concussions

Discussion of Minnesota Girls High School Hockey

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greybeard58
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Anoka HS alum Briana Scurry

Post by greybeard58 » Fri Aug 12, 2022 10:30 pm

Anoka HS alum Briana Scurry "The problem with concussions is a lot of us suffer in silence"

Soccer star Briana Scurry still remembers the day she knew she wanted to be an Olympian: It was 1980, and Scurry, then 8 years old, watched on TV as the underdog men's U.S. Olympic ice hockey team beat Team USSR in Lake Placid, NY.

"I was so inspired, I rose up from the couch and declared to my parents that I wanted to be an Olympian," Scurry says. "They, thankfully, were nurturing of that little inspiration and helped me hone my skills in all different sports through high school."

Scurry would go on to become one of the top goalkeepers in the history of U.S. women's soccer. She won two Olympic gold medals, in 1996 and 2004, and a World Cup in 1999. But her soccer career ended abruptly in 2010, when she was playing in the new Women's Professional Soccer league and a member of the opposing team collided with her, crashing her knee into Scurry's right temple.

"My whole life changed from that moment," Scurry says. "I knew there was something really wrong. ... That was the last soccer game I've ever played.”

The collision left Scurry with a traumatic brain injury, which resulted in constant, excruciating headaches, blurred vision, cognitive problems and depression. She was unable to work and the league soon collapsed, leaving her without a medical team or training facility to help her. To make matters worse, Scurry's insurance company refused to cover the surgery she needed to repair the nerve that was the source of her pain, and she was reduced to pawning her two gold medals.

"It was the most difficult thing I'd ever done in my life," Scurry says of selling her Olympic medals for $18,000. "But it was the patch and the temporary fix that I needed to get some stability in order to continue to press forward and get the help I needed."

Scurry credits Chryssa, the woman who would become her wife, with helping to pressure the insurance company into covering her surgery and therapy — and with helping her buy back her Olympic medals. In 2017, Scurry became the first Black woman to be inducted in the National Soccer Hall of Fame. She tells her story in the new memoir, My Greatest Save.


Interview Excerpt
On her life-changing traumatic brain injury in 2010

In the first half I bent over for a low ball coming from my left-hand side, and as I was going to make that save and I was bent over, the attacking player came from the right-hand side and, trying to get her toe on the ball in front of me, crashed into the side of my head with her knee. And I never saw her coming. [Because] I didn't see her, I couldn't brace at all for it. So I was completely exposed. She crashed into me. We bundled over. And, of course, my first thought was, Did I make the save? Sure enough, I had the ball in my hands. ...

I had had concussions before — you get some blurry vision, you get some sensitivities. And then ... it fades away, like the wave of the emotions and the issue fade away and you get clarity again. But I wasn't getting clarity. I was tipping to the left. The names on the jerseys were blurry. And at half time, which blew maybe seven or eight minutes later, I was walking off the pitch and ... my trainer came into the pitch to meet me, and she grabbed my hands and she said, "Bri, are you okay?" And I said, "No, I'm not." ...

For the longest time, I was mad at [the player who crashed into me]. I found out what her name was and exactly who she was. And for several years, I was angry at her for putting me in this position, for not avoiding contact with me. I realized over time that my anger towards her wasn't helping me and ... for a long time wished I could undo that hit. And when you're in an emotional state like a concussion, you are essentially disconnected from yourself. And I had all these symptoms and I was so angry at her. And I prayed so many days. I was like, "Why couldn't you have just missed me?" Because I was a different person now. I changed emotionally, I was different. My confidence, my focus, all these different things. And I was so lost in the wilderness.

On having suicidal thoughts because of her emotional and physical symptoms
I was in that state of emotional distress. I had emotional and physical symptoms. I had depression. I once stood on the ledge of a waterfalls in Little Falls, New Jersey, and contemplated suicide. The railing where the falls were was really low and the water was just rushing over the falls and I could feel the mist of that water on my face. And I contemplated jumping over and I knew if I did that I wouldn't survive it because I couldn't swim. And the water was so high because it had rained just recently. I knew if I go into this water, I'm never coming out. But what stopped me was the image of my mom and some official, some law enforcement official knocking on her door and notifying her that her baby was gone. I couldn't do that to her. So that image got me off the ledge and onto some solid ground, literally. And after that, I decided I wasn't going to commit suicide while my mother was alive because I just couldn't do it to her. And that was the beginning of my journey back to me.

