The recent story about football and concussion, a type of traumatic brain injury (TBI), contained absolutely essential information for parents and anyone who works with youth ("Damien player’s injury jolts isle prep spots community," Star-Advertiser, Aug. 23).

Especially important was the Star-Advertiser’s emphasis on safety and prevention. It is important to note that each year, U.S. emergency departments treat an estimated 135,000 sports- and recreation-related TBIs, including concussions, among children ages 5 to 18.

Sports injuries tend to get a lot of media coverage and to generate discussion on safety measures. Overall, however, sports account for only 25 percent of the 1.7 million new cases of TBI reported in the U.S. each year — an overwhelming number in comparison, for example, to the 800,000 new cases of stroke each year.

Falls account for most of the total. Among children up to age 14, falls account for 35.2 percent of TBI, and among adults, 65 years and older, falls account for 61 percent.

But among all age groups, motor vehicle crashes and traffic-related incidents are the second leading cause of TBI. Many of these crashes include bicycle, motorcycle and mo-ped crashes.

TBI is by far the greatest risk posed to cyclists: one-third of emergency department visits, two-thirds of hospital admissions, three-quarters of deaths.

Unfortunately, most TBIs go unreported — the bump is mild and there are no apparent symptoms. Even if an MRI or CT scan shows no swelling or bleeding, individuals may still face sustained symptoms. Although there is no cure for traumatic brain injuries, the body does heal itself to an extent; a good rehabilitation program promotes this natural recovery.

Most people with a TBI recover quickly and fully, although, for some, recovery may be slower, especially among older adults, very young children and teens who may need extensive rehabilitation therapies. Those who have had a TBI in the past are also at risk of having another one and may find that it takes longer to recover with the next one.

Symptoms range from physical (headaches, nausea, etc.) to cognitive (memory and multi-tasking problems) to emotional (depression, drop in grades, substance abuse). Personality changes may be present as well, which may be why the divorce rate following a TBI is so high.

In concussions or mild traumatic brain injuries, most do not experience persistent symptoms. However, those who do experience them have a difficult time adjusting to society because their disabilities are not visually apparent.

Local discussion has centered on a helmet law for motorcycles — an issue for a later discussion — but not enough attention has been paid to our children and bicycles.

No state has a universal bicycle helmet law. Only 21 states and the District of Columbia have statewide bicycle helmet laws, and they apply only to young riders (often riders younger than 16). Local ordinances in a few other states require bicycle helmets for some or all riders.

But what we do know so far indicates that bike helmet laws work (as do motorcycle laws).

For example, New York state reported that since it introduced its helmet law for riders under 14, the annual rate of cyclists hospitalized from bicycle-related TBI fell considerably.

It is impossible for each of us to live in a bubble safe from harm, but there are ways to take precautions and make sure our children learn how to participate in sports, and other physical activities, and protect themselves from serious injury.

Kent S. Yamamoto, M.D., is medical director of the brain injury program at Rehabilitation Hospital of the Pacific.