Links for Keyword: Brain Injury/Concussion
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By ALAN SCHWARZ NORMAN, Okla. — Moments after her son finished practicing with his fifth-grade tackle football team, Beth Sparks examined his scuffed and battered helmet for what she admitted was the first time. She looked at the polycarbonate shell and felt the foam inside before noticing a small emblem on the back that read, “MEETS NOCSAE STANDARD.” “I would think that means it meets the national guidelines — you know, for head injuries, concussions, that sort of thing,” she said. “That’s what it would mean to me.” That assumption, made by countless parents, coaches, administrators and even doctors involved with the 4.4 million children who play tackle football, is just one of many false beliefs in the largely unmonitored world of football helmets. Helmets both new and used are not — and have never been — formally tested against the forces believed to cause concussions. The industry, which receives no governmental or other independent oversight, requires helmets for players of all ages to withstand only the extremely high-level force that would otherwise fracture skulls. The standard has not changed meaningfully since it was written in 1973, despite rising concussion rates in youth football and the growing awareness of how the injury can cause significant short- and long-term problems with memory, depression and other cognitive functions, especially in children. Copyright 2010 The New York Times Company
By MARILYN BERGER During the horrendous heat wave in July, when all of us in New York were not quite ourselves, I started feeling funny. I was sleeping too much; my right foot was dragging; my typing was skewed; I lost interest in reading the paper, about which I am usually obsessive. I figured I’d been done in by the weather. But when it improved and I didn’t, I finally gave in and called my longtime doctor, a brilliant diagnostician who had given me my annual checkup just a month earlier. I hate to be the kind of patient who calls about every hangnail, and worse, I couldn’t report anything specific — just the foot and a sort of general lethargy. It didn’t occur to me to connect my symptoms with a minor accident I’d had in May, when I fell off my bike onto the grass, crunching my helmet. (At my checkup, the doctor and I had discussed this and another fall I’d taken, noting the curiosity that when you’re young you “fall,” but when you’re older you “have a fall.”) But when there’s something wrong with your head, I’ve discovered, you have no way of knowing there is something wrong with your head. And that Catch-22 almost proved fatal. I described my symptoms to my doctor on the phone, and she replied crisply: “Doesn’t sound like you. Go see a neurologist.” Copyright 2010 The New York Times Company
By TARA PARKER-POPE During basketball practice last year, 12-year-old Nicole Dehart was shooting the ball when a defender tried aggressively to block her shot. The two players made contact, and Nicole hit the floor headfirst. “The way she was hit took her whole body out from under her, and she landed directly on her head,” said her mother, Christine White, of Pataskala, Ohio. “We immediately knew this was serious. She was very confused and looking at people like she didn’t know who they were.” At the hospital, doctors diagnosed a concussion —an increasingly common injury in youth basketball, particularly among girls, yet one that has yet to gain widespread attention. In fact, Ms. White said, she knew enough to worry about concussions — but when Nicole played soccer, not basketball. “I worried more about broken bones, being that it is a hard floor,” she said. “But the physical contact of basketball is a lot like football inside.” On Monday, the medical journal Pediatrics reported that about 375,000 children and teenagers are treated in hospital emergency rooms each year for basketball-related injuries. Notably, the proportion related to head trauma is on the rise. In 2007, the last year of the study, about 4 percent of youth basketball injuries were to the head, about double the number of such injuries reported by emergency rooms in 1997. Copyright 2010 The New York Times Company
