“Concussion” Movie is Just the Beginning of the Brain Injury Conversation

by Tony Doran, Psy.D.
HeadFirst Concussion Care Program Director
and Ann-Marie Sedor, HeadFirst Concussion Care Marketing

The much-anticipated movie “Concussion” is scheduled for release this year on Christmas Day, and already there is Oscar Award talk for Will Smith, who plays the role of Dr. Bennet Omalu. It was Dr. Omalu who discovered the tragic progressive degenerative effects of years of multiple concussions in NFL players, which he named CTE (chronic traumatic encephalopathy).

US-ENTERTAINMENT-SCREENING-CONCUSSION

Bennet Omalu, M.D., (L) and actor Will Smith attend the screening of the major motion film, “Concussion,” on November 23, 2015. (VALERIE MACON/AFP/Getty Images)

The film highlights the NFL’s initial response of anger and denial. Indeed, since Dr. Omalu’s discovery in 2002, the NFL has experienced lawsuits, exposés, and finger-pointing in general. Now, 13 years later, bystanders have watched the NFL’s reaction to this scientific research unfold in a manner not unlike many stages of grief – first denial, then anger, on to bargaining and, finally, acceptance. (Although, the League is still working on fully coming to terms with this last step.)

For their part, the NFL hasn’t had much reaction to the movie, preferring to keep the controversy at arm’s length. While Dr. Omalu has vocalized his opposition to children playing football until they are legally and emotionally old enough to understand the danger of putting their brains at risk, the NFL can’t afford to lose any of their reported $7+ billion in annual revenue.

Yet, while the debate rages on, two points are patently clear from years of scientific research: that children repeatedly hitting their heads during developmental years is potentially very harmful, and that college and professional football players can face significant health consequences from playing the sport.

But just how serious are families going to be about keeping their children from playing football? Indeed, this is just the beginning of the conversation about brain injuries.

As a community-based concussion clinic that has treated more than 30,000 traumatic brain injury patients over the past three years, HeadFirst Concussion Care has seen multiple reasons for why people sustain concussions. And while football is a violent sport, soccer, lacrosse and hockey also put our youth at risk for head trauma.

And again, this is just half of the dialogue. HeadFirst’s data shows that traumatic brain injuries sustained while playing organized sports with a concussion protocol in place (high school or college sports) account for a relatively small percentage of our patients. In fact, in as many as 80 percent of our patients, concussions are sustained by other mechanisms of injury. These include non-organized sports-related injuries (bike riding, skateboarding, trampolining, skiing, pick-up or other informal recreational games), slips and falls, motor vehicle accidents, and assaults.

The key message is that the people must understand that traumatic brain injuries can happen to anyone, anywhere, at any time. Not just kids. Not just athletes. And certainly, not just NFL players. And since anyone is at risk, everyone must understand the proper protocols for healing an injured brain.

On a final note to end the year, my holiday wish is that families, schools, and employers begin to talk about head injuries and follow traumatic brain injury protocols to keep all children and adults safe.

Just How Long Do the Effects of Adolescent Concussions Last?

An article in this week’s New York Times blog discussed the findings of a recent study of now middle-aged people who had sustained concussions in their youth.

The long-lasting effects of concussion may have been subtle to the individuals, themselves, but the results of the study spoke volumes to the scientists conducting it.

Researchers from the University of Montreal studied a group of people who’d played high school or college sports 30 years before, some of whom had sustained concussions. In the years since, they remained physically active but had stopped competing. None had complained of failing memory or other impairments more than any other average 50- to 60-year-old.

But, after being given a series of MRI scans to measure the volume of brain segments and the metabolic health of certain neurons, as well as cognitive written and verbal tests, those volunteers who had suffered concussions in their youth were found to have just a little bit more trouble recalling events, words and names more than the volunteers who’d never received a concussion.

Some of those who had been hit in the head in the decades prior were found to have slightly less volume in the hippocampus, an area of the brain associated with memory and learning, while others had thinner cortexes, metabolic slowing or cell abnormalities.

The researchers found that the 50-year-old study participants who had been hit in the head had brains that were structurally and metabolically similar to those of uninjured 60-year-olds.