A brain injury cut short Briana Scurry's soccer career. It didn't end her story
Read more: https://www.npr.org/2022/07/27/11127318 ... ain-injury

greybeard58
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Remembering McKenna Elizabeth Brown

Post by greybeard58 » Sun Aug 14, 2022 12:46 pm

Remembering McKenna Elizabeth Brown

McKenna Elizabeth Brown of Palm Harbor, a 16 year old Senior at East Lake High School, passed away on August 7th. McKenna loved life, her family, God, hockey, The Chapel, her teammates, and friends. She was the beloved daughter of Hunter and Cheryl McCormick Brown. She is survived by her older brother, friend, and mentor MacCallum. She was a best friend and advocate to her sister McKinley. Her grandparents are Sharon McCormick (Tampa), Ruth Brown, & Jim Gardhouse (Guelph Ontario, Canada), and Jean McCormick (Seminole). She has aunts, uncles and many cousins in Missouri, Canada, and Europe. She was preceded in death by grandfathers Don Brown and Kenneth McCormick Sr.
McKenna's service will be Saturday, August 13th at The Chapel in Trinity, 8833 Mitchell Blvd. Trinity, FL, 34655. Visitation will be from 10-12 and the service will begin at 12.
In lieu of flowers we request you consider making a donation in McKenna's name to either the BU CTE Brain Bank or the American Foundation for Suicide Prevention.
BU
https://www.bu.edu/cte/financial-support/
or
AFSP
https://supporting.afsp.org/index.cfm?f ... tCEALw_wcB
To send flowers to the family or plant a tree in memory of McKenna, please visit our floral store.

Published by Hubbell Funeral Home & Crematory on Aug. 10, 2022.

https://www.legacy.com/us/obituaries/na ... n-obituary

NEW SUICIDE PREVENTION LINK https://988lifeline.org/

greybeard58
Posts: 2332
Joined: Sat Aug 21, 2004 11:40 pm

Female athletes underrepresented in sports science research

Post by greybeard58 » Tue Sep 06, 2022 11:38 am

Female athletes underrepresented in sports science research

As Title IX's first generation ages, research needed to identify effects of playing sports
Read more: https://www.usatoday.com/story/sports/c ... 353912002/

greybeard58
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The Incidence of Concussion and Symptom Non-Reporting Among Professional Women's Ice Hockey Players

Post by greybeard58 » Mon Sep 12, 2022 3:55 pm

The Incidence of Concussion and Symptom Non-Reporting Among Professional Women's Ice Hockey Players
David A Bloom, Darryl C Whitney, Guillem Gonzalez-Lomas, Cordelia W Carter
PMID: 34605752
Abstract
Background: Female ice hockey players have rates of sports-related concussion that are similar to male participants at various levels of play, despite differences in the rules that do not allow for body checking in the women's game. At the elite level, there are limited data regarding concussion rates and concussion symptom reporting. Therefore, it was hypothesized that there would be a high incidence of concussion and concussion symptom-reporting in professional women's ice hockey players.

Methods: A survey was given to 54 players in the National Women's Hockey League at the end of the 2018-2019 season. Players reported on the number of concussions diagnosed by a physician throughout their careers, the number of times they have had concussion symptoms, if they had ever continued playing after experiencing concussion symptoms, and if they had ever failed to report concussion symptoms to a medical professional or coach.

Results: Fifty-four players completed the survey. Thirty-one (57%) respondents reported at least one concussion diagnosed during their playing career, with 16 (30%) reporting two or more diagnosed concussions. Thirty-six (67%) players reported experiencing concussion symptoms at least once, with 26 (48%) reporting two or more occurrences of such symptoms. Of the 36 players who had experienced symptoms of concussion, 25 (69%) reported that they continued playing at least once after experiencing concussion symptoms. Seventeen players (36%) reported that they did not initially tell anyone about their concussion symptoms on at least one occasion, while seven players (19%) never disclosed their symptoms.

