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Published on March 14, 2019

A forum to clear up confusion about concussionsClear up confusion about concussions

As volunteer physician for the Barnstable High School football team, Peter Bentivegna, MD, FACS, has seen his share of head injuries.

Dr. Bentivegna, who is a plastic surgeon but also the father of one of the Barnstable High School (BHS) assistant coaches, attends all the home games. His time on the sidelines led to the realization that there didn’t seem to be a consistent local protocol for treating concussions among young athletes. So he decided to organize a forum where the community could talk about it.

“Concussion Discussion,” a symposium for medical professionals, coaches, trainers, parents and young athletes, will be held from 9 a.m. to noon on April 6 in the Knight Auditorium at BHS on West Main Street in Hyannis. The free program will feature a panel of local physicians and will be moderated by Dr. Bentivegna. Panelists will include neurologist Sean Horrigan, DO; neurosurgeon Nicholas Coppa, MD, FAANS; pediatrician Kathryn Rudman, MD, who is the official doctor for BHS; and physiatrist Andrew Judelson, MD, director of the Sports Concussion Clinic at Spaulding Rehabilitation Hospital in Sandwich. There will be time for discussion and questions.

The forum, sponsored by Cape Cod Healthcare, will also feature a talk by Michael J. O’Brien, MD, director of the Sports Concussion Clinic at Boston Children’s Hospital and assistant professor of orthopedics at Harvard Medical Schooll.

Cape Cod Healthcare will offer CE credits for doctors and CEUs for other staff who attend.

Consistency Needed

Dr. Bentivegna hopes the symposium will lead to some consistency in protocol for young athletes across the Cape’s 15 towns. While football has a reputation for concussions, they are an issue across all kinds of sports including lacrosse, ice and field hockey, soccer, skiing and snowboarding, baseball, softball, cheerleading, basketball and volleyball. Nationwide, children and teens make up approximately 70 percent of all sports- and recreation-related concussions seen in the emergency departments, according to the Centers for Disease Control and Prevention.

“It’s become obvious there is no real protocol as far as how everyone takes care of these patients,” Dr. Bentivegna said. “Everyone kind of takes care of them the way they were taught to take of them years ago and there’s been a lot of new information that’s come out with respect to return to play and return to school. These are the kind of things (for which) we’d like to have a protocol on the Cape.”

The nature of concussions makes them difficult to treat, he said. “There’s a lot of variation, from the little ding that you get and a little dizziness, to something that can be a problem.”

A concussion affects the neurons in your brain, according to symposium panelist Dr. Horrigan. People worry that a concussion is a “structural” injury, but it’s largely a “functional” injury, he said, that can cause irritability, lack of focus, cognitive slowing, headaches, and visual disturbances, among other symptoms.

Affects Schoolwork

For students, the effects of a concussion can reach far beyond the athletic field.

“There’s a lot going on at the school because the teachers want to know, when can they come back to the classroom?” Dr. Bentivegna said. Some students may need special accommodations after a head injury in order to stay on top of their work, he added.

“It’s really important to continue to work towards a better consensus on how to diagnose these patients and to monitor them more carefully,” said Dr. Horrigan.

The Concussion Discussion symposium is a first step in understanding the latest treatments and taking a consistent approach, Dr. Bentivegna said.

“When we have a symposium like this, everyone is in one room and they hear, ‘This is the latest and greatest going on.’

“I’ll be learning as well.”