By Steve Yanda Across the spectrum of athletics from youth soccer to the National Football League, concussions are one of the most worrisome of injuries: hard to diagnose and even harder to know when an athlete has recovered. Now, in an unusual combination of real sports and their digital imitators, a handful of colleges, including the University of Maryland, are turning to a video game for help. Athletic trainers in College Park and on other campuses are using the Wii Fit video game as an objective and practical -- if unproven -- method of assessing athletes' balance, an important yardstick for determining recovery from concussion. For the past year, Maryland and Ohio State have partnered to conduct research into the reliability of Wii Fit -- an exercise video game played on Nintendo's Wii console, which allows for physical interaction between player and game -- as an effective concussion management instrument. Darryl Conway, Maryland's head athletic trainer, said this will be the third year the school has used components of the game to conduct baseline testing of its athletes' balance. Proponents of using Wii Fit as a tool to examine concussions praise its simplicity and affordability -- not to mention its popularity with student-athletes. "The athletes love it because what we've done is we've incorporated this fun game that they're playing at home into their rehab system," said Tamerah Hunt, director of research at the Ohio State Sports Concussion Program. "But they're also enjoying it at a time when they're injured or at a time when their spirits are down, and they have to come into the athletic training room every day and they have to get all this treatment . . . and it's kind of a reaction of, 'Oh, this is fun.' " © 2010 The Washington Post Company
by Carl Zimmer Every spring the National Football League conducts that most cherished of American rituals, the college draft. A couple of months before the event, prospective players show off their abilities in an athletic audition known as the combine. Last winter’s combine was different from that of previous years, though. Along with the traditional 40-yard dashes and bench presses, the latest crop of aspirants also had to log time in front of a computer, trying to solve a series of brainteasers. In one test, Xs and Os were sprinkled across the computer screen as the athletes took a test that measured how well they could remember the position of each letter. In another, words like red and blue appeared on the screen in different colors. The football players had to press a key as quickly as possible if the word matched its color. These teasers are not intended to help coaches make their draft picks. They are for the benefit of the players themselves—or, to be more precise, for the benefit of the players’ gray matter. Under pressure from Congress, the N.F.L. is taking steps to do a better job of protecting its players from brain damage. The little computer challenges that the draft candidates had to solve measure some of the brain’s most crucial functions, such as its ability to hold several pieces of information at once. Given the nature of football, it is extremely likely that a number of this year’s draft picks will someday suffer a head injury on the field. After that happens, N.F.L. doctors will give them the same tests again. By comparing the new results with the baseline scores recorded just before the draft, the doctors will get a clearer sense of how badly the football players have damaged their brains and what degree of caution to take during recovery.
By Marita Vera There is nothing more exhilarating for a boxing audience than to see a fighter hit the mat in a knockout. But being on the losing end of a KO punch can damage a lot more than a pugilist's pride—research suggests that the blows that cause knockouts can be debilitating to a boxer's short and long-term health. Repeated blows to the brain can cause chronic damage such as personality changes and dementia. If the punches have enough impact to cause uncontrollable brain swelling or hemorrhage, the fighter could even die. So what causes a knockout? Concussions, and lots of them. While it often seems as though the effect is caused by a single well-placed shot, it is usually the result of many quick punches. Each punch creates a concussion (technically defined as any head injury that causes a disruption of neurological function), and each concussion brings the boxer closer to a state of darkness. Here's how it happens: The body contains dissolved sodium, potassium and calcium, collectively known as electrolytes, which are responsible for conducting impulses along neurons. Every time a fighter receives a blow to a nerve, potassium leaves the cell and calcium rushes in, destabilizing the electrolyte balance, while the brain does all it can to keep these levels in balance. With each successive blow, this balance becomes harder and harder to maintain, and more and more energy must be spent in the process. When the body reaches the point where the damage outweighs the body's ability to repair itself, the brain shuts down to conserve enough energy to fix the injured neurons at a later point. ©2010 Hearst Communication, Inc.