Conclusion: There is a high incidence of sport-related concussions reported in women's professional ice hockey players as well as an alarming rate of symptom nonreporting.

Clinical relevance: This study provides new data on rates of concussion and symptom non-reporting among female professional ice hockey players and will aid clinicians in decision making when caring for these athletes.

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Incidence of Sports-Related Concussion Among NCAA Women's Ice Hockey Athletes.
Brook EM, Kroshus E, Hu CH, Gedman M, Collins JE, Matzkin EG.
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Echlin PS, Tator CH, Cusimano MD, Cantu RC, Taunton JE, Upshur RE, Hall CR, Johnson AM, Forwell LA, Skopelja EN.
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Implementation and effect of concussion education in collegiate women's ice hockey.
Piana LE, Garvey KD, Kroshus E, Brook EM, Matzkin EG.
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Ingram BM, Kay MC, Vander Vegt CB, Register-Mihalik JK.
J Sport Rehabil. 2019 Sep 1;28(7):774-777. doi: 10.1123/jsr.2018-0102.
PMID: 30300048 Review.
The incidence of concussion in professional and collegiate ice hockey: are we making progress? A systematic review of the literature.
Ruhe A, Gänsslen A, Klein W.
Br J Sports Med. 2014 Jan;48(2):102-6. doi: 10.1136/bjsports-2012-091609. Epub 2013 May 3.
PMID: 23645831 Review.


https://pubmed.ncbi.nlm.nih.gov/34605752/

greybeard58
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Concussion increases risk of behavioral and emotional problems in kids

Post by greybeard58 » Sun Sep 18, 2022 12:50 pm

Concussion increases risk of behavioral and emotional problems in kids

University of Rochester researchers have been at the forefront of efforts to understand how blows to the head impact the brain, including how concussions change brain structure . Now researchers at the Del Monte Institute for Neuroscience have found that kids who experience a traumatic brain injury (TBI), even a mild one, have more emotional and behavioral problems than kids who do not.

“These hits to the head are hard to study because much of it depends on recall of an injury since the impacts do not all require a visit to a doctor,” said Daniel Lopez, a Ph.D. candidate in the Epidemiology program and first author of the study out today in NeuroImage. "But being able to analyze longitudinal data from a large cohort and ask important questions like this gives us valuable information into how a TBI, even a mild one, impacts a developing brain."​

Researchers used MRI and behavioral data collected from thousands of children who participated in the Adolescence Brain Cognitive Development (ABCD) Study. They revealed children with a mild TBI experienced a 15-percent increased risk of an emotional or behavioral problem. The risk was the highest in children around ten years old. Researchers found that children who had a significant hit to the head but did not meet diagnostic criteria for a mild TBI also had an increased risk of these behavioral and emotional problems.

The University of Rochester Medical Center is one of 21 research sites collecting data for the National Institutes of Health ABCD Study. Since 2017, 340 children from the greater Rochester area have been part of the 10-year study that is following 11,750 children through early adulthood. It looks at how biological development, behaviors, and experiences impact brain maturation and other aspects of their lives, including academic achievement, social development, and overall health.

Researchers hope future ABCD Study data will better reveal the impact these head hits have on mental health and psychiatric problems. “We know some of the brain regions associated with increased risk of mental health problems are impacted during a TBI,” said Ed Freedman, Ph.D., associate professor of Neuroscience and co-principal investigator of the ABCD Study at the University of Rochester. Freedman also led this study. “With more time and data, we hope to gain a better understanding of the long-term impact of even a mild TBI.”

Additional co-authors include Zachary Christensen, John J. Foxe, Ph.D., Laura Ziemer, and Paige Nicklas, all members of the Frederick J. and Marion A Schindler Cognitive Neurophysiology Lab that is part of the Del Monte Institute for Neuroscience at the University of Rochester. The research was supported by the National Institute on Drug Abuse, and the UR Intellectual and Developmental Disabilities Research Center.

