As for Ali Champness, she sat out the rest of the season on the advice of Dr. Mark Ashley — co-founder and head of the Centre for Neuro Skills, which has clinics in Bakersfield and Irving, Texas, specializing in traumatic–brain injury rehabilitation. Champness joined the school's swim team, but after three weeks she called her mom from a competitive meet in a panic. "Mom, you need to get me to a doctor," Kim Champness remembers her daughter saying.
At Ashley's center, an MRI and a CAT scan revealed bleeding in Champness' brain. A cardiologist found that the initial concussion had deregulated Champness' autonomic nervous system. For months, whenever she jogged on the treadmill, her heartbeat soared high enough to trigger cardiac arrest or stroke. Champness still goes to rehab three hours a day.
Among other severe cases Ashley has handled was one dating back five years, which involved Zackery Lystedt, a 13-year-old football player from the Seattle suburbs nicknamed "Ray Ray" after his idol, rampaging Baltimore Colts linebacker Ray Lewis. In the second quarter of a game, Lystedt fell backward after an unremarkable tackle and hit the back of his head, although the injury escaped the notice of his father in the stands. "I thought he had gotten the wind knocked out of him," Victor Lystedt recalls.
Lystedt played every down for the rest of the game, even forcing a fumble and sprinting to a 32-yard return. But when his dad met him after the game, Lystedt started stumbling and muttering, "My head hurts really bad."
He collapsed onto the field. His left eye suddenly "blew out" and turned an inky black, the result of swelling in his skull. Then he convulsed into dozens of strokes. Says Victor, who witnessed the spectacle, helpless and confused, "My boy was dying on a football field."
His son survived, but his serious health problems continue.
Concussive episodes in youth aren't limited to soccer and football players, says Dr. William Jones, a staff physician at the Memorial Hermann Sports Medicine Institute in Houston. In recent years, due partly to better detection, Jones has witnessed a staggering increase in concussions, even in high school cheerleaders and 10-year-old gymnasts.
Because of this, school districts en masse are adopting new procedures for dealing with blows to the head. The most popular is the ImPACT test. A simple computer program designed by a pair of Pittsburgh doctors in the early 1990s, the exam finds an athlete's "baseline" — his mental aptitude and quickness of reflexes when he's not suffering concussive symptoms — which can be used later in a comparative test to see if a collision has caused a lag.
But the test has hit real-world snags. The first is its price: At packages costing roughly $600 per school for the first year, ImPACT is too expensive for some districts. And many of those that do buy the program cannot afford to pay a specialist to administer it. Instead, that duty tends to fall on coaches or trainers, who often are unqualified to conduct the test. As shown in a case in the New York City suburbs, the results can be tragic.
In 2008, Ryne Dougherty, a 16-year-old high school linebacker in Essex County, N.J., sat out three weeks following a concussion. But after taking an ImPACT test, he was cleared to play. During his first game back, he suffered a brain hemorrhage; he died within a week.
Dougherty's ImPACT results were ominously low, the family has claimed in a lawsuit against the school district. Additionally, according to the test results, Dougherty reported feeling "foggy" but still was cleared to play.
"Fogginess is the lead predictor of lasting head trauma," says Beth Baldinger, the attorney representing Dougherty's family in a suit against the district. "This case screams ignorance."
Michele Chemidlin, the trainer who administered the test, did not respond to phone messages and an email requesting comment for this story. She told Sports Illustrated that Dougherty's test was interrupted by a "disruptive" teammate, which made the results "invalid." But Baldinger says the trainer retracted that story in a recent deposition.
"She testified that she never even bothered to see Dougherty's test results," says the attorney. "It was one of the most brutal depositions I've ever been involved in. She left the room crying several times."
Kenneth Podell, a Detroit neuropsychologist and one of the creators of ImPACT, declined to comment specifically on Dougherty's case. But he says that in ideal circumstances, the test should be administered by a medical professional.
"It's better than nothing," says UCLA's Hovda of ImPACT. "I don't mean any disrespect, but neuropsychological tests, which require responses and performance from individuals, are always going to have problems because there's always going to be variances."
One of those variances is that an athlete can cheat the system. In April, Indianapolis Colts quarterback Peyton Manning flippantly admitted he intentionally performs poorly on baseline exams so that if he takes postconcussion tests, the results won't look as bad. NFL Commissioner Roger Goodell later said that cheating on concussion testing is an issue the league must address.
Complicating head-trauma detection is a recently released Purdue University study that concludes that youth athletes who aren't clinically diagnosed with a concussion still can experience fundamental brain changes that may be detrimental.
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