By ALAN SCHWARZ The National Football League is producing a poster that bluntly alerts its players to the long-term effects of concussions, using words like “depression” and “early onset of dementia” that those close to the issue described as both staggering and overdue. The poster, soon to be hung in locker rooms leaguewide, becomes by far the N.F.L.’s most definitive statement on the cognitive risks of football, which it had discredited for most of the past several years as academic studies and reports of deceased players’ brain damage mounted. The new document also warns players that repeated concussions “can change your life and your family’s life forever,” a clear nod to retired players’ wives who have spoken out on the issue, occasionally before Congress. A draft of the poster also features photographs of unnamed youngsters in various sports with the reminder, “Other athletes are watching.” The new poster, which will also become a brochure given to all players, presents a stark change in league approach. It replaces a pamphlet given since 2007 that said, “Current research with professional athletes has not shown that having more than one or two concussions leads to permanent problems if each injury is treated properly,” and also left open the question of “if there are any long-term effects of concussion in N.F.L. athletes.” Copyright 2010 The New York Times Company
By Charles Q. Choi The blast waves from explosions could jolt the skull into generating electricity, potentially damaging the brain, scientists now suggest. Although the burns and shrapnel wounds that explosions can inflict are their most obvious hazards, perhaps the greatest danger comes from a blast's shock wave. These rapidly generate ripples in a person's innards, potentially causing traumatic brain injuries with deleterious effects ranging from a simple concussion to long-term impaired mental function. Now scientists have uncovered a surprising possible way by which a blast might affect the brain — electric fields created when bone is hit by a shock wave. Story continues below ↓advertisement | your ad here "It's always exciting to look at a phenomenon that may have been missed in the past," said researcher Steven Johnson, a theoretical physicist at MIT. "Moreover, this is potentially an issue that can directly affect the lives of our soldiers , which gives it a special interest for all of us who are involved." A variety of materials generate electricity when mechanically stressed. This effect, known as piezoelectricity, is commonly seen in guitar pickups and loudspeakers. Johnson and his colleagues developed a new computer model of the electric fields generated in the skull by an improvised explosive device (IED) — the kind often rigged up nowadays in combat zones. The model results suggest the generated electric fields could exceed electrical safety guidelines by a factor of 10. In fact, they might be comparable in magnitude to medical procedures employing electromagnetic fields that can disrupt brain function. © 2010 LiveScience.com.
Related chapters from BP7e: Chapter 19: Language and Hemispheric Asymmetry; Chapter 3: Neurophysiology: The Generation, Transmission, and Integration of Neural Signals
Related chapters from MM:Chapter 15: Language and Our Divided Brain; Chapter 3: Neurophysiology: The Generation, Transmission, and Integration of Neural Signals
Link ID: 14001 - Posted: 06.24.2010
By ALAN SCHWARZ ANNAPOLIS, Md.,— The night that Sylvia Mackey and Eleanor Perfetto first met, back in October at a Baltimore Ravens reception for former National Football League players and their families, their connection was immediate. As she sat on a couch with her husband, Mrs. Mackey watched Dr. Perfetto cradle the hand of her husband as he blankly shuffled across the floor toward the Mackeys. “Your husband has dementia,” Mrs. Mackey said. “Yours does, too,” Dr. Perfetto replied. “We both just knew,” Dr. Perfetto recalled on Friday, when the two visited the assisted-living facility where Dr. Perfetto’s husband, Ralph Wenzel, resides. Mrs. Mackey quickly added, “You can see it in the wives’ faces just like the husbands’.” On that evening last October, Mrs. Mackey added another N.F.L. wife to her growing network of women who seek her guidance and support as their husbands deteriorate mentally. Her husband, John, was a Hall of Fame tight end for the Baltimore Colts in the late 1960s and early ’70s, and is probably the most notable victim of dementia among former football players. Mrs. Mackey said that she regularly communicates with about 10 women like Dr. Perfetto as they learn to handle their husbands’ dementia, which often begins as early as their 50s. “I know about 20 in all,” Mrs. Mackey said. “And if I know 20, there are probably 60 or 80 out there.” Copyright 2007 The New York Times Company
