Legislation establishing a protocol for managing possible concussions in Pennsylvania's student athletes passed the State House  unanimously yesterday afternoon and is expected to pass in the Senate soon after it re-convenes October 17th.  Among other provisions, it specifies when an athlete must be removed from play and what steps must be taken before he or she is allowed to return.

Dr. Joe Maroon, a UPMC neurosurgeon, said 30 other states have such a law, and it's long overdue in Pennsylvania.  About 250,000 high school athletes in the U.S. get concussions each year, and Dr. Maroon says 90% recover completely, but 5- to 10%, for reasons not fully understood,  can have long-term effects such as personality disorders, memory impairment, lack of ability to process information, impaired reaction time, and sleep disorders.

Dr. Maroon and a colleague reported recently that trauma to the brain may release various neurochemicals that lead to headaches and impairment of function and memory through an inflammatory process.  There is some evidence that natural substances such as Vitamin D3, fish oil, curcamin, and magnesium can reduce these symptoms, at least in animals.

Girls may be at twice the risk of concussion from a given impact,said Dr. Maroon, possibly because of weaker neck muscles, and the young brain is very vulnerable.

Dr. Maroon says millions of student athletes have had baseline neuro-cognitive testing which can be re-administered after a concussion to gauge lingering effects that aren't evident in a neurological exam and determine when it is safe for an athlete to return to activity.

State Senator Jay Costa, a sponsor of the legislation, says it puts decisions affecting student athletes' well-being in the right hands, "…out of the coaches' hands…and into the hands of the medical professionals who totally understand concussion management…."  The law requires the Departments of Health and Education to develop and disseminate concussion guidelines for athletes, coaches and parents.  Parents will have to acknowledge that they're aware of the protocol, which will bring them into the process in a way Sen. Costa says they've never been before.