurred, it’s really best to err on the side of caution,” advised Dr. David Hilmo, a Physical Medicine and Rehabilitation Specialist. “When a patient has experienced a head injury, he may not notice the onset of symptoms — but family members or friends may notice a change in behavior, confusion, change in personality, cloudy thinking or inability to respond to questions.”

Hilmo explained that a patient will likely report a headache or feel dizzy. In fact, the CDC reports these are the two most common symptoms reported immediately following the incidence of a concussion by injured athletes. Although the patient may downplay the way he feels, it is important to see a physician to be sure the brain injury isn’t more serious.

While it is difficult to anticipate and prevent brain injuries on the field, you can take measures to protect children during normal physical activities. Hilmo recommends helmets.

“Fortunately the use of helmets is becoming more in style with high-profile athletes in cycling, snowboarding and longboarding, so it is easier to convince your kids of the importance of wearing protective headgear,” Hilmo said.

Watching people, both young and old, engage in daily physical activity is a good thing. But an important part of those activities is knowing what signs to look for in the event of a brain injury. Know the signs, seek immediate medical care and wear protective head gear when possible.