By ALAN SCHWARZ Since the former National Football League player Andre Waters killed himself in November, an explanation for his suicide has remained a mystery. But after examining remains of Mr. Waters’s brain, a neuropathologist in Pittsburgh is claiming that Mr. Waters had sustained brain damage from playing football and he says that led to his depression and ultimate death. Chris Nowinski, a former Harvard football player and professional wrestler, contacted Dr. Bennet Omalu after he read about Mr. Waters’s suicide. The neuropathologist, Dr. Bennet Omalu of the University of Pittsburgh, a leading expert in forensic pathology, determined that Mr. Waters’s brain tissue had degenerated into that of an 85-year-old man with similar characteristics as those of early-stage Alzheimer’s victims. Dr. Omalu said he believed that the damage was either caused or drastically expedited by successive concussions Mr. Waters, 44, had sustained playing football. In a telephone interview, Dr. Omalu said that brain trauma “is the significant contributory factor” to Mr. Waters’s brain damage, “no matter how you look at it, distort it, bend it. It’s the significant forensic factor given the global scenario.” He added that although he planned further investigation, the depression that family members recalled Mr. Waters exhibiting in his final years was almost certainly exacerbated, if not caused, by the state of his brain — and that if he had lived, within 10 or 15 years “Andre Waters would have been fully incapacitated.” Copyright 2007 The New York Times Company
Related chapters from BP7e: Chapter 19: Language and Hemispheric Asymmetry; Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 15: Language and Our Divided Brain; Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders
Link ID: 9855 - Posted: 06.24.2010
by Andy Coghlan Crazy as it sounds, alcohol may one day be given to people with brain injuries to help them recover. The idea has arisen from a study of 38,000 people with head injuries, which found that those with alcohol in their blood were more likely to survive. For every 100 people who died when stone-cold sober, only 88 died with ethanol – the kind of alcohol in drinks – in their veins. "The finding raises the intriguing possibility that administering ethanol to patients with brain injuries may improve outcome," conclude the investigators. Lead researcher Ali Salim of the Cedars-Sinai Medical Center in Los Angeles said he hoped a trial could be mounted, but more information is needed first. "We need a better understanding of the exact mechanism, the appropriate dose and specific timing of treatment before we can embark on clinical trials," he told New Scientist. Salim said that several previous studies have found similar beneficial effects – although others do not. Animal experiments, meanwhile, suggest that relatively low doses of alcohol protect the brain from injury, but high doses increase the risk of death. More research is also needed to establish how alcohol protects the brain, but Salim says it may work by blunting the amount of adrenalin reaching the brain, which reduces inflammation. © Copyright Reed Business Information Ltd
Related chapters from BP7e: Chapter 19: Language and Hemispheric Asymmetry; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 15: Language and Our Divided Brain; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 13290 - Posted: 06.24.2010
By Andrew Holtz PORTLAND, OREGON -- It is easy to understand how explosions involving shrapnel – such as those caused by improvised explosive devices in Iraq – could cause brain damage. But what about such injuries that seem to be caused by blasts themselves, rather than from being thrown or hit by shrapnel? Researchers have a few ideas, but one scientist has used some of the world’s most powerful computers at the Lawrence Livermore National Laboratory in California to get a better answer. Willy Moss and colleague Michael King used available data on blast waves from explosions and the physical properties of the human skull, brain and cerebrospinal fluid to craft a three-dimensional simulation of a soldier standing less than 15 feet from an explosion of 5 lbs. of C4. (See image to the right.) “It sweeps over. There’s lots of oscillation. The skull is ringing. It’s not pleasant,” Moss told the audience at the meeting of the Acoustical Society of America here. Moss says their simulations suggest that the intense pressures of such blasts flex the skull and ripple the brain. Pressures as little as one atmosphere over normal atmospheric pressure can do that kind of damage. They repeated the simulation to include helmets, first using data from an older style that uses webbing to create space around a soldier’s head. (See video below.) “What you see is the blast sweeps under the helmet. It acts as a wind scoop; it focuses the blast. The blast pressure is bigger between your head and the helmet than if you weren’t wearing the helmet at all.” © 1996-2009 Scientific American Inc.
HELEN BRANSWELL Traumatic brain injuries have become the signature wound of the wars in Afghanistan and Iraq and troops who sustain them face a daunting array of potential medical consequences later on, a report on the issue commissioned by the U.S. Department of Veterans Affairs. The report from the Institute of Medicine – a body that advises the U.S. government on science, medicine and health – said military personnel who sustain severe or even moderate brain injuries may go on to develop Alzheimer's-like dementia or symptoms similar to Parkinson's, a neurodegenerative disease. They face a higher risk of developing seizure disorders and psychoses, problems with social interactions and difficulty holding down a job. Troops who sustain even mild brain injuries are more likely to develop post-traumatic stress disorder (PTSD). And all are at a higher risk of experiencing aggressive behaviour, depression and memory problems. The report urged the U.S. government to ramp up research in the area, saying there is not enough evidence in the medical literature – especially as relates to mild brain injuries – to determine what today's troops face and how best to help them recover from or cope with the health problems they may develop. © Copyright 2008 CTVglobemedia Publishing Inc.
