Concussions: Teen's Tragedy Spurs Policy Change

By Kathleen Doheny
WebMD Health News

Reviewed by Hansa D. Bhargava, MD

Oct. 15, 2014 -- At 13, Zackery Lystedt was a star player on his junior-high-school football team.

Then one game changed everything.

It was the second quarter. Lystedt went down hard after making a tackle, clutching both sides of his helmet in pain. He shook it off and kept playing, taking hit after hit. Only later did his family find out that first impact had given him a concussion.

At the end of the game, Lystedt collapsed in his father's arms. He was airlifted to Harborview Medical Center in Seattle, where surgeons determined he'd had multiple strokes. They removed the left and right sides of his skull -- the only way to relieve pressure -- and left the bone out.

He spent 2 months in a coma, 7 days on life support, and 93 days in the hospital. That was in 2006.

He's spent the last 8 years relearning how to walk, talk, and regain his independence.

Lystedt told his story at a sports medicine conference at the American Academy of Pediatrics' annual meeting last week. His case helped spark a movement to create laws regarding concussions and young athletes -- laws that might have prevented his injury had they been in place 8 years ago.

Recovery Time Is Key

Each year, about 4 million sports- and recreation-related concussions happen in the U.S., according to the CDC. Of those, many affect young people.

Most of the time, concussions are minor and people can spring back quickly and make a full recovery, says Stanley Herring, MD. He's a clinical professor and co-medical director of the Sports Concussion Program at University of Washington Medicine and Seattle Children's Hospital.

Herring told the conference that giving the injured time to recover is vital.

Over the years, experts have learned much more about concussions and their effects on the brain. "It's not the first concussion, but playing while concussed that can lead to rare and devastating consequences," Herring said.

Repetitive brain trauma, including concussions and even less-severe hits to the head, is linked with a worsening brain disease known as chronic traumatic encephalopathy, or CTE.

That condition has long been seen in boxers, but more recently has been confirmed in retired professional football players and other athletes who had repeated head trauma, according to the National Institute for Occupational Safety and Health. CTE can lead to memory loss, confusion, impaired judgment, impulse control problems, aggression, and depression.

In 2013, the NFL reached a $765 million settlement with thousands of former players who have dementia, Alzheimer's, and depression. The players contend that the league hid the dangers of concussions, and in some cases, returned injured players to the field.

The mindset of allowing young athletes time to recover before they get back on the field, though, is finally taking hold. As of February, all 50 states now have a concussion law on the books, Herring says. In general, the laws call for young athletes to be removed from play if a concussion is suspected. They must also be medically checked before being approved to return to play.

None of this progress would have happened, Herring says, without the Lystedt family's efforts.

The Lystedt Law

After Lystedt's injury, his parents Victor and Mercedes sprang into action. They not only wanted to save their son's life and closely watch his medical care, but also to change policy. They began in Washington State, pushing for what would become the Zackery Lystedt Law.

Herring has been a key part of that policy-changing team, forming a bond with the Lystedt family as they lobbied relentlessly for change.

"There would be no law in the state of Washington, and I would argue elsewhere, without the Lystedt family," says Herring, who is also a team doctor for the Seattle Seahawks and Mariners.

"Trying to change social behavior doesn't happen without a story," he says.

Eventually, their efforts resulted in a Washington State bill that requires educating parents and athletes about concussions and removing athletes from play if they have a suspected concussion. They also must have an evaluation and get written clearance to return to play.

The Lystedt Law was signed May 14, 2009, with Herring, the Lystedt family, and others on hand.

"In 2010, the NFL joined in the effort to pass youth concussion laws in all 50 states," Herring says. "Their help was of great value."

At first, "there was a big concern that athletes would hide their injuries," Herring says. But since then, research has tracked concussions before and after the law took effect. More concussions have been reported after the law's effective date than before, he says.

Also, "we've made great strides with coaches," Herring says. "Coaches used to yell at me."

But with widespread concussion laws, "the coaches are grateful now. They are out of the crosshairs," he says. The laws level the playing field, so to speak: "If my guy has to come out, your guy has to come out."

Herring says there's more work to do, though. Some players still report playing with symptoms of a concussion, which can include headache, fuzzy vision, trouble thinking clearly or concentrating, sleeping problems, and anxiety. Also, some coaches aren't aware of the symptoms of concussion, he says.

Parents, too, have some learning to do. In another study presented at the conference, others found that parents still have misconceptions about concussion treatment and recovery. Researchers from the Hospital for Sick Children polled 511 parents of children, ages 5 to 18, who sought medical care at an emergency department within 2 weeks of their child having a head injury.

While nearly all knew their child should stop playing and see a doctor if a concussion is suspected, only about 1 of 4 were aware of guidelines on when their child could return to sports and school work.

In another study, researchers from Children's Hospital Los Angeles polled more than 460 parents. They fell short on spotting concussion symptoms.

Today, Lystedt continues to work on his recovery. He told the crowd at the conference – who gave him a standing ovation -- that he is honored to be part of the concussion awareness movement.

"I would not wish my injury, or an injury like mine, on anyone else. God chose me and my family for this, and we have a duty to educate as many people as we can so they don't have to go through what we have had to go through."

Studies presented at a medical meeting are considered preliminary until published in a peer-reviewed journal.


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SOURCES: American Academy of Pediatrics National Conference & Exhibition, Oct. 10-14, 2014, San Diego.Stanley Herring, MD, professor, co-medical director, Sports Concussion Program, University of Washington Medicine and Seattle Children's Hospital.

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