Head concussions in athletes have received increased media attention because of new information about the nature of the brain injury, as well as new research on the long term effects of concussions. Spaulding Network clinicians are seeing an increasing number of athletes suffering from concussion symptoms on the field and the lingering effects of mild TBI.
What happens to the brain during a concussion?
The brain's soft tissues are normally cushioned by spinal fluid and protected by the skull. When an athlete sustains a concussion, the brain hits against the skull and causes bruising of the brain, tearing of blood vessels and nerve damage. The most common symptoms of a concussion are blurred vision, nausea, excess sleep, headache, nausea, blurred vision, and in severe cases, loss of consciousness and vomiting.
When an athlete suffers from a concussion it is necessary to sit out and let the brain heal. The difficulty is that a concussion is not a visible injury, so many coaches and trainers don't know when or how long the athlete should rest for. One of the new dangers discovered in concussion research is in Second Impact Syndrome.
Second Impact Syndrome (SIS) is a rare condition in which a second concussion occurs before the first concussion has healed, leading to severe brain swelling and often catastrophic results. The most common symptoms of SIS are dilated pupils, loss of eye movement and unconsciousness, which may ultimately lead to respiratory failure and death. Over time an athlete who has received multiple head injuries can develop a brain disease known as Chronic Traumatic Encephalopathy (CTE). The symptoms of CTE include memory impairment, emotional instability, erratic behavior, and depression, seen mostly in players in their 40s and 50s. CTE was originally found in boxers, NFL players are also demonstrating symptoms that have been confirmed through brain autopsies.
With recent publicity from doctors and neurologists, more research is being done on concussions to help determine the physiological effects. With advances in technology, doctors have designed a test called ImPACT, is a computer-based testing program designed for the management of sports related concussions. ImPACT provides a baseline cognitive assessment that can be compared with an injured athlete's post-concussion scores to help track recovery for a safe return to play.
ImPACT is now being used by 24 NFL teams, 18 MLB teams, and all NHL teams, helping their training staff identify the appropriate time for an athlete's return to play. Head injuries in athletes which were once an ignored subject are finally becoming noticed at the professional level.
Boston University is working with the NFL and former athletes who have suffered from suspected Post Concussion Syndrome. Many NFL athletes have decided to donate their post-mortem brains to BU's Center for the Study of Traumatic Encephalopathy. Ted Johnson, a former linebacker for the New England Patriots, is among the many players who have volunteered to be part the research to help benefit current professional athletes as well as children who are participating in youth sports.
There is also exciting new research underway at the Carolina Sports Medicine Research Laboratory at UNC Chapel Hill. The research project is the first of its kind which uses state-of-the-art technology to study head trauma during live practices and games. Sixty North Carolina players use helmets fitted with accelerometers, which are soft, spring-like devices situated between the cushions inside the helmets. When a player's helmet is struck, the accelerometer records the g-force (a measure of acceleration against the earth's gravitational pull).
The accelerometers also measure the location of each hit to top of the helmet, side, front, or back and the angle of each impact. The accelerometers have pioneered the way in researching and diagnosing head trauma. With the research found on the field, North Carolina's athletic trainers have actually been able to rule out concussions, allowing athletes to return to play without the risk of SIS.
Spaulding Network staff not only work with individuals who have sustained concussions, but our Athletic Trainers (ATCs) work with athletes on the field- from high school teams to professional athletes. It is critical that our ATCs are using the latest assessments and interventions to help prevent concussions and the long term effects of TBI.
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