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The Nightmare That Keeps On Visiting

Puck Sniper

I am guilty of exposing myself to a situation that made things worse for me than it had to be. I once suffered a concussion in a hockey game where I was elbowed in the head and ending up smacking my head again on the ice when I fell. I sustained an obvious concussion, and as soon as I came to that realization, I realized that the injury would probably keep me from playing. Obviously, I was incredibly anxious to get back out there. As soon as my symptoms showed signs of tailing off, I jumped at what I saw was an opportunity and played a game the next day. I took a mild hit — one that normally wouldn’t have injured me — and ended up on the ice in double the pain. My symptoms took a dramatic upswing and I ended up taking months to recover. Even now, I still deal with mild problems that are remnants of my injury. It was a hard and vivid lesson.

Over time, repeated instances of second-impact syndrome put an individual’s future health in serious jeopardy. That’s why sub-concussive blows are so dangerous. Consider a soccer player who’s used to heading a ball all the time, or a hockey player who’s had his or her fair share of big collisions that leave them with some dizziness. When these blows are frequent, the brain is taking repeated injury. Even if those individual injuries are mild, the eventual cumulative effect can be devastating.

But the problem is not entirely out of your hands. If you sustain a concussion, take your time with your recovery. I know as well as you do that it can be incredibly stressful and frustrating to not be able to live your life the way you normally do. I understand as well as anyone the mental torture that accompanies the pain and the ever-present headaches. But you need to think in the long-term, and look out for yourself. Even after you start to notice your symptoms disappear, take extra time to make sure that they fully disappear and slowly integrate yourself back into a normal lifestyle instead of throwing yourself back into the craziness of life. Be safe, and don’t condemn yourself to a state of living that you don’t need to go through. Believe me, the short-term happiness you might gain by neglecting proper recovery isn’t worth it.

It’s rare for individuals who have suffered concussions to reach a state of life that is completely unmarked by their injury. You usually bear some scars for the rest of your life. You might suddenly notice that you have vertigo or terrible motion sickness. You might suddenly develop chronic migraines, light sensitivity, and randomly lose vision for a few seconds several times a day. Those are all things that I have gone through in post-concussion syndrome from an injury I suffered a long time ago. Any pain that you feel at the exact moment you take a blow to the head is usually nothing compared to the slog that you have to endure afterwards.

But, to anyone who’s going through it: you are strong enough to get through it. Stay true to yourself and be diligent about giving your brain the best recovery possible. Do it for both yourself and the people around you who care about you, and do what you can to make your future a happier one. I know that it’s a scary situation, but there are things you can do to make it easier on yourself in the long run. It doesn’t have to derail your life, and remember: nothing is more important than your brain. You might feel otherwise, but there just isn’t anything that should take a higher priority. Don’t expose yourself to situations that are going to put you in danger. You can get better and find yourself again, and there’s a big support network out there for you.

Post-concussion syndrome can be a nightmare, but, in the immortal words of good ol’ Albus Dumbledore: “Happiness can be found even in the darkest of times, if one only remembers to turn on the light.”

The Nightmare That Keeps On Visiting
Why post-concussion syndrome and improper recovery are the scariest parts of an already scary injury
Read more: https://medium.com/@PuckSniper_3/the-ni ... 3e61bff2d7

One coach's perspective

Coach Jen says

"I'm a youth hockey coach; my daughter was a part time goalie this season and played out as a winger, but will be a full time goalie this coming season. One of her best friends got a concussion after an altercation with another player & has been faced with serious learning issues since it happened. And that was last year. Although us coaches have been trained somewhat on concussion protocol, including an entire module via USA Hockey, I still don't think it's enough. Parents will push their kids to play through and just 'shake it off’ because "you're a tough hockey player." They don't have a clue as to the permanent damage that could happen when their kid grows up, and won't know until it's too late. My daughter's friend is dealing with her issues, and she still plays, but it definitely could have been avoided."
https://mobile.twitter.com/AlohaJen3/st ... 6541689856

Do concussion protocols in youth hockey go far enough?