We could conclude that, even with an active lifestyle, people who have received concussions as children could end up having brain function that is older than their chronological age.

Dr. Kevin M. Guskiewicz, chairman of exercise and sports science at the University of North Carolina at Chapel Hill, suggests that everyone, whether having sustained concussions or not, exercise their brain to overcome the effects of cognitive aging. “Exercise. Do puzzles. Read. Learn new things. Those are all good for your brain anyway,” he says.

Mild Brain Injuries Just Don’t Exist

We find it interesting people still call concussions “mild brain injuries.”  Furthermore, culture makes every attempt to break down the preconceived notion that concussions are nothing serious.

“Just shake off,” they say, or “Man-up.” We can thank educational resources like the dictionary and encyclopedia for perpetuating this misconception. Even Wikipedia, the popular online Web site, plainly states that “The terms mild brain injury, mild traumatic brain injury (MTBI), mild head injury (MHI), minor head trauma, and concussion may be used interchangeably.”

If people believe that a concussion is so mild, we invite them to review the following details: 

1) Did you know that the word concussion comes from the Latin word concutere which means TO SHAKE VIOLENTLY.

2) Concussion side effects can include physical,

cognitive and emotional impairments. Think that’s mild? These side effects can range from blurred vision and headaches to convulsion and amnesia. In severe cases, psychiatric disorders and even long-term memory loss (including a greater risk of developing Alzheimer’s) are possible. Hardly mild.

Don’t get us wrong, in nearly all cases, people who sustain a concussion will live a happy, healthy and fully functional life.  We just need to make sure our facts are straight, especially from the resources we use to learn.

Concussions are a brain injury, not a “mild injury,” not a “mild head trauma”…  A brain injury.

Courtesy WebMD

Uncovering Clues About Concussions in High School Football Players

Steven Broglio, Ph.D., A.T.C., director of the University of Michigan’s Neurotrauma Research Laboratory and assistant professor at the U-M School of Kinesiology, has been conducting research on the number of hits sustained by a high school football player and is reporting staggering numbers.

Using helmet sensors, Broglio found that the average player sustains more than 650 impacts per football season, though some players experience more than 2,000 hits. A concussion will occur with a hit that measures about 90 to 100 g-force, which Broglio reports as a head smashing against a wall at 20mph.

Another interesting note about is his finding that concussions don’t seem to occur as a result of the “snowball” effect—that is, lots of smaller hits don’t equal a concussion. Rather, all it takes to sustain a concussion is a single, solid hit.

Michigan is one of the few states remaining which has not passed youth concussion protection legislation.

Take a look at the video from the University of Michigan News Service to see Broglio’s helmet sensor and how the hits were measured.

Young Teens’ Brains Most Vulnerable to Concussions, Study Shows

A groundbreaking study recently completed by Dave Ellemberg, a neuropsychologist who heads up the department of Kinesology at the University of Montreal, has found that adolescents are more susceptible to the effects of sport-related concussions.

Ellemberg compared the consequences of trauma on three different age groups: children, adolescents and adults. His results show that all three groups are equally afflicted by the concussion injury but that adolescent brains are more sensitive than the brains of the other two groups.

This is new information because it had been thought for years that younger brains could recover more quickly from the initial effects of injury.

According to Ellemberg, “The frontal regions of the brain are more vulnerable to concussions. These areas oversee executive functions responsible for planning, organizing and managing information. During adolescence, these functions are developing rapidly which makes them more fragile to stress and trauma.”

Teams need to have an adult trained in what to do if a child has a concussion. In addition, an effort should be made to eliminate violence and situations that can lead to concussions, Ellemberg added.

According to Ellemberg, these results force us to re-evaluate our understanding of sport-related concussions. “The situation is more serious than we think,” he says. “Contrarily to professional athletes, youngsters don’t have a medical doctor and a protocol in place for becoming active again. However, for me, their brain is more important than the brain of a famous football player. It needs to be protected with the right diagnostic tools and an adapted framework.”

The results were published in the February 28 edition of Brain Injury, the official journal of the International Brain Injury Association.