Dr. Allison Hennigan, a board-certified neurologist at Northeast Texas Neurology Associates, leads the Oct. 27 Walk With a Doc. She will discuss concussions. 

Walk With a Doc, a project of the Smith County Medical Society, begins with registration at 5:45 p.m. Thursdays at Rose Rudman Trail. The presentation begins at 6 p.m., followed by walking.

For more information on Walk With a Doc, call the Smith County Medical Society office at 903-593-7058 or visit walkwithadoc.org/our-locations/tyler-tx/.

What is a concussion? What sports have the highest risk for concussion? A concussion is a mild traumatic brain injury that occurs when the brain hits the inside of the skull in response to the head hitting something external. Football has the highest risk for men’s sports; soccer has the highest risk for women. Cheerleading and baseball also have risk.

When should an athlete be pulled from a game? When in doubt, sit it out! Anytime there is a suspected concussion, an athlete should be pulled. 

When should an athlete be allowed to participate again? After a concussion, most schools have a return to play program. This monitors after-concussion symptoms at different levels of exercise. After concussion symptoms include trouble concentrating, headaches, nausea and balance problems. Of note, the recommendations used to be to keep the person awake after a concussion, but that is no longer the case. Rest is very important, especially in the first two to three days. If post-concussive symptoms persist after that (if the person still has headaches or dizziness), it is OK to continue a mild exercise regimen as long as their symptoms are not aggravated by the activity. Some people need to take time off school after a concussion because mental activities can aggravate concussion symptoms, as well. But they absolutely need to get back to school before they can get back to playing.

What is the best way to prevent concussion? If you’ve had one concussion are you more likely to get another?

The only way to prevent a concussion is not to play. Helmets help prevent devastating head injuries, but concussions are still there. There are some drills and certain ways of hitting in football that are more likely to lead to concussion, which is why they have been outlawed by different rules. Stanford University took a big step and decided to have no-contact football practices to reduce the incidence of concussions last year. Their record was actually better than before. Following the rules protects players for the most part. Having a concussion previously is the biggest risk factor for having another concussion.

Are there any lasting health consequences of one concussion? Multiple concussions? A second concussion soon after the first can lead to a much longer period of recovery (several weeks instead of several days). The chemistry of the brain changes with concussion. Blood flow increases to help the healing, and the healing is further delayed by a repeat concussion. We do not know the lasting effects of one concussion, but have a pretty good idea about the effects of multiple concussions. Chronic traumatic encephalopathy has been seen over and over again in football players (and others) and can be present with mood changes, dementia, chronic balance problems and parkinsonism.