Do concussion protocols in youth hockey go far enough?
New research casts doubt on existing rules
http://www.cbc.ca/sports/youth-hockey-c ... -1.4588546

Plenty of healthy D were available and not sitting out for concussion

Barnes participated in her first camp with the Olympic team back in April. She said she put her best foot forward with the Americans, but that it apparently wasn’t enough. She was cut.

“I was pretty upset,” Barnes recalls. “That’s when I knew I needed to keep working and keep doing what I do best. (The coaches) told me to stay ready, and that’s what I did.”

After missing the cut with the American squad, Barnes made her way to Boston College for her freshman year. She’d played in just five games with the Eagles as the season got underway, before receiving the most important call of her life. Team USA General Manager Reagan Carey was on the line, inviting her back to join the American squad.

Barnes was out with a minor concussion at the time, so she was watching her Boston College teammates practice. She remembers her college coaches, who knew she would be getting the call before Barnes did, acting strange around her.

“I got called and then from that moment it was pretty crazy,” she said. “I was pretty shocked to be called up. I didn’t expect it at all.”

As soon as she got off the phone with Carey, Barnes did what any 19-year-old would do: She called her parents. It was such a shock to Scott and Michelle that they didn’t believe her.

“I said, ‘Shut up, no you’re not. I don’t have time for this,’ ” Michelle said.

Her husband asked where the cameras were. He said it felt like a prank.

But it wasn’t.

Barnes withdrew from Boston College and headed to Florida to join the best women’s hockey players in the country.

Golden girl: At 19, Keene's Barnes took long road to gold medal with US women
Read more: http://www.sentinelsource.com/sports/lo ... 52337.html

The time for sports to change is now

“Science will take time; common sense says we should be doing more now.”
Haley Wickenheiser

“We don’t need more science to make policy changes to keep people safe in hockey, for example.”
Dr. Brian Levine

Concussion researchers say time for sports to change is now
More can be done to protect athletes, even while studies continue.
Read more: https://www.thestar.com/sports/2018/03/ ... s-now.html

Megan Hans
"I'm about 75% sure I have a concussion from being run over in a hockey game last night."
https://mobile.twitter.com/M3ganHans/st ... 3385538560

Sarah L
“Makes have my bell rung a little easier, certainly didn’t enjoy having dizzy spells for 6 hours after the game.”
Really? Your brain is worth 1 point?
Hockey. Head injuries. Concussion.
https://mobile.twitter.com/Dubh_Artach/ ... 3847243777

Alexia Jordan

I’ve had 4 concussions in my lifetime. 3 occurred in less than 10 months. One occurred during hockey season after my helmet was knocked off and as I was skating towards the bench (because we are required to have it on at all times) the puck came near me and I had my head checked into the boards.”
https://mobile.twitter.com/alexiajordan24

Rosemarie Scolaro Moser, PhD

"Female players had an increased concussion risk in football and ice hockey when compared to male players.”

Future research should focus on concussion in women’s contact sports, as there is little evidence available in this area.
Read more at: https://link.springer.com/article/10.10 ... 017-0854-4

“With that, they cleared me for hockey, but my brain injury wasn’t going away,”

Katie Abernathy

On June 20, 2017, Abernathy was away at a summer hockey camp when she lost her footing on the ice, causing her injuries.

“We were doing races, so I was racing (one of) my little brothers (13-yearold Gordie Abernathy) down the ice, and I just hit a rough patch I guess and couldn’t slow down,” explained Abernathy. “I lost an edge and flew into the boards. I think my shoulder hit first and then I hit my head on the boards and another patch on the ice. After that, I don’t really remember much. On the accounts of my coaches, they said I just laid there for three minutes or so. When I woke up from being passed out, I just screamed.”

After regaining consciousness, it was evident that Abernathy had suffered some sort of injury, so her coaches called her parents and drove her to the nearest hospital, where the doctors assessed that she had suffered a concussion. However, they decided against running a CT scan, due to the high exposure of radiation that would be given to her head. Abernathy was also having trouble breathing, so the doctors ran an X-ray, assuming she had suffered a broken rib, but instead discovered she had fractured the T8 vertebrae on her spine.

“She seemed so well when she first got injured that I didn’t recognize how serious it was because her pain tolerance is so high,” explained Katie’s mother, Andrea Abernathy. “Actually, the ER physicians were shocked that her back was broken. Because her pain tolerance was so high, they were on the verge of sending her home when they discovered that her back was (officially) broken.”

