While working with the Pittsburgh Steelers, Dr. Maroon and his colleagues developed a battery of preseason neuropyschological tests for the team. These screenings test cognitive actions like memory recall, the ability to utilize information, and rapid eye movements. "After a concussion, the patient can have problems with amnesia, confusion and concentration," said Dr. Maroon. "The damage caused after one concussion is often reversible after an appropriate recovery time, but if a second injury is sustained before then, the damage can be devastating. The decision on when an athlete is ready to return to play isn't straightforward."

Each player is tested before the season and the results are used as comparison in the event the athlete receives a blow to the head. "By having a baseline for each player at the beginning of the season, it provides a way to give coaches and athletes objective data of the player's side," Dr. Maroon said. "We use this system almost every game for the Steelers, and it is how we assessed Merill Hodge (former player with the Steelers and Chicago Bears) and recommended he not return at all."

In a recent study, approximately 1,800 professional, 500 college, and 800 high school athletes were tested in the preseason. Sixty-five of those were re-tested after suffering a concussion. The results were crucial in recommending that three professional players forego their athletic career and helped establish parameters for return to play in the rest. The entire National Hockey League and most National Football League teams have now adopted these standards of preseason neuropsychological testing.

Taking Sports Related Head Injuries Seriously

During the 1995 football season, approximately 39 percent of high school players were injured and approximately 22 percent of those who are hospitalized were admitted with a head or neck injury. In any given football season, 10 percent of all college players will sustain a head injury.

"Parents of high school or college athletes need to be aware of the potential for permanent damage their children could suffer as a result of football-related head injuries," said Brain T. Andrews, M.D., Chair of the Neurotrauma and Critical Care Sections of the American Association of Neurological Surgeons. "Every head injury should be taken seriously and it is important to understand that the damage done by multiple concussions can be cumulative.

When someone suffers a concussion, at the moment of impact, the patient's brain is rocked back and forth inside the skull. There is potential for tearing blood vessels and pulling nerve fibers. If the blow is severe, the resulting injuries can cause the brain to swell, blocking the flow of oxygen-carrying blood.

To avoid head injury, it is important to follow the following prevention tips:

• Players should always wear appropriate safety gear when participating in sports and recreational activities.

• Make sure the playing surface is conducive to safe play. The ground surface should be soft and free of debris, rocks, holes and ruts.

• Select leagues and teams that have the same commitment to safety as you do. Make sure the team coach has had training in first aid and CPR.