Mild traumatic brain injury increases risk of behavioral and emotional problems in kids
Read more: https://www.urmc.rochester.edu/news/pub ... ms-in-kids

greybeard58
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Re: concussions

Post by greybeard58 » Wed Sep 21, 2022 10:44 am

• Calls for ‘urgent action by government’ to address failures
• FA and PFA strongly criticized over concussion risk in football





Campaign groups have welcomed the publication of a damning new parliamentary report into the management of brain injuries in sport.
The report, based on a four-month inquiry by the digital, culture, media and sport select committee, calls for “urgent action by the government to address a long-term failure to reduce the risk of brain injuries in sport”. It is strongly critical of both the Football Association and the Professional Footballers’ Association for “failing to fight hard enough or publicly enough to address the issue of concussion” and recommends an urgent overhaul of concussion management across all grassroots and elite sport in the UK.



“What is astounding is that when it comes to reducing the risks of brain injury, sport has been allowed to mark its own homework,” said the committee chair, Julian Knight MP. “The Health and Safety Executive is responsible by law, however risk management appears to have been delegated to the national governing bodies, such as the FA.
“That is a dereliction of duty which must change. The failure by these sporting organizations to address the issue of acquired brain injury is compounded by a lack of action by government. Too often it has failed to take action on player welfare and instead relied on unaccountable sporting bodies.”
Judith Gates, a founder of the charity Head For Change, described the report “as a turning point, a first step, in addressing the problem openly and taking steps to find solutions”. Gates said that while the report clearly showed that “mistakes have been made” she feels we “need to learn from these rather than apportioning blame. The focus should be twofold: immediate care for players currently suffering but education and awareness of the dangers for future players.”
The former England scrum-half Kyran Bracken, speaking on behalf of the Progressive Rugby group, said: “I truly hope the committee’s findings will be a watershed in the approach to the management and research of concussion in sport and expect to see sporting bodies being held accountable for the duty of care their employees have a right to expect.” Progressive Rugby also called on World Rugby to “urgently address the current elite return to play protocols, which we maintain are not fit for purpose”.

At the elite level the parliamentary report criticized UK Sport for running a system in which there is “no overall responsibility to mandate minimum standards for concussion and head trauma” and which “allows sports to be funded as long as their protocols look good on paper”. It also criticized the FA for not taking a stronger, sustained interest in the issue after the coroner’s verdict on the death of Jeff Astle from industrial disease in 2002, and the PFA for not pressuring the FA to do it. At the grassroots level, it criticized NHS England for failing to keep full records on concussion injuries, and for failing to ensure clinicians have the most up-to-date training.
Among its key recommendations are that the government should establish a UK-wide minimum standard definition for concussion as well as a new set of concussion protocols that all sports must use, and that the Health and Safety Executive should work with national governing bodies of all sports to establish a national framework for the reporting of sporting injuries.
It also called for UK Sport to be mandated to take a governance role in assuring that all the sports it funds raise awareness on the dangers of concussion effectively, and for UK Sport to pay for a medical officer with responsibility to ensure the safety of participants at every major sporting event.
Overall, the report recommends a move away from the conservative approach towards research into the issue advocated by the international Concussion in Sport Group, which currently underpins most UK policy, towards a more precautionary approach. It suggests the government convenes its own specialist concussion group every four years to review the existing evidence into the long-term risks of concussion, and also recommends that the government should establish a single fund to co-ordinate and pay for research.
The report is published on the same day as a landmark new study by the Drake Foundation and Imperial College in collaboration with the Rugby Football Union. The study showed that 23% of a group of 44 current elite rugby players had abnormalities in their brain structure, including small tears in their blood vessels and other “white matter” damage.