Eventually, Abernathy was sent home but with strict instructions to remain immobile for two weeks and then to see a spine specialist, which then helped allow her to perform her own daily care. She was able to walk around the house a little bit but was unable to do much else. Three months after that first appointment, Abernathy went back to the specialist to have some more imagery done. Due to some leftover stem cells, her spine had healed a lot better than initially thought.

“With that, they cleared me for hockey, but my brain injury wasn’t going away,” recalled Abernathy. “It was actually around that time that I went to see Hurley’s Neuropsych (at Hurley Medical Center in Flint) and they referred me to Todd Mabeau.”

Already cleared to skate in practice, Mabeau worked with Abernathy for two and a half months. He cleared her to play in games by mid-November, concluding her full recovery in a mere five months. Abernathy continued seeing Mabeau for a total of sixteen weeks.

Grand Blanc hockey player overcomes severe injuries
Read more: http://grandblancview.mihomepaper.com/n ... jurie.html

Brain shakes

The key difference between impacts that led to concussions and those that did not, the researchers discovered, had to do with how -- and more importantly where -- the brain shakes. After an average hit, the researchers' computer model suggests the brain shakes back and forth around 30 times a second in a fairly uniform way; that is, most parts of the brain move in unison.

In injury cases, the brain's motion is more complex. Instead of the brain moving largely in unison, an area deep in the brain called the corpus callosum - which connects the left and right halves of the brain -- shakes more rapidly than the surrounding areas, placing significant strain on those tissues.

Probing the complex nature of concussion
Read the study at: https://www.sciencedaily.com/releases/2 ... 171308.htm

30% of NCAA concussions show no symptoms until 30 minutes after game

The Knight Commission on Intercollegiate Athletics said today that recent college sports scandals have threatened not only the integrity of intercollegiate athletics but raised basic questions about the NCAA’s ability to prevent abuses, protect the rights of athletes, and clean up corruption.

At today’s fall meeting, NCAA President Mark Emmert told the Knight Commission, “We cannot go into the next basketball season without seeing fundamental change in the way college basketball is operating.”

Emmert acknowledged that the schools have a public trust problem. He said recent NCAA polling showed that nearly 80 percent of people believed “big universities put money ahead of their student-athletes,” and that nearly 70 percent of big schools are part of the problem, not the solution.

Knight Commission Sees Integrity of College Sports At Risk
Read more: https://www.knightcommission.org/2017/1 ... athletics/

Other highlights from Knight Commission Forum on October 30th via Aspen Institute:

University of Michigan researcher Steve Broglio: Football has NCAA's 4th highest concussion rate behind wrestling, men’s/women's ice hockey.

Broglio: 30% of NCAA player concussions show no symptoms until 30 minutes after the game. Only 6% have loss of conscious.

Texas A&M’s Laboratory for Diversity in Sport’s George Cunningham: I’m not sure most countries want this model (sports associated with higher education vs European/Asian club model). Simply look at physical activity rates among adults to see the value of the club model.

Andrew Carroll

Former Minnesota Duluth captain's suicide stuns family, hockey community
As the hockey world that Andrew Carroll touched has mourned and wondered about his death at age 32, the former UMD star's immediate family has remembered a wonderful uncle.
MARCH 31, 2018 — 1:46AM

Andrew Carroll, right, played for the Bakersfield (Calif.) Condors of the East Coast Hockey League in 2013-14.



Alaska Anchorage was in its familiar position near the bottom of the WCHA standings when it came into Duluth and swept the hometown Bulldogs to end the 2008-09 regular season.

Minnesota Duluth coach Scott Sandelin was under fire after four straight losing years from the fall of 2004 to the spring of 2008, and now this once-promising season had deteriorated into a seventh-place finish in the WCHA.

Andrew Carroll was a senior and the first hockey player in UMD annals to serve as a co-captain for three years. The Bulldogs left the ice at the DECC after the 4-3 loss to the Seawolves on Saturday night and soon there was a players-only meeting taking place in the locker room.

