A Youth Game Crash Affects An Entire Family And Shows How Head Injuries Can Linger

By Krystina Lucido

Along the old road lined with brick houses built long ago, snow blanketed the trees and ducks skated across the frozen-over pond outside the door of Park School, where Abby Cahalan played futsal -- a version of indoor soccer played on a basketball court with a weighted ball.

It was Feb. 17, 2008. Abby was just weeks away from trying out for spring sports for the first time at Ridgley Middle School. But the coaches there would never get to see how good this 12-year-old could be.

Abby Cahalan  (John Cahalan)

Abby shot around with the rest of her Baltimore Bays team, just like any other day. Her parents watched from the stands; her 17-year-old brother Joe and twin sister Lauren waited at home. 

Abby knew her teammate had the ball on the defensive end of the tiny court, barely one-third the length of a basketball court, but she couldn't see through the wall of opposition, two girls wide. The white uniforms parted in front of Abby just in time for her to see the one-pound ball come full-force straight at her face. Hit squarely in the forehead, the impact stunned Abby and she wobbled to the ground. Everything turned fuzzy.

Play stopped as Abby made her way to the bench. Coaches and teammates surrounded her. Jack Cahalan handed his daughter tissues to wipe the blood from the all-too-typical nosebleed she sported. "Can you go back in and play?" he asked. Getting off the bench and stuffing the last bit of tissue up her nose, Abby replied, "Yes. I want to go back in."

When Joyce Cahalan saw how hard the hit was, she wondered if her daughter had a concussion. After an anxious ride home down Knox Avenue, Joyce immediately logged on to the computer to research concussions as Abby labored up the steps to take a shower, looking unusually tired and teary-eyed.

"I didn't really think much of it," Abby's twin sister Lauren said. "My friend had had a concussion a year before but it only lasted like two days and then she was fine."

All reliable online sources must have been using Lauren's friend as a yardstick. They offered Joyce the same advice: Wait. Symptoms will go away in a few days.

But the symptoms never went away. No one could have prepared Jack and Joyce Cahalan for how severely this one play, this one hit, would change their lives.

Traumatic brain injuries -- or concussions -- have increased 21 percent since 2004, according to a report released March 2010, based on the Center for Disease Control and Prevention's 2004 report. The increase has been most apparent partly "among children as more become active in sports."

"People are much more aware of even the possibility that a brain injury can occur playing sports," Joyce Cahalan said. "That was just never, ever on my radar."
Recent studies on the effects concussions have in the lives of retired National Football League players sparked further research at all levels of play. Were it not for all the recent interest, medical experts and advocates may never have realized how distressing brain injuries can be for youngsters like Abby.

"We didn't know about the brain like we know now," said Diane Triplett, executive director of the Brain Injury Association of Maryland. "In the last 10 years, what we have learned about the developing brain has increased ten-fold. So we now know how the brain works and when it's injured how it doesn't work."

Jack Cahalan never thought to ask the important question, the question he now knows is more important than "Can you play?"

Are you OK?

Concerned about the spike in sports concussion, the Brain Injury Association of Maryland lobbied for state legislation to provide guidelines for coaches and parents. The Maryland Concussion Bill, similar to measures introduced in 16 other states this year, was modeled after the Zackery Lystedt Brain Project. It called for education and action to increase coaches' and parents' knowledge of concussions -- how to recognize them and how to manage them from evaluating a player's condition to whether or not he or she should return to play. The Cahalans testified in support of the bill, which did not get out of committee this session.

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