The Drake Foundation has called for “additional updates to the game’s laws and protocols to minimise players’ exposure to head impacts.” The RFU has promised more research as a priority and pledged to set up “a specialist clinical service for the assessment and management of retired elite male and female rugby players between the ages of 30-55 to individually assess their brain health.”
Richard Boardman of Rylands Law, the firm representing a group of 175 rugby players – including the former England forward Steve Thompson – bringing action against the RFU and other governing bodies, said: “It’s pleasing to see stakeholders with an interest in sport seeing the scale of this problem the same way we do. Namely, that those who have either played or are currently playing contact sports in this country, particularly at the elite level, with brain damage, is at an epidemic level.”
Thompson, a World Cup winner in 2003, has now at 42 been diagnosed with early onset dementia and told the Guardian in December last year: “It’s the rugby that’s put me through this,” adding: “The amount of head bangs I had in training. I was known for it. ‘Oh, he’s having a little sleep, he’ll get up in a minute.’”
This article was amended on 23 July 2021. The concussion in sport report was produced by the digital, culture, media and sport select committee, not the Department for Digital, Culture, Media and Sport itself as an earlier version implied in the text and headline.

https://www.theguardian.com/sport/2021/ ... ning-point

greybeard58
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The proof is in the numbers: 988 will save lives

Post by greybeard58 » Wed Sep 28, 2022 2:18 pm

Opinion
The proof is in the numbers: 988 will save lives
By Hannah Wesolowski
September 21, 2022 at 7:00 a.m. EDT
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Hannah Wesolowski is chief advocacy officer of the National Alliance on Mental Illness.
For too long, there hasn’t been an easy, safe way for someone experiencing suicidal thoughts or a mental health crisis to get immediate help. Fortunately, that appears to be changing thanks to 988.

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The number, which became available nationwide earlier this summer, is a dedicated phone line that anyone can contact for mental health, substance use and suicidal crises. When Congress and the Federal Communications Commission designated it as an emergency line in 2020, there were questions about why the number was needed and how effective it would be. But now, we have data to support the resource: Demand for help is high, and the number is giving thousands of people the assistance they need.
The Substance Abuse and Mental Health Services Administration estimated that contact volume to 988 will more than double in its first year. The latest data since the July 16 transition shows the number of contacts to 988 via call, text and chat in August 2022 increased 45 percent over August 2021 — an increase of 152,000 contacts. That is 152,000 more people getting help when they need it most.
This significant increase in contacts has occurred even before there has been any wide-scale public awareness campaign to promote 988, so the number of contacts will likely continue to grow.
Fortunately, in the lead-up to 988’s availability, call centers and state leaders rose to the challenge to meet the increased need. The average answer time across calls, texts and chats are decreasing, and answer rates are increasing, with 20 states answering more than 90 percent of in-state calls in August compared to just seven in January.

This has real benefits. 988 connects people with trained crisis counselors who can actively engage callers and resolve crises over the phone. This reduces the need for an in-person response, which has historically been conducted by law enforcement (contributing to high rates of incarceration of people with mental illness).
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Getting help amid increasing suicidal crises

If you or someone you know needs help, call the National Suicide Prevention Lifeline at 988. You can also reach at a crisis counselor by messaging the Crisis Text Line at 741741.
To support someone going through a mentally tough time: Offer a safe space to talk and listen. Validate and affirm their feelings. Don’t engage in toxic positivity. Don’t be pushy with advice. Ask how you can help.
Because suicide is often impulsive, reducing access to suicidal methods sharply decreases its rates. When the United Kingdom got rid of lethal gas ovens suicides plummeted. Bridge barriers, gun safes and blister packaging pills have all proven to reduce suicide.
Since the pandemic, depression, anxiety, suicidal ideation have reached historic highs, especially among children and teens. Experts say urgent reforms are needed for America’s underfunded, fragmented and difficult-to-access mental health system.
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Research has repeatedly shown that receiving support over the phone can reduce suicide risk. It can also help connect people with more mental health services to get well and stay well.
988’s success thus far gives us a historic opportunity to reimagine how we respond to people in a mental health crisis, and it couldn’t be more timely. The United States is in the midst of a mental health emergency. American adults are experiencing a threefold increase in symptoms of anxiety and depression compared to 2019. One American dies by suicide every 11 minutes.

