Doctors’ Notes


Concussions & ImPACT Tests

Biochemical Scramble and the Importance of ImPACT Testing for Your Children

Concussion comes from the Latin word concussus meaning to shake violently. The tremendous force of a blow to the head can create contusions (bruises) and a loss of nerve connections in the brain. These nerve connections help us perform basic functions like concentration, reaction time, short and long term memory, and visual cognition, as well as basic things like sleep, speech, and emotions.

Concussions occur from these contusions and neuron tears, and also from a kind of biochemical scramble. Though we often think of concussions occurring from fast, hard-hitting sports like football and ice hockey, they can occur from any collision (including bicycle, ATV, and skateboard accidents) or contact activity (such as soccer, gymnastics, or even dancing).

What really makes our brain work are the connections formed by chemical transmitters. Our brains establish these connections as we grow, and their potential is realized when we reach our 20s. Adults have already made all the connections they’re going to make, but children have not. That’s why concussions are so dangerous to children, and why it’s so crucial to recognize them before more serious injuries, like Second Impact Syndrome or Post-Concussion Syndrome, can occur.

A critical way to assess these brain functions both before and after an injury, and so a critical way both to accurately diagnose concussions and to monitor recovery from them, is an ImPACT test.

ImPACT (Immediate Post-Concussion Assessment and Cognitive Test) was developed almost twenty years ago, right here in Pittsburgh, by the UPMC Concussion Center. ImPACT, which can be given to children 10 years of age and older, assesses a child’s alertness and function. The child completes a set of questions about symptoms, then goes through a series of exercises designed to test the network of functions that the brain can perform. The test produces a baseline result score for each type of function.

Having a baseline report before an injury occurs is absolutely essential, because the baseline is the comparison doctors will use to assess changes or damage caused by a concussion.

If a child suffers a head injury, he or she can, as part of a comprehensive neurological evaluation, repeat the ImPACT test within 72 hrs of the injury. By comparing the results of the baseline test and the post-injury test, and then considering them in conjunction with a physical exam, a doctor can determine:

  1. If a concussion occurred;
  2. The relative severity of the concussion;
  3. The focus of any therapy to help recover from the concussion.

Baseline scores are relative for two years.

At Kids Plus Pediatrics, we offer ImPACT testing in all our offices, at any time we’re open – including Saturday and Sunday mornings. A baseline test doesn’t require a physician visit. A post-injury test occurs in conjunction with a physical exam by a doctor. We can discuss the results with you, and, if necessary after an injury assessment, refer you to a certified concussion center for more treatment.

At Kids Plus, we focus on wellness and prevention for every one of our patients. That’s why this baseline testing, especially for active and athletic children, is so important.

Concussions are much more common than most people know. 90% of most diagnosed concussions in children do not involve a loss of consciousness. Unless you can spot the signs and symptoms, a concussion in your child could go undiagnosed.

With ImPACT baseline testing, and with the concussion handout and discussion we provide after the test, you and your children will be more aware of concussions and the dangers they present. Most importantly, you will be better prepared to recognize and to treat concuss ions if they occur.

Working together, we can minimize the risks and effects of head injuries on our Kids Plus patients and their families.

For more on the effects and treatment of concussions locally, see this Pittsburgh Post-Gazette article, and this Pittsburgh Tribune-Review article, in which the American Academy of Neurology recommends a new standard of treatment and evaluation for youth sports head injuries that Dr. Godinez and Travis Lewis are both trained and certified to deliver.