Is it heat exhaustion or a concussion?

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By Jess Schmidt

The news is full of stories of sports-related concussions and how they impact health. Coaches and parents are going to great lengths to reduce student-athletes’ risk of brain injuries. However, a hidden danger lurks this time of year, and it can have an impact on the severity of a concussion or potentially "hide"? a concussion.

In the peak of the summer and throughout the fall, heat is a problem for athletes. When players begin having two practices a day at the start of fall season sports, the risks increase exponentially. The issue is that the result of not hydrating and resting between practices can result in symptoms similar to that of a concussion making it difficult to differentiate between the two.


While there are many techniques for checking a student-athlete for a concussion, even the most careful athletic trainer or medic might see a student-athlete with heat exhaustion fail concussion assessment tests despite a concussion not being present.


"If someone collapses on the field or sidelines, you may not be able to immediately differentiate whether the cause is heat exhaustion or a concussion,"? said Dr. Harry Kerasidis, a neurologist who studies concussions and the psychology around brain injury. "The typical symptoms of heat exhaustion, such as weakness, lethargy, imbalance and even loss of consciousness are very similar to some concussion symptoms."?

Patients who are suspected to have a head-injury are typically sent to the hospital where a CT scan is performed. A CT scan is used to check for brain bleeds but will not provide answers about a potential concussion. Medics and athletic trainers know to check for the heat exhaustion symptom of clammy, cold skin when examining student-athletes who exhibit the symptoms shared by heat exhaustion and concussion to try to rule out one or the other. The problem is that if a student is experiencing both heat exhaustion and concussion, the field tests may miss one or the other.

If heat exhaustion isn’t treated quickly by bringing the victim into a cooler environment or being placed in an ice bath, a more dangerous condition can present itself: heat stroke. It is imperative that in these hot months, athletic trainers and other medics can quickly determine if a student-athlete has a concussion or heat exhaustion.

Kerasidis continued: "Unfortunately, a person with heat exhaustion may start flagging the same issues as the person with concussion. They aren’t mutually exclusive. A player could take a hit, be more vulnerable because they are going into heat exhaustion, and as a result experience a concussion. Biomarkers, such as the brain’s electrical signals, (often measured by an electroencephalogram or EEG), can play a role in patient management. Heat exhaustion may have similar symptoms and cause brain dysfunction, but a player with heat exhaustion won’t have the same EEG traits as a player who has had a traumatic injury to the brain."?

An FDA-cleared head-injury assessment system, BrainScope One, can reduce reliance on expensive hospital, emergency room tests and quickly help a provider determine if a concussion was suffered. The BrainScope system can quickly analyze the electrical activity in the brain to look for signs of traumatic brain injury. It can be easily used in a clinic or in a student athletic center.

The BrainScope system is designed for use by licensed medical professionals, including athletic trainers, physicians, nurse practitioners, medical assistants and military medics, after they complete BrainScope provided training.

"The BrainScope looks for telltale electrical activity in the brain indicating signs of traumatic injury to the brain. It provides quick and easily read assessments that can be done at the time of injury on the sideline to determine whether brain injury has occurred. The BrainScope assessment results can help determine the presence and severity of a traumatic brain injury and whether something like a CT scan should be considered. With newer algorithms (pending FDA clearance), the BrainScope can also help assess the longer-term consequences, including helping with Return-to-Play decisions,"? Kerasidis said.

Erase the doubt before sitting out … be sure … be safe … be ahead of the game

For more information about the BrainScope and how it can benefit your athletic program, visit or call 855-927-2461.

To learn more about Dr. Kerasidis’ research on concussion evaluation and treatment, visit

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