Kevin Pates was covering the Bulldogs for the Duluth News Tribune at the time and offered this when we exchanged messages this week:

“I’m not sure if Carroll was the most outspoken in that meeting, but during his 153 games as a UMD left winger, he spoke loudly and with dogged determination at practice and in games. This guy did smile, a lot, but he was very serious in his approach to the game.’’

Whatever the message in that meeting, from Carroll and others, including goalie Alex Stalock, the Bulldogs of March 2009 saved a season, probably saved Sandelin’s job, and inspired a revival that has UMD back in the Frozen Four next week in St. Paul — the third such appearance in eight seasons.

Andrew Carroll

Andrew Carroll
The Bulldogs have had an “AC’’ decal in honor of Carroll on their helmets since a midweek game with Minnesota State Mankato in late January.

A few days earlier, Andrew had been visiting friends in Chicago, with tickets to watch the Blackhawks and New York Islanders on Saturday night at United Center.

Carroll, 32, was not known as a drinker, and did not drink that Friday. Suddenly, around midnight, he grabbed his bag, told his companions that he had to get back home, headed for O’Hare, bought a ticket for a 7 a.m. flight, then went to a parking structure and jumped to his death.

Loved ones, hockey friends, fans of his dogged determination on the ice, strangers hearing or reading of his death — no one can avoid the thought, “Why?” and yet the people closest to Andrew must move on from that.

Chris Carroll, his older bro­ther by 3½ years, started taking Andrew to the rink at Bobby Theisen Park in Shoreview when he was first on skates. They were the children in a family of four, rivals, ruffians and best of pals.

“Everybody is going to face difficult situations in life, even tragic situations,’’ Chris said this week. “You have to make a choice as to how you’re going to respond. Ultimately, there can be good, if somehow your response might help others.’’

Carissa Carroll, Chris’ wife, already had taken on that task with her response after the birth of Jack, their second child, in 2013. Luke is 7, daughter Taylor is 2½, and Jack, 5, was born with Down syndrome.

Carissa started Jack’s Basket, a nonprofit to offer support to families with children with Down syndrome. She writes a blog at jacksbasket.org, and she wrote of her brother-in-law’s death in a Jan. 28 post under the headline, “Bring your brokenness, and I’ll bring mine.’’

As the hockey world that Andrew Carroll touched has mourned and wondered, the immediate family has remembered a wonderful uncle. There’s the homemade rink in Chris and Carissa’s backyard, and Andrew, a bachelor, was out there often with Luke and Jack.

“He even had Taylor started on skates,’’ Chris said. “He was going to turn all of them into real hockey players.’’

Chris Carroll is the boys hockey coach at Blaine, after several years as an assistant. Andrew spent six of his first seven years after college playing in the ECHL and the American Hockey League. In the offseason, he would train players from Blaine and elsewhere, both on the ice and in the workout room.

Blaine’s Riley Tufte, a UMD sophomore and a first-round draft choice of the Dallas Stars in 2016, was a prized hockey pupil for Carroll.

“He was very energetic and never liked to lose,’’ Tufte said. “You couldn’t outwork him. If you did 50 pushups, he’d do 60. He pushed you to work harder. I can’t thank him enough.”

On that January weekend in Chicago, Andrew was with Tanner Tufte, and they were going to stay at the Wrigley­ville condo of Gavin Tufte. The Tuftes are Riley’s brothers.

They were back in the condo late Friday, talking, and then Andrew said he had to get back to the Twin Cities, grabbed his bag, and headed for O’Hare.

• • •

The players-only meeting at the DECC on March 7, 2009 broke up, and it was followed by a strong week of practice, and then the Bulldogs went to Colorado College and swept the Tigers in the first round of the WCHA playoffs. That put them in the WCHA Final Five, where Stalock, the Wild’s current backup goalie, gave up one goal total in beating the Gophers, North Dakota and Denver, and UMD advanced to the regional — at Mariucci Arena.

“We were down to Prince­ton two goals with under a minute left, and scored twice … the last in the final second,’’ Sandelin said. “Andrew was so fired up; I had to say, ‘Calm down … we still have to win this thing.’ ’’

The Bulldogs won in overtime, and then the improbable, program-turning, job-saving March run ended with a 2-1 loss to Miami (Ohio) in the West Regional final.

