Wednesday, January 30, 2008

Everything you need to know about concussion, from the Wakeboarding community

Who would've thought that a comprehensive and informative article about the pathophysiology and effect of concussion would show up in a Wakeboarding website. Some snippets:
"Let's start with a little lesson about the brain...

What actually happens when somebody gets a concussion...

After sustaining a concussion, the symptoms may last anywhere from a few minutes to several days or even longer. It is important to recognize when the symptoms completely fade away and know that until they are gone, you should avoid anything that may cause the brain to be rattled around even a little bit...

Basically, what really matters when returning to a sport is making sure you wait for all of your symptoms to disappear...

Whether you're a rider, driver or passenger out on the boat, knowing what a concussion is and what symptoms to look for can make a big difference when you or someone you know suffers a blow to the head....

Monday, January 28, 2008

Time and Rest

It is good to see an article get it right from the start:
A healthy brain will dictate Macartney's return to racing

...the injury Macartney sustained in a scary crash during the Hahnenkamm downhill Jan. 19 at Kitzbühel was a severe concussion — and the only thing that can fully heal a bruised brain is time and rest. A lot of rest. Doctors have instructed the 30-year-old U.S. Ski Team veteran downhiller to rest and let his brain heal.

Nine days post-injury, and he still has symptoms:
"The medical team at USSA will measure Macartney’s brain function and alertness with impact tests built around the baseline test Macartney took when he was 100 percent healthy. Six days after the accident, in which Macartney crashed off the final jump of the Streif course and banged his head multiple times on the icy track and losing consciousness, he was battling a slight headache and a general feeling of cloudiness.

“It’s an overall feeling of cloudiness, not as sharp on the recollection of certain people’s names,” Macartney said. “[I’m] going through things and saying, ‘oh yeah, what was that thing I was just talking about half an hour ago.’ A lot of that stuff is still not 100 percent.”

Sunday, January 27, 2008

Concussion Stories

It seems like there are more and more news articles mentioning concussion every day. Many of these articles appear to be reporting old news or how concussion testing is becoming more common, such as this story, though:
"...says the Panthers also took extra precaution when it came to a concussion. Every player with Carolina would have to take a computer test that measured your memorization and reaction time to a series of questions, and they'd write down your score... after you had a concussion, you had to take that test again. Until your score was back up to your original score, you didn't play."
Or this story about a baseball player with post-concussion syndrome 2 years after hitting his head:
"Koskie has suffered from postconcussion syndrome since he was hurt on July 5, 2006, while backpedaling to catch a popup... the symptoms lasted for months, and the Milwaukee medical staff thought he was experiencing anxiety or that the problem was in part mental... Koskie, who estimates he'd had anywhere from 8-15 mild concussions in his professional career, remembers feeling so tired for so long.

"I look back and say to myself, 'I decided to do that?' " he said. "I wasn't thinking properly. You think at the time you're OK, but then when you get tested and your cognitive skills are so poor, you realize in what kind of shape you're in.
And this article about the process a high school football player experienced recovering from a concussion last season:
"As he walked off the field with his teammates for halftime, he said, he knew things weren't right.

"I felt like I was in a cartoon," the senior receiver said. "I couldn't remember where I put my helmet. I put down my helmet and couldn't find it"... during the game he "felt silly" and was "cracking jokes." Everything was humorous, he said. Afterward, things weren't so funny. Hopkins suffered headaches and nausea after the game and went to the emergency room.

To compound his head injury, Hopkins was involved in a car accident in which his head hit a window. His concussion worsened. He had taken the ImPACT test once after his concussion on the football field. A week later he took it again.

"I did really bad" ... he did finally return to the field for the final two games. "It was another piece of reference I could bring to my neurologist. It gave me an idea how bad the injury really was. It really gave me an idea where I stood."

Friday, January 25, 2008

Various Observations & Ironies

...a "Roughneck" getting concussed.

...retired NFL/Current AHL player writes about concussions on his blog.

..in the "Extreme" Games (aka: X Games)a "little concussion" forces a competitor to sit out... not so extreme after all?

