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Knocked Out: For Kids, Concussions Can Be Worse Than for Adults

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Two days later, though, on the way to a game, recalls her mother, Kim Champness, Ali complained of a headache and dizziness.

During play, the ball was kicked in the air and "brushed across the front of [Ali's] face," says Kim. "It was not a hard hit at all, but right after that, she started stuttering." Ali saw a doctor, who discovered a number of much more serious problems.

In the past, a "bell ringer" was thought of the same way as a cut or a sprained ankle, with no lasting side effects. Until a few years ago, the NFL's medical committee on concussions published studies that concluded players were not suffering long-term damage from head trauma incurred during athletic competition.

The lack of awareness carried over to the training rooms of every sport, and high-profile athletes such as boxer Muhammad Ali and All-Pro safety Dave Duerson were prematurely sent back into action. Years later, they essentially lost their minds. (The Centers for Disease Control and Prevention estimates that as many as 3.8 million sports- and recreation-related concussions occur each year. Out of this figure, about 235,000 people are hospitalized and 50,000 die per annum, according to the CDC.)

"Ninety percent of concussions went undiagnosed," Chris Nowinski of the Boston-based Sports Legacy Institute tells Village Voice Media. "In fact, today you can talk to an athlete and ask the amount of concussions they've had and give them the actual definition, and that number will increase."

Nowinski, a former World Wrestling Entertainment pro and author of Head Games: Football's Concussion Crisis, along with noted neurosurgeon Dr. Robert Cantu, founded the Sports Legacy Institute. The foundation works with Boston University's Center for the Study of Traumatic Encephalopathy in performing post-death pathology on brains donated by former athletes.

One of the latest specimens examined was that of Duerson, a former NFL standout who, after years of dementia and depression, shot himself to death — in the chest so his brain would be preserved — on February 17. Neurologists later confirmed that Duerson, who had played for the Chicago Bears, New York Giants, and Phoenix Cardinals (now called the Arizona Cardinals), was afflicted with chronic traumatic encephalopathy (CTE), a neurodegenerative disease linked to the total amount of distress a brain receives during a lifetime. Because a concussed person may not always exhibit such classic symptoms as headaches and nausea, CTE is, in essence, an invisible killer that can cause the brain of a 35-year-old to resemble that of an 80-year-old.

These findings have helped turn the National Football League from concussion skeptics into an organization that is spreading the word that head trauma in sports can have deadly consequences. The campaign has even trickled down to the NFL-licensed Madden NFL video games, in which a concussed player in the yet-to-be-released Madden NFL 12 cannot return to play after suffering the injury. In February, the league urged all states to pass concussion legislation in youth athletics.

For the 75 former NFL pros who sued the league in July, alleging it concealed the dangers of the injuries for decades, it's too little, too late. Football retirees such as Mark Duper, Ottis Anderson, and Raymond Clayborn are claiming that the league was careless in its false assumptions. (As of press time, the NFL planned to contest the allegations.)

The proper treatment of concussions, especially in youth sports, is still a developing — and somewhat murky — science.

In 2004, Jake Snakenberg, a Denver-area high school freshman, knocked his head during a football game but assured his mother he felt ready to play again. A week later, the young fullback once again hit his head during a game.

The blow was unremarkable, but Snakenberg staggered to his feet and fell back down. He never got back up, and was declared dead the next day from second-impact syndrome, a swelling of the brain derived from a second concussion before the symptoms of the first have passed.

These types of injuries are exacerbated in youth athletes because the human brain doesn't metabolically or neurochemically mature until a person is in his or her early to mid-20s, according to David Hovda, professor and director of the University of California-Los Angeles' Brain Injury Research Center. This includes the young brain of Matt Blea, who nearly died on a California football field close to two years ago.

On Thanksgiving Day 2009, Blea, a 16-year-old junior and starting running back for San Jose High, tried to retrieve an underthrown ball during the opening possession of the 66th annual Big Bone rivalry against Lincoln High. Despite his modest 5-foot-5-inch, 140-pound frame, Matt was the recipient of all-league honors, as well as props from an opposing linebacker, who once told him, "I don't know how you ran me over, because you're so little."

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By Steve Jansen and Gus Garcia-Roberts