Andrew Carroll’s college career was over after 153 games.

“He sat on the bench in the locker room in his uniform for a long time,’’ Sandelin said. “Really long … maybe two hours. He didn’t know if he’d get a chance to play pro. He thought it might be his last game.

“And Andrew loved playing hockey games as much as anybody I’ve been around.’’

Patrick Reusse is a sports columnist who writes two to three columns per week. He also can be heard on AM-1500 KSTP from 3 to 6 p.m. weekdays.
preusse@startribune.com 612-673-7129

http://www.startribune.com/former-umd-c ... 478402803/

Neurologists admit youth concussions a scary part of contact sports
Published on: April 22, 2016 | Last Updated: April 22, 2016 5:52 PM PDT
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Eliminating full-contact hitting from all practices.

Creating a “super helmet” equipped with an outer layer that crumples on impact, lessening the impact to a player’s brain.

Special turf under layers that cushion falls.

These are some of the extraordinary steps being taken to make football a safer game.

But Dr. Steve Galetta of New York University’s Langone Medical Center, who understands the vagaries of concussions and brain trauma as well as anyone, has his doubts that the sport can eliminate the worry every parent feels when their kid decides to play football, hockey or another collision sport.

In Vancouver for the 68th annual convention of the American Academy of Neurology, the exuberant 59-year-old native of Brooklyn, N.Y., even wonders whether the neurological effects of playing football — from grammar school to sprint football at the University of Pennsylvania — will catch up to him one day.

“If you have a 10-year history in collision sport, you have a 25-fold greater risk of having cognitive problems,” Galetta said. “In the 12 years I played, I would have all the factors that are now emerging as high risk. I do think about it very much. I love football. I love watching it. It gave me a tremendous advantage in understanding teamwork, in overcoming adversity. But I have deep concerns as a parent. I would likely advise not doing it. There are other sports that teach you the same principles without colliding your head.”

Galetta, a leading neuro-ophthalmologist, and colleague Dr. Laura Balcer, vice-chair of neurology and co-director of Langone’s concussion centre, are among medical professionals drawn to the new scourge of sports concussions and chronic brain disease from other areas of neurology.

Sports neurology became an official section of the AAN only eight years ago. (The medical society was established in 1948.) Today, programs related to concussion and sports medicine are proliferating.

“It’s the fastest growing area in neurology,” Galetta said. “There is a lot of uncharted water here.”

Their initial investigative work was in multiple sclerosis — MS — a disabling disease that attacks the brain and central nervous system and whose changes can be observed through light-sensitive tissue at the back of the eye. Since vision impairment is one of the pronounced symptoms of concussion — “50 per cent of the brain’s pathways are dedicated to vision” — Galetta and Balcer expanded their focus into that area. They authored a study of a simple eye test, known as the King-Devick sideline test, that can help diagnose a concussion in less than a minute, using three pages of numbers and a stopwatch.

The B.C. Lions were one of four Canadian Football League teams trying out the test last season. Balcer believes the beauty of KD is that it works for athletes as young as five years old and can be administered by a parent.

“There is no substitute for a parent’s judgment, or anyone’s judgment, that a child should come out of a game,” she says. “The KD test is helpful when there’s ambiguity. But there is no be-all and end-all test for concussion.”

A member of the NCAA concussion task force and the Ivy League concussion committee, Balcer remains “fascinated by the game of football. ” But, she adds, “I watch it with a much different eye than I did, say, six years ago. What’s comforting is that (concussion) research is going on. It’s being taken at a much different level of seriousness.”

Everyone knows that professional football is a violent and dangerous game, with long-term implications for its participants. What’s more concerning to Galetta and Balcer are the 99 per cent whose careers in youth sports must be weighed on the risk-reward scale of a mounting public health issue.

“The real problem is at the youth level, where two-thirds of sports concussions occur, and there’s no way you can have athletic trainers there,” Galetta said. “Parents need to be empowered, or have a group of people who know exactly what should happen, if their kid appears to have a meaningful injury. Emerging scientific evidence is showing that banging your head on a repetitive basis is not a good idea. For some, it could be catastrophic.”