It's a scene football fans will see over and over during the bowl and NFL playoff seasons: a player, often the quarterback, being slammed to the ground and hitting the back of his head on the landing. Sure, it hurts, but what happens to the inside of the skull? Researchers and doctors long have relied upon crude approximations made from test dummy crashes or mathematical models that infer – rather loosely – what happens to the brain during traumatic brain injury or concussion. But the truth is that the state of the art in understanding brain deformation after impact is rather crude and uncertain because such methods don't give any true picture of what happens. Now, mechanical engineers at Washington University in St. Louis and collaborators have devised a technique on humans that for the first time shows just what the brain does when the skull accelerates.
Related chapters from BP7e: Chapter 2: Functional Neuroanatomy: The Nervous System and Behavior; Chapter 19: Language and Hemispheric Asymmetry
Related chapters from MM:Chapter 2: Cells and Structures: The Anatomy of the Nervous System; Chapter 15: Language and Our Divided Brain
Link ID: 8288 - Posted: 06.24.2010
PITTSBURGH, – High school and college athletes with migraine headache characteristics after a concussion may have increased neurocognitive impairment, suggests a University of Pittsburgh Sports Medicine Concussion Program study published in the May issue of the Journal of Neurosurgery. The study results speak to the need for extreme caution in clinical evaluation and return-to-play decisions, say the authors. In the study, athletes who had characteristics of post-traumatic migraine (PTM) headache following a concussion also showed increased neurocognitive function impairment and related symptoms compared to concussed athletes with no post-injury headache or non-migraine headache. "The findings of our study strongly support the need for clinicians to exercise increased vigilance in making decisions about managing a concussed athlete with PTM and extreme caution as to when that athlete should be allowed to return to play," said the study's lead author, Jason Mihalik, CAT(C), A.T.C., who now is a doctoral student working in the Sports Medicine Research Laboratory at the University of North Carolina at Chapel Hill. "This research is important because headache is the most common reported symptom after a sports-related head injury. As many as 86 percent of these injuries are accompanied by some type of headache," commented study co-author Joseph Maroon, M.D., professor of neurological surgery at the University of Pittsburgh School of Medicine.
NEW ORLEANS – A new study in rats has found that after severe spinal cord injury, molecules intended to help nerves communicate can attack the tissue surrounding the initial injury and cause further damage. Interestingly, this latent, or secondary, injury develops over days and even weeks after the initial injury. It also appears to cause larger, more debilitating lesions in the spinal cord, said Randy Christensen, the study’s lead author and a postdoctoral researcher in neuroscience at Ohio State University. Receiving the initial brunt of the secondary trauma seem to be the neurons, or the cells in gray matter. As time passes, however, tissue in the white matter is also destroyed by secondary damage. Oligodendrocytes, the main cell type in white matter, begin to self-destruct during the secondary injury.
Penn scientists find that coaster G’s, twists, and speeds are not enough to injure the brain (Philadelphia, PA) – To meet the growing expectations of thrill-seekers, amusement park rides have been built bigger, faster, and more exciting. But do bigger thrills come with added risks of injury? Published medical case studies have proposed a link between roller coaster forces and brain injury. Already the State of New Jersey has enacted legislation limiting G forces, and similar legislation has been proposed by members of the U.S. House of Representatives. According to a pair of researchers at the University of Pennsylvania, however, medical science does not support the notion that roller coasters produce forces large enough to harm the brains of riders. Their findings are presented in the October issue of the Journal of Neurotrauma. "We should step back and separate the facts from the hype," said Douglas H. Smith, MD, from the Department of Neurosurgery and the Head Injury Center at the Penn School of Medicine and co-author of the study. "To our knowledge, no peer-reviewed studies have definitively linked brain injury in healthy individuals to riding the latest, and most powerful roller coasters. In fact, G forces really aren't the issue here."