The stats for our youth are especially dire. The number of adolescents going to emergency departments with suspected suicide attempts has skyrocketed, increasing by more than 31 percent between 2019 and 2021. At my organization, the National Alliance on Mental Illness, we witness daily what the human impact of these numbers is on individuals, families, friends and communities across our country.
As we mark Suicide Prevention Awareness Month, we owe it to our loved ones and our communities to recognize the urgent need and unprecedented opportunity we have in front of us. With the transition to 988 to access mental health and suicide emergency care, we have the potential to fundamentally transform our crisis response and save lives — but only if we continue to act.
Indeed, our work is just beginning. We need to build a full continuum of crisis services around 988 in every community. Every call, text or chat needs to be answered by a local call center with culturally competent resources. And for those who need more help, there should be an in-person mental health crisis response team available to provide appropriate, safe and effective care.

Far too often, we’ve seen mental health initiatives begin with great promise, only to fall short due to the lack of investment. 988 is a huge step forward, but we can’t stop halfway when lives are on the line. With continued investment and focus, 988 can be transformative.
Right now, mental health is a bright spot of policy cooperation and bipartisanship. In the 2021 budget, the lifeline received just $24 million. That investment has grown to more than $250 million in 2022, and President Biden has requested nearly $700 million for 988 and crisis services in 2023. That money would not only help build up 988 capacity but also support a full crisis continuum of care.
The challenge is to build on the success of the 988 rollout, both at the federal and state levels. This effort will prevent more lives from being tragically lost every day. We can and must provide the hope of a brighter tomorrow for anyone who is struggling.
If you or someone you know is struggling or in crisis, help is available.

Call or text 988 or chat 988lifeline.org.

https://www.washingtonpost.com/opinions ... e-success/

greybeard58
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It’s never ‘just’ a concussion

Post by greybeard58 » Thu Oct 06, 2022 11:15 am

It’s never ‘just’ a concussion. Your brain is vulnerable and hurting.
Physicians say we need to recognize that concussions are brain injuries to be taken seriously

By Richard Sima
October 5, 2022 at 9:05 a.m. EDT

(George Wylesol for The Washington Post)

Listen


Our brain is soft and squishy akin to the consistency of warm Jell-O.

Though cushioned by our skull (and sometimes a helmet), our brain will still feel the effects of a strong enough impact.

After a bad blow to the head, “inside your skull, your brain sloshes around,” said John Leddy, a clinical professor of orthopedics and the director of the Concussion Management Clinic at the University at Buffalo. A concussion is labeled a mild traumatic brain injury but “the word ‘mild’ is a misnomer,” Leddy said.

As a type of traumatic brain injury, concussions are designated mild because, through the images of a standard MRI or CT scan, the brain generally looks normal because there is no obvious large-scale damage. (A visible brain bleed would bump the injury to moderate or severe traumatic brain injury.)

With advanced brain imaging, however, it is easier to see the microstructural damage to the brain’s white matter, or nerve fibers, caused by a concussion. This type of physical damage is known as diffuse axonal injury, for the harm done to axons, which are the long, thin cable-like neuronal offshoots that connect neurons and brain regions.

Emerging research suggests that diffuse axonal injury can cause immediate and persistent disruption of brain networks and may be a key contributor to the short-term and long-term consequences of concussions.

We still do not completely understand what causes a concussion, but we do know that its effects can cause widespread disruption to the brain and its normal functioning.

What’s a concussion? How many is too many? What if I hit my head on a door?

What happens inside your skull after a hit
As our brain moves, twists and rotates, the neurons shear and stretch, which causes them to indiscriminately release neurotransmitters, the molecules neurons use to communicate with one another.

This uninhibited chemical release occasionally occurs in the part of the brainstem controlling the hands and arms, and can cause muscles there to involuntarily flex and extend in what is called a “fencing response.” This is probably what happened when Miami Dolphins quarterback Tua Tagovailoa remained on the field with his arms and hands contorted and splayed above his face after his head hit the turf.

This primitive motor reflex is “almost like a traumatically induced seizure,” said Steve Broglio, a professor of kinesiology at the University of Michigan and director of the Michigan Concussion Center.