The greatest obstacle in getting that message through is sometimes the athletes themselves. A Penn study involving 250 respondents, lured by a $5 Starbucks gift card, asked if they had tried to hide a previous concussion.

Forty-three per cent replied in the affirmative; another 22 per cent said they would do it again.

“Studies have shown concussions are reported 10 times more frequently after a season than in the season,” Galena explains. “Undetected or unreported concussions are actually far more frequent. So, we still have a lot of education to do.”

mbeamish@postmedia.com

Twitter.com/sixbeamers

http://vancouversun.com/sports/sports-c ... cal-damage

Approximately 1 in 5 children who’ve had TBI will also develop ADHD

Children who have had a serious head injury are more likely to develop attention deficit hyperactivity disorder (ADHD) — but new research suggests that symptoms may not develop for up to a decade later.

Traumatic brain injury (TBI) is a frequent cause for hospitalization in young children and teenagers. It’s associated with developing mental conditions, including secondary ADHD, a form of ADHD that develops following an injury.

Approximately 1 in 5 children who’ve had TBI will also develop ADHD, but it usually manifests within a few years.

However, a study published today in JAMA Pediatrics says that it may take significantly longer in some cases.

“Children with a history of TBI, even those with less severe injuries, have an increased risk for the development of new-onset attention problems, potentially many years after injury,” Megan Narad, PhD, lead author and postdoctoral fellow at Cincinnati Children’s Hospital Medical Center, told Healthline.

“While previous studies suggest kids with a history of TBI are at risk for developing attention problems, they only followed kids two to three years after injury. Our study is unique in that we followed children 7 to 10 years after their injury,” she said.

Traumatic Brain Injury in Children Can Lead to ADHD Years Later
Read more: https://www.healthline.com/health-news/ ... -to-adhd#1

Secondary Attention-Deficit/Hyperactivity Disorder in Children and Adolescents 5 to 10 Years After Traumatic Brain Injury
Review the study: https://jamanetwork.com/journals/jamape ... ct/2675285

Traumatic Brain Injuries Are Tied to Dementia


In the largest study of its kind, researchers have found that traumatic brain injury is associated with an increased risk of dementia. The risk of dementia was highest among people who had suffered multiple T.B.I.s. But even a single mild T.B.I. was tied to an increased risk of dementia.

Traumatic Brain Injuries Are Tied to Dementia
Read more: https://www.nytimes.com/2018/04/10/well ... entia.html

Lasting Effects of Childhood TBI

“The significance of problems might not be realized until years after the injury when higher-level cognitive and behavioral functioning is required to meet typical developmental milestones, especially when the injury occurs at a very young age,” wrote the report authors.

Better follow-up care for childhood TBI and more instruction for parents, educators, and physicians are needed, argues the report. Later this year, the CDC plans to release the first evidence-based clinical guideline on the diagnosis and management of mild TBI among children. More rigorous data on long-term outcomes and care for children with TBI are also needed.

...“The information provided in this report represents a call to action to improve the care children receive after a TBI so they can maximize their potential for recovery,” the authors wrote.

Lasting Effects of Childhood TBI
Read more: https://jamanetwork.com/journals/jama/f ... le/2678027

Even mild concussion can increase the likelihood of headaches in the years after

Concussion increases the risk of prolonged headache woes
Even mild concussion can increase the likelihood of headaches in the years after.
Read more: https://www.eurekalert.org/pub_releases ... 040418.php

Do Brain-Wiring Differences Make Women More Vulnerable to Concussions?

Do Brain-Wiring Differences Make Women More Vulnerable to Concussions?
Female axons—brain cells’ output cables—are shown to have a thinner structure
Read more: https://www.scientificamerican.com/arti ... ncussions/

Concussions rose dramatically after checking eliminated

After USA Hockey eliminated body checking from Peewee youth hockey (11-12 yr olds) in 2011, overall injuries fell 17%, according to new study.

Number of concussions, however, rose by 50%.

Read the study at: http://journals.sagepub.com/doi/pdf/10. ... 7117741647

New study finds athletes who suffer even minor concussions can have problems focusing in class and taking in new information.

The devastating effects of repeated concussions on college athletes have been well documented -- brain disease that can lead to mood changes, concentration problems and even suicidal tendencies. What researchers haven’t captured much -- until now -- is how milder brain injuries can do the same (to a degree).

