Second-impact syndrome, the cause of Rowan’s death, is rare. However, persisting symptoms after concussion — also known as post-concussion syndrome — are more common and can have devastating effects on people’s lives.
Rowan’s parents envisioned a world where this happens to no other family. They petitioned for more education on concussions, for better surveillance and for improved return-to-learn and return-to-play practices.
On March 7, 2018, concussion safety legislation known as Rowan’s Law was passed by the Ontario legislature, compelling sport organizations across the province to take concussions seriously.
As a cognitive neurologist and concussion researcher with the Canadian Concussion Centre at Toronto Western Hospital who sees people with brain diseases, I believe Rowan’s Law is a necessary, important step that will help protect the young athletes of Ontario.
However, all its recommendations highlight the need for better understanding, detection and management of concussions. We must admit there is a lot we do not know.
This law should also have more widespread ramifications. People of all ages can suffer concussions. Many do happen in the context of sport. But many are the consequence of motor vehicle accidents, trauma, domestic violence and falls.
Symptoms of a brain injury
Until recently, concussions were considered trivial incidents, not worthy of medical attention. We now know that the symptoms that accompany concussions are the result of a brain injury.
The changes in the brain from a concussion do not appear on conventional imaging tests such as CT scans or MRIs; nor are there any other tests to diagnose a concussion.
But we know that these changes can cause symptoms such as headache, dizziness and unsteadiness, as well as changes in mood, concentration and memory.
Although most people recover from a concussion, 10 to 15 percent can develop persistent symptoms lasting months or years.
This can have profound effects on school, work and relationships. These consequences from head injury can make return to one’s life difficult, and in some cases impossible, as not everyone recovers.
I am always amazed that most people realise that memory, attention, language, movement and such activities are functions of the brain but don’t understand it is also responsible for mood, love, judgment and the like.
Mandatory concussion education
Rowan’s Law imposes requirements on sports organisations. These are all geared towards recognising a concussion and avoiding repeat concussion while an individual is still recovering.
Rowan’s Law, Concussion Legislation requires:
- Medical clearance of a concussed athlete before they return to play.
- Mandatory concussion education for young athletes, parents and coaches.
- The immediate removal of a young athlete from play if a concussion is suspected.
- Strict adherence to return-to-learn and return-to-play protocols for youth athletes with concussions.
The law mandates that coaches and others responsible for young athletes are educated about concussion and take action when they suspect one has occurred.