...story-starved Super Bowl media identify post-concussion syndrome from Tom Brady wearing sunglasses

Wednesday, January 23, 2008

Helmets and Skiing    

Let's not forget the inherent dangers of our favorite winter sport:
"American skier Scott Macartney was released from a hospital Wednesday, four days after he suffered a concussion and was placed in a medically induced coma following a crash during a World Cup downhill race.... Macartney was clocked at 140 km/h when he crashed Saturday in Kitzbuehel... he lost his balance at the final jump and fell on his head, the impact breaking his helmet. He briefly lost consciousness and organizers said at the time he had a brain contusion."
"A Bucks County man has died while skiing at the Steamboat Ski Area in Colorado, but authorities say they haven't determined the cause of death. (The skier) was found dead on an intermediate ski run on Tuesday, where he was skiing with his daughter and friends when he fell behind. They reported him missing when he failed to show up at the base."
" A 15-year-old skier from Oklahoma died Friday at Wolf Creek Ski Area after smashing into a tree.... he apparently suffered head and neck injuries, though results of an autopsy were not yet available... the skier was wearing a helmet."
        (Sources: here, here, and here).


Some point to helmets as a precaution:
"While helmet use has increased about 5% annually for the past several years to nearly 40% for skiers and snowboarders, "it still isn't where we'd like it to be... they are advised for skiers at any age and level of experience."
While others say helmets do not save lives:
"...a new study reports that although more people are donning helmets, wearing them hasn't decreased accident-related deaths. The National Ski Areas Association's report said that about 37 people have been killed each year on the slopes, for the past ten years, a rate that has not decreased since helmet use became more widespread.

"More people are wearing helmets and they prevent injuries... the helmet has a way of deflecting force a way from the skull and the brain itself."
"
Interestingly, one researcher (Jasper Shealy, a professor emeritus at the Rochester Institute of Technology in Rochester) conducted research that found skiing fatalities were most likely to occur on wide, smooth and well-groomed intermediate-level "blue" trails.

However, the potential benefits of wearing a helmet seem obvious:
"Wearing a helmet doesn't give you license to do the most dangerous stunts possible. But if you take a spill, having one is still the best idea considering the alternative.
Once you fall and hit your head you'll realize why"

"You can't really have fun if you're dead," said a snowboarder. "Concussions suck.""

Monday, January 21, 2008

The many faces of concussion

A recent article in the Boston Globe stated:
"By the end of the season, it's a good bet every team will have had at least one player with a concussion... the truth is, it's a very dangerous game, with a schedule that is far too long - one that leads to players getting hurt..."
However, some teams disguise concussions:
"Center Sergei Fedorov missed his second straight game last night, and there's a chance he might be out until after the All-Star break... Fedorov was hit hard by Phoenix defenseman Keith Ballard early in the third period of a game Thursday. The Blue Jackets aren't sure whether Fedorov suffered a concussion. He's said to be experiencing flu-like symptoms."
Even high school teams are dealing with the issue, although some appear to be relying on CT-scan results:
"...missed his third straight game with a concussion... CAT scans came back OK, and it is just a matter of time before he can return."
At least concussion has received top billing as the NFL's worst injury, when referring to Crosby's ankle injury:
"Look, Crosby has a bad ankle, not a concussion... he hasn't died. The NHL will survive him missing the all-star snoozefest in Dixie"

Friday, January 18, 2008

"Huge" Implications

A new study out of the Montreal Neurological Institute identifies depression as a "physical outcome" of mild brain injuries:
"When athletes get depressed after suffering a concussion, coaches, other players and even doctors tend to take the symptom lightly, writing it off as a psychological fallout of being sidelined from the game.