A now deceased NHL player had a brain condition linked to concussions — the first time a professional hockey player has been diagnosed with the disease. Reggie Fleming played 13 crushing seasons as a defenceman and forward during the 1960s and 1970s. Fleming was one of the National Hockey League's hardest hitters in the days before helmets. After Fleming died on July 11 at the age of 73, he became the first NHL player to have his brain examined by the Sports Legacy Institute, which is studying the long-term impact of concussions. "We discovered that Mr. Fleming was suffering from chronic traumatic encephalopathy when he died," said Chris Nowinski, co-director of the institute in Boston. "It's a progressive degenerative disease." Chronic traumatic encephalopathy CTE is characterized by a build-up of a toxic protein called tau — the same abnormal protein found in Alzheimer's disease. At first, the abnormal protein impairs normal brain function and eventually kills brain cells. The symptoms — memory impairment, emotional instability, erratic behaviour, depression and problems with impulse control and eventually dementia — are similar to Alzheimer's, which is why athletes may be misdiagnosed. But the proteins are distributed in different parts of the brain. © CBC 2009
Related chapters from BP7e: Chapter 19: Language and Hemispheric Asymmetry; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 15: Language and Our Divided Brain; Chapter 13: Memory, Learning, and Development
Link ID: 13588 - Posted: 06.24.2010
By ALAN SCHWARZ No direct impact caused Paul McQuigg’s brain injury in Iraq three years ago. And no wound from the incident visibly explains why Mr. McQuigg, now an office manager at a California Marine base, can get lost in his own neighborhood or arrive at the grocery store having forgotten why he left home. But his blast injury — concussive brain trauma caused by an explosion’s invisible force waves — is no less real to him than a missing limb is to other veterans. Just how real could become clearer after he dies, when doctors slice up his brain to examine any damage. Mr. McQuigg, 32, is one of 20 active and retired members of the military who recently agreed to donate their brain tissue upon death so that the effects of blast injuries — which, unlike most concussions, do not involve any direct contact with the head — can be better understood and treated. The research will be conducted by the Sports Legacy Institute, a nonprofit organization based in Waltham, Mass., and by the Boston University Center for the Study of Traumatic Encephalopathy, whose recent examination of the brains of deceased football players has found damage linked to cognitive decline and depression. Whether single, non-impact blasts in battle can cause the same damage as the years of repetitive head bashing seen in football is of particular interest to researchers. The damage, primarily toxic protein deposits and tangled brain fibers, cannot be detected through noninvasive procedures like M.R.I.’s and CT scans. Copyright 2009 The New York Times Company
By BENEDICT CAREY A long-awaited government report is calling on the military to test all new recruits for cognitive skills and then do large-scale studies of returning combat veterans to better evaluate and respond to traumatic brain injury, the signature wound of the Iraq war. For years, veterans’ advocates and researchers have called for more careful investigation of head injuries — not just severe wounds but also “closed head” injuries, which do not produce visible damage and do not show up on CT scans. Some doctors and veterans say the high blast impact of I.E.D.’s, the roadside explosives that have accounted for most head injuries to troops in Iraq, may be creating symptoms that differ from the sort of concussions suffered in sports or car accidents. Many veterans have complained of persistent, sometimes disabling symptoms like sleeplessness, dizziness and confusion that can resemble disorders like post-traumatic stress and can complicate disability assessments. The report, released Thursday by the Institute of Medicine, a government advisory group that studies health and medical issues, recommends that the Departments of Defense and Veterans Affairs conduct careful studies “to confirm reports of long-term or latent effects of exposure to blasts.” Some 5,500 military personnel have suffered brain injuries from mild to severe. The wounds account for an estimated 22 percent of all casualties in Afghanistan and Iraq — about twice the rate in Vietnam. Experts attribute this increase in part to better on-site medical care and body armor that allows ground troops to survive blasts that would otherwise be deadly. Copyright 2008 The New York Times Company