Curtis Benson was trying his best to defend the net, playing goalie for his Raleigh Youth Hockey Association Junior Hurricanes travel team, when he collided with a swarm of bodies in front of him. Later that day, he took to the ice rink again, where he was bumped some more.

A day and a half after the original collision, Benson went to the emergency room, and soon after, he was escorted to a concussions clinic. He later learned his fall from the collision had resulted in a concussion.

“I didn’t actually mention anything to my coach because I just kind of tried to shake it off,” he said. “I definitely felt pressure from (my) teammates and coach wondering when I would be able to get back.”

It was the first of four concussions he would sustain during high school — two playing hockey, one in a car accident and one snowboarding.

Benson, now a sophomore chemistry major at UNC-Chapel Hill, continues to grapple with the consequences of his head injuries.

“I struggle remembering things and memorizing things in school,” he said. “I lost a few IQ points, I think, after a couple of them.”

As many as 3.8 million concussions happen each year as a result of sports and other recreational activities. A study from 2001-09 by the Centers for Disease Control and Prevention showed that over 173,000 children under the age of 19 were treated for concussions in emergency departments each year.

Doctors and researchers have only recently learned of the sometimes horrific effects that concussions can cause. And with this new awareness, some athletes, like Benson, are faced with a tough decision: Play through the pain and risk further injury, or leave behind the game they love.

‘Sort of like snowflakes’

Benson lived for moments on the rink when his team was behind, when he would make a big glove save or when he would dive across the net to deflect the puck.

Though Benson aspired to play in the National Hockey League, he decided to end his hockey career after his third concussion when the doctor told him he would face the possibility of further concussions and permanent damage to his brain.

“I kind of went back and forth about it,” Benson said on the decision to quit the game he had started playing in middle school.

“(Playing professionally) was something I had been working for for a long time, so I was really wanting to pursue that, so when the third concussion happened, I realized that pursuing that (wasn’t) worth my own health,” he said.

Several studies have been conducted to learn more about concussions and their effects.

Kevin Guskiewicz — who has experienced three concussions himself — is one of the leading researchers on the subject. He has worked with the Pittsburgh Steelers of the National Football League and with UNC-CH as an athletic trainer since 1995.

“Concussions are sort of like snowflakes — that there are no two alike,” he said. “You and I could have a concussion on the same day from the same mechanism, and we can respond very differently in terms of what we experience.”

A concussion — which is derived from the Latin word concutere, meaning to shake violently — occurs when the brain smashes against the skull after a whiplash-like motion or a blow to the head.

Guskiewicz said the symptoms can vary, but there are a few telling signs: recurring headaches, dizziness and blurred vision.

Benson would add sensitivity to light and sound, nausea and trouble sleeping to his list.

“It kind of feels like if you just put one hand on one side of your head and one hand on the other side to squeeze,” Benson said. “That’s kind of how it feels for the first couple of weeks, at least.”

Heightened concern

Many people erroneously believe that a loss of consciousness is necessary for a concussion. Benson’s third concussion, in a car accident, didn’t cause him to lose consciousness. His teacher noticed he wasn’t thinking normally after he got to school.

“I arrived late, and they knew I was acting strange because we were talking about politics in French, and I was talking about how I liked cupcakes in French,” Benson said.

High school women’s soccer has the third highest concussion rate, coming in behind only football and Benson’s sport, men’s ice hockey.

At least 50 youth football players from 20 states died or had serious head injuries resulting from hits to the head since 1997, according to The New York Times.

The movie “Concussion,” which opened in theaters on Christmas Day, has brought even more national scrutiny to the subject. But Guskiewicz said the movie was sensationalized, and many American parents are overreacting to the recent condemning evidence.

“There’s no concussion crisis in America,” Guskiewicz said. “There’s no more concussions occurring today than there were 10 or 15 years ago. It’s just that there’s been this awareness created.”

Benson said when he sustained his first concussion, that level of awareness didn’t exist.

Luckily for him, his primary care doctors had also served as concussion specialists. They had a concussion test ready for him: There were drawings, number matching exercises and color associations to test his memory. For the first two weeks, he was only doing puzzles and napping — anything to avoid cognitive stress. He was out of hockey for three months. Gradually, Benson became more active until he was functioning at the level he had been before. He thought he was ready to compete again.

Changing the narrative

Benson endured two months of throbbing migraines and haziness after his first concussion because he didn’t initially allow his brain time to rest.

Michelle Wood, a coach for 23 years and currently the volleyball and women’s basketball coach at East Chapel Hill High School, said the concussion-testing process is evolving to mitigate these sorts of delays in treatment. Athletes’ scores are compared to their previous results, so doctors can see large differences in cognition, and they don’t waste time researching scores considered normal for a given age range.

Still, Scarlett Steinert, the director of healthful living and athletics for Chapel Hill-Carrboro City Schools, said more money needs to filter toward concussion awareness and education in middle school and high school sports.

“Money would help hire more coaches, more eyes,” she said. “I know there are school districts (that) can’t afford refurbishing of helmets, refurbishing of new equipment or as much safety equipment as you need for a sport like lacrosse or those kinds of things.”

Each school in CHCCS employs only one athletic trainer, who does not specialize in any sport.

Bernard Leach, the athletic supervisor for the Chapel Hill Parks and Recreation Department, said the department has only been cautious of concussions for two to three years. In the seven years the department has operated a football league, Leach said there have been no reported concussions. The department has no written policy about concussions.

“We make sure that our equipment is in perfect working condition and safe,” he said. “We encourage our coaches or instruct our coaches to teach proper tackling techniques.”

Leach said coaches and parents are told what to do if an athlete exhibits any concussion-like symptoms and that permission from a doctor is required before a young person can return.

Benson hadn’t immediately sought out such treatment, exacerbating the symptoms of the head injuries affecting his life today.

He doesn’t play sports anymore. He sometimes can’t handle concerts or loud rooms. He experiences recurring migraines.

When Benson watches goalie highlights of teams like the Carolina Hurricanes, he sometimes has a strong urge to get back on the rink. But then he sees a big hit:

“It actually kind of makes my head hurt thinking about it.”