But a new Canadian study suggests depression is actually a physical outcome of such head injuries, which appear to undermine activity in key regions of the brain."
Using fMRI, researchers looked at concussed athletes with and without depression:
"The tests revealed that all the depressed athletes had reduced activity in the areas of the brain that have been linked to major depression. Further analysis found lower grey matter density in those areas, too."
The actual research article (link is to the abstract) identifies reduced activation in the dorsolateral prefrontal cortex and striatum and attenuated deactivation in medial frontal and temporal regions ans conclude that:
"...depressed mood following a concussion may reflect an underlying pathophysiology consistent with a limbic-frontal model of depression. Given that depression is associated with considerable functional disability, this finding has important clinical implications for the management of individuals with a cerebral concussion.

Tuesday, January 15, 2008

10-day follow-up

Flyers player Joffrey Lupul can remember the collision in which he sustained a concussion and a spinal bruise 10 days ago:
"Even when I was on the ice I kind of knew what happened... I just could not get up. I remember thinking to myself, "Try and get up,' but I couldn't."
While his sensation is returning to normal, the concussion symptoms still linger:
".. he will be examined either tomorrow or Thursday. Paul Holmgren said Lupul no longer had tingling in his hands, but was still suffering from concussion-like symptoms."

Monday, January 14, 2008

Don't you know that it's different for girls...

With basketball season in full-swing, let's not forget that women tend to experience concussions at a rate almost 2:1 over men. Here is a great example of how physical and dangerous woman's basketball can be:
"The latest episode took place Thursday against Michigan. The 5-foot-3 Malone was involved in a collision before halftime, forcing her to miss the first 12 minutes of the second half. Once her headache cleared, she was allowed to return...

Late in the game, a Michigan player swung her elbow and nailed Malone in the eye. Malone remained on the ground for several seconds."
The player appears to have some insight into the dangers, but not a lot...:
"Since I got that first concussion, any small hit will probably cause another one," Malone said. "I passed the (concussion) test barely. It's good that I passed it but it's still a little nerve wracking."
Returning to the same game after sustaining what appears to be a concussion, and then lowering threshold for sustaining another; is it worth it?

Thursday, January 10, 2008

Concussion on XBOX 360?!?

It is pretty scary that simulations of NFL games have players leaving the game from concussions:
"...but Jones absorbed a vicious hit from SS Rodney Harrison and looked rattled. However, it was Harrison who got the worst end of it suffering yet another concussion that will sideline him for the rest of the game."

Gradual onset, gradual recovery

Here is an example of a player who didn't even know he had a concussion for several days:
"I noticed when I got hit that I hit my head and I didn't feel bad the next day -- or the next three or four days..."

"I played two more and it slowly got worse and I felt before the game in Denver [Dec. 23] that something wasn't right."

After sitting out 6 games over 2-3 weeks, gradual return to exertion appears to be the key, with two days of symptom-free biking. However, it doesn't sound like this guy is quite ready:
"It's tough to explain to someone who hasn't had one [concussion]," he said. "It's been a different experience and at times tough days, but I feel better. I've had some good days and you wake up the next morning and feel not as good.

"But I feel optimistic. I still have some slight [headaches] but not as bad as I used to."

Wednesday, January 9, 2008

Why we need trainers at ALL athletic competitions

Some schools recognize the importance of having trainers on-site during athletic events.
"I had a kid drop out of a drill in practice, he was face down, and I didn't know if it was heat-related, or what," said Nick Collins, the head football coach. "We have kids get hit in practice and we need someone there who is skilled enough to evaluate for a concussion."

I know it is a big jump from college to high school, but imagine if there was no trainer at Washington State, where a college basketball player was struck in the head during a practice, collapsed and appeared to stop breathing.
"...took an elbow to the face during the scrimmage... he went down on all fours, rose to his feet, and walked off the court before falling to his knees, then collapsing on the floor."

the trainer administered mouth-to-mouth resuscitation for one breath before he responded and regained consciousness

Tuesday, January 8, 2008

Back from a long hiatus

Got wrapped up in life, but hockey season is in full swing. Patrice Bergeron is still experiencing symptoms from a concussion sustained in Oct 2006, Joffrey Lupel is recovering from a concussion and a bruised spinal cord, reporters are listing the the 7 deadly sins associated with hits in the NHL, and even other bloggers are talking about concussions in the NHL.

So much for web dominance!