At the same time, the metabolism of the brain is thrown out of whack as it tries to fix the delicate balance of ions that neurons need to properly generate electrical signals. The brain now needs more glucose to help recover, but the concussion also decreases its baseline cerebral blood flow, causing an energy mismatch between what the brain needs and how much fuel it gets, which may contribute to fatigue symptoms.

Research also shows that concussions possibly disrupt our brain’s autonomic nervous system, including our “fight-or-flight” sympathetic nervous system and our “rest-or-digest” parasympathetic nervous system. The result is that essential, unconscious functions that the autonomic nervous system keeps carefully regulated — blood pressure, heart rate, breathing — may all be knocked off kilter by a concussion.

New symptoms can crop up weeks after the injury
A concussion can have both short-term and potentially long-lasting effects, which are still not completely understood. And the wide variety of possible physical, emotional and cognitive symptoms following a concussion reflects both the bluntness of the trauma and what parts of the brain were injured.

Soon after a concussive event, people may have amnesia about the impact, headaches, confusion or unconsciousness. They may experience ringing in the ears, nausea, disorientation, fatigue or blurred vision.

Other symptoms may crop up in the days or weeks following the injury, such as a lack of concentration, mood changes, sleep disturbances, balance problems, or sensitivities to light and sound.

How my dryer door gave me a concussion

A concussion puts the brain in a very vulnerable state, which magnifies the risk of severe concussion symptoms by orders of magnitude from a second hit, Leddy said.

The most extreme and rarest example of severe outcomes is “second impact syndrome,” where someone experiences a second head injury shortly after a first. Primarily reported in male high school football players, the second injury can lead to irreversible brain swelling and even death.

More commonly, being hit again before the brain fully recovers from its first injury can exacerbate the consequences and make symptoms more severe, numerous and persistent. Just as spraining an ankle makes it more likely to be sprained again, “once you injure the brain, it is easier to injure it again,” Broglio said.

Diagnosing a concussion
The clinical diagnosis of a concussion is still imperfect and depends on the physical signs that a physician can observe and the symptoms the patient reports. There is, as of yet, no objective measure for concussion.

In professional sporting events, it is a clinical judgment call — researchers are working to develop more objective tests for potential biomarkers — but it is best to err on the side of caution and remove the player if a concussion is suspected, Leddy said.

“The presumption of a sports medicine doctor is that this athlete is going to try to play no matter what they’re feeling,” Leddy said. “But the doctor’s job is to protect the athlete first and foremost.”

Tua Tagovailoa’s head injury spurs scrutiny of NFL concussion protocol

Just as diagnosing a concussion is challenging, predicting how long it takes to recover from one is equally tricky.

The brain is likely to compensate for the damage by reorganizing itself and its connections. For 80 to 90 percent of adolescents and adults, it takes about two weeks to recover to clinically normal levels of functioning spontaneously, Broglio said. Younger children, on average, take longer to recover, usually within four weeks. But a sizable minority of people — at least 15 percent — with concussion experience persisting neurocognitive dysfunction, though some studies suggest this percentage is an underestimation.

We still do not understand why some people are more susceptible to worse outcomes than others. The most consistent predictor of a slower recovery is the severity of the symptoms.

But generally, with proper care, one or two concussions can be manageable.

“I would never recommend hitting your head,” Broglio said. “But if somebody had one concussion, I wouldn't be too panicked.”

Repeated brain impacts and injuries, like those that can be sustained over a long sporting career, however, have been linked to an increased risk of neurodegenerative diseases, including Alzheimer’s, other forms of dementia, Parkinson’s and chronic traumatic encephalopathy, or CTE, a rare condition prominently associated with football and boxing.


Physicians say, perhaps surprisingly, that the lesson from concussion research is not to necessarily give up sports. Concussions are injuries to the brain that should be taken seriously, but physical activity is also good for the brain.

There is risk in everything we do in life, Broglio said, and all sports carry a possibility of concussion. But “the risk of not being physically active is more than getting a concussion while physically active,” he said.

But above all, when dealing with a traumatic brain injury, it is better to be safe than sorry.

https://www.washingtonpost.com/wellness ... in-injury/

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