Kurt Thyreen kept it secret. He didn't even tell his dad.
The Hersey middle linebacker took a pounding in a Friday night high school football game against Elk Grove and said nothing.
The next week the headaches were so bad he couldn't even play the trumpet in band class. The pressure was too intense.
Thyreen didn't let on, until the next Friday against Forest View he ran off the field, complaining to his dad, also the defensive coordinator, that he couldn't uncross his eyes. He collapsed on the field, a stroke paralyzing the entire left side of his body.
Thyreen was rushed to the hospital, where doctors found a clot on the right side of his brain. They dissolved the clot, but the brain swelled beyond their control.
Five days later, Kurt Thyreen died.
It has been 25 years since Thyreen's passing, but Hersey athletic trainer Hal Hilmer still tells his story to every frustrated kid who insists they don't need to sit out after a concussion.
"We get kids that think it's not serious, that say, 'I just feel tired or have a headache.' Those are all classic signs of a concussion," Hilmer said. "It's not something you want to mess around with."
Crisis among kids
At least 50 high school or youth football players have been killed or sustained serious head injuries since 1997, according to research done by the New York Times.
Far more of the roughly 1.5 million kids that annually play junior high or high school football will suffer concussions.
A recent study in the American Journal of Sports Medicine found that catastrophic head injuries were three times as prevalent among high school players as those in college. Part of that is due to physiology.
"Their brains are fuller," said Dr. Dean Karahalios of the Chicago Institute of Neurosurgery and Neuroresearch, and a Hinsdale Central graduate. "There is not enough cushion to absorb shock."
But Karhalios cautions that young athletes may not recognize subtle brain injuries.
One misconception is that an athlete must lose consciousness in order to sustain a concussion; in fact, it is estimated that only 10 percent diagnosed with concussions lose consciousness.
Former WWE wrestler Chris Nowinski, who retired from wrestling after suffering post-concussion syndrome, cited a study in his 2006 book Head Games: Football's Concussion Crisis that nine out of 10 concussions go undiagnosed.
In a study done in Pennsylvania in 1999, Dr. Wayne Langburt found that when removing the word "concussion" and just asking kids if they experienced symptoms such as headaches or dizziness, 47 percent claimed to have suffered a concussion.
"Everybody believes the reason they're not reported is because kids are hiding them. That's false," said Nowinski, who played football at Hersey and later at Harvard. "The No. 1 reason why is they think it's not a serious injury. The rule in football is if you can walk, you can play."
'Not a weapon'
Larry McKeon's Naperville North coaching staff drives the point home from Day One of training camp. It is reinforced by a poster in the Huskies locker room.
"We tell the kids the helmet is not a weapon," he said.
Karahalios said that players must be taught to avoid helmet-to-helmet contact, and keep the head up while tackling. Parents also must know.
But nothing can prevent the accidents such as that of former Naperville North player Mark Rochwick, who nearly died after a blood vessel broke in his brain from a random hit in a game in 2002 at Wheaton North.
"To be truthful," McKeon said, "most (head injuries) come from inadvertent hits."
After a jarring hit where they got their "bell rung," a kid shrugs off a headache as a scar of battle on the field.
Once on the sideline, though, the athletic trainer will examine a kid's pupils, ask him to recite the alphabet backward, or have him perform balance-type exercises.
If symptoms persist after 15 minutes a player should not return to the game.
"So much of it has to do with knowing the athlete and what they act like," said Hinsdale Central athletic trainer Ted Hirschfeld. "The kids think they know how to answer questions. There are things you can fake but things you can't fake."
Naperville Central has athletic trainer Bill Hughes, two certified assistants and an orthopedic physician on the field every Friday night.
But they still rely on kids to report when a teammate needs attention.
"They know when somebody is not functioning well. I may not, but they know," Hughes said. "We encourage them to protect each other."
Like Kurt Thyreen, Brandon Schultz had bad headaches days after getting "dinged up" in a game in Washington nine years ago.
Schultz played the next week but was slow getting up from a tackle. He collapsed and did not regain consciousness for five days.
Schultz lived but today stays in a rehabilitation facility refilling ball washers at a golf course with a condition researchers are calling "second impact syndrome."
Hughes shows a video of Brandon to any kid in a hurry to return to the field.
"They interview him 10 years after the incident, and it's pathetic," Hughes said. "I'd like to show it to parents who push to get kids back on the field prematurely."
Karahalios said that while second impact syndrome is rare, it is the most severe complication of sending a concussed player out to soon.
The first concussion may be trivial, or not even diagnosed, but a second injury could send a cascade of events that causes the brain to swell. A player can lapse into a coma or die.
"It's such a counter-intuitive injury. It's invisible," Nowinski said. "The athlete looks fine, says they feel fine. That is unless you send them back early, and they end up either dead or have a long-term debilitating condition."
Testing the brain
A rule of thumb is that athletes should not return to the field until they have had seven symptom-free days.
One tool athletic trainers have used in determining recovery following concussion is the ImPACT test.
Developed by doctors at the University of Pittsburgh, the ImPACT test can manage sports-related concussions by measuring reaction time and memory after an injury.
At Hinsdale Central, varsity and sophomore football players take a "baseline test" over the summer. The six-part program tests neurocognitive activity to measure how the normal brain is functioning.
In the days after an athlete has sustained a head injury, the ImPACT test can be used once the athlete says that the other symptoms of a concussion have cleared up and they feel they are ready to play.
"This literally tells us when the brain is working the way it's supposed to," Hirschfeld said.
Naperville Central also runs its baseline test on incoming freshmen. If injured athletes test with a brain functioning as it should, they are permitted to resume non-contact exercises for two days, then may practice.
"The test is valuable because it is objective," Hughes said. "The kids are all going to lie to me so they can play, but they can't lie to the test."
Keeping kids safe
McKeon said the biggest safeguard his program has against head injuries is "the best helmets money can buy," the Riddell Revolution, that does not over-inflate the way older models did.
Recently, Riddell has patented Head Impact Telemetry System (HITS) technology in select Revolution helmets. HITS electronics records every impact, allowing coaches to monitor the number and severity of impacts during games and practices.
Nine Division I colleges have HITS software for their helmets, including Illinois.
But there is no substitute for educating kids on injuries.
Nowinski contends that the facts concerning head injuries should be included when teaching CPR and first aid.
Hilmer and every athletic trainer like him deal every season with an athlete whose head is in the clouds -- but wants back on the field.
He insists that they will find how much different their head feels after recuperating from injury for a few days.
He doesn't want another story like Kurt Thyreen's.
"I've told parents and kids I don't want to go through something like that again," he said. "Once is enough."