Joe and Rosa Croce say that football saved their son's life.
While the danger of head injuries is causing many parents to reconsider letting their children play football, the Croces, of Oakdale, credit the increased awareness and emphasis on head safety for helping detect a pre-existing condition that could have proved fatal.
Joe Croce Jr., a 14-year-old freshman on Connetquot's junior varsity football team, left an Oct. 3 game at William Floyd High School complaining of memory loss after sustaining a hit to the head. The team's coaches signaled for Floyd's on-site athletic trainer, who administered a series of questions designed to determine the extent of a player's injury.
Concerned by the results, the trainer sought out Croce's parents and urged them to take their son to the hospital for a CT scan. The scan revealed Joe Jr. had hydrocephalus, which is the buildup of fluid on the brain. If left untreated, the pressure of the fluid would eventually cause serious brain damage.
Croce underwent surgery two days later at Cohen Children's Medical Center in New Hyde Park. Doctors used a scope with a camera attached, entered through the top of his head, found the blockage, cut a new ventricle next to it and coated it with titanium.
He was out of the hospital the next day and returned to class two weeks later. He plans to play lacrosse in the spring.
"I feel football saved his life," Rosa Croce said. "We would have never known."
Hydrocephalus is usually detected at birth and often is treated by running a shunt from the brain to the abdomen to force the flow of the fluid. That type of surgery would have likely ended Croce's high school athletic career, his father said.
But Croce's case called for a less-invasive surgery, said Dr. Steven Schneider, Cohen's co-chief of pediatric neurosurgery, who performed the procedure. Schneider was able to open a new duct for fluid to bypass the blockage. The key now, Schneider says, is that the duct stays open, but he called the chances "pretty high" based on a follow-up MRI.
Schneider said Joe Jr. will be cleared for "collision sports" such as lacrosse and football, which was what most worried the teen entering surgery.
"That's all he kept asking the doctors," Rosa said. "Am I going to be able to play sports?"
Schneider said Croce likely had been living with the fluid buildup for years but was not affected because his brain made constant adjustments for it. "Then all it took was a relatively minor head injury or concussion," he said, "to tip over its edge."
Schneider said the condition "absolutely" would have affected Croce at some point during his life.Schneider said people with untreated hydrocephalus are more susceptible to damage from head injuries and can suffer symptoms more commonly associated with dementia -- loss of memory, balance and control over bodily functions -- as early as their 30s.
"It was a ticking time bomb," Joe Sr. said. "Even though his brain kept adjusting, something might have happened in a few months, a few years or even 20 years down the line where he may black out driving a car or something."
Instead, it came to light because of a football injury.
Joe Jr. remembers being confused when he came off the field in the third quarter. He said he asked teammates what play they had just run. He thought it was still the first quarter. Croce said teammates encouraged him to report his symptoms to a coach. "When I didn't remember," he said, "I knew something was wrong."
Croce approached junior varsity head coach Matt Buderman and assistant coach Scott Ferguson and told them about his lapse in memory. Buderman flagged down Jason McKay, Floyd's athletic trainer.
McKay said he asked Croce a series of 22 questions to gauge how many concussionlike symptoms present. He recalled Croce had "about eight" symptoms. One is enough to warrant a follow-up with a specialist.
McKay said he "very rarely" sees players who report lapses in memory. Croce also showed signs of "perseverating questioning," which is when a person repeats questions a few minutes apart, he said.
Don Webster, executive director of Section XI, which oversees interscholastic sports in Suffolk, estimated that 80 percent of the county's districts employ an athletic trainer "in some capacity" -- full time or part time -- to assist with all athletics, not just football.
Joe Jr. has since watched video of the game and said there was one hit in which his head seemed to snap back a bit. He wondered if that was the one that set this all in motion. He'll likely never know. But his family believes the way everything happened is "a blessing."
"Plain and simple, if he didn't play the sport," Joe Sr. said, "we never would have known, until something horrible happened."
Hydrocephalus is a rare condition in which there is excess fluid around the brain because one of the ventricles is either too narrow or blocked, thereby restricting the normal flow of fluid. It is typically identified at birth but also can develop later in life. Surgery, either by inserting a shunt from the brain to the abdomen or by creating a new duct for the fluid, is the most common way of treating the condition. If left untreated, hydrocephalus can lead to dementia-like symptoms in people as young as their 30s.
Source: National Institutes of Health