Athletes and veterans may not present overt symptoms from more minor brain injuries, but that damage can still interfere with their academics, a new study from the University of Montana and the University of Vermont has found. These students might have memory loss, issues focusing in class or vision problems -- and might not even know it. The findings were published this month in Scientific Reports, a branch of Nature Research Journal.

Mild Concussions, Big Problems
Read more: https://www.insidehighered.com/news/201 ... tudy-finds

Concussions Preventing Veterans, Athletes From Succeeding in College

Many of the more than two million veterans who have taken advantage of the Post-9/11 GI Bill have struggled academically in college. Similarly, albeit for different reasons, so have many college athletes. Results of a new study focusing on the long-term effects of concussions or mild Traumatic Brain Injury (mTBI) in both populations offers new evidence for why they might not be making the grade.

The study in Scientific Reports, a journal published by a Nature Research Journal, revealed slower visual and auditory reaction times by veterans and athletes to simple environmental stimuli years after experiencing mTBIs. Participants also struggled with significant reductions in eye-tracking accuracy and were plagued by intrusive saccadic eye movements, making it difficult to focus for even short periods of time.

A discernable difference was measured in oculomotor performance between study participants, whose eyes frequently deviated from a moving laser target, and a control group. The deviation was further complicated by irregular episodic occurrences of fast eye movements known as saccadic intrusions. Consequently, veterans and athletes who displayed no post-concussive symptoms under current protocols are struggling in class due to an inability to follow lectures and retain information from readings, and are missing key parts of class presentations.

The study raises serious questions about whether athletes are being cleared to return to the playing fields too soon, and more importantly, if veterans are returning to active duty while still experiencing cognitive impairments and abnormal eye movements. Current NFL concussion protocols, for example, often have players returning to action the same day or within a few weeks. Results show that veterans and athletes who had a history of concussions years later still have post-concussive symptoms similar to individuals with major traumatic brain injuries.

Study: Concussions Preventing Veterans, Athletes From Succeeding in College
Read more: https://www.uvm.edu/uvmnews/news/study- ... ng-college

A consortium of The NFL, Pop Warner, and US Football is now recommending no tackle football until the 7th grade. The MSHSH and NFHS both imposed penalties on head contact including disqualification. The MSHSH discourages this as a penalty. And in fact Jason Nickelby of the MSHSL instructed officials to ignore concussion symptoms.

Had a different ruling been issued, might Jeff Parker still be alive?

"'By deciding to participate as a player in the hockey game, Parker voluntarily chose to accept the risk,' a judge wrote in a 1995 ruling." Had a different ruling been issued, might Parker still be alive?


The Tragic Diagnosis They Already Knew: Their Brother Died With C.T.E.

Jeff Parker, who played in the N.H.L. from 1986 to 1991 and died last year at age 53, will be seen as another link between hockey head hits and C.T.E.; the league has denied that such a link exists.

By JOHN BRANCH MAY 3, 2018

To the family of the former N.H.L. player Jeff Parker, the posthumous diagnosis of C.T.E., or chronic traumatic encephalopathy, was the predictable conclusion. All those hits to the head, including that final one that knocked him out of the game altogether, and all those subsequent years of struggle? In the final, difficult years before Parker’s death last September at age 53, the family figured that it must be C.T.E.

“It just makes me sad,” John Parker, Jeff’s younger brother, said through tears. “It doesn’t bring him back. It just makes you feel sad, that he was living with this, and it’s a thing. It’s a real thing.”

To the N.H.L. and its commissioner, Gary Bettman, the diagnosis is likely to be the latest piece of evidence to dismiss or combat. Even as links build a chain bridging the sport to C.T.E., the degenerative brain disease associated with repetitive head trauma, and some of the game’s most revered names push the league to take a more open-minded approach, the N.H.L. has denied any connection between long-term brain damage and hits to the head.

The N.F.L. did the same, for many years, until the evidence became too overwhelming, the numbers too much to counter with plausible deniability. Facing a huge class-action lawsuit, the N.F.L. eventually admitted to the connection and agreed to a roughly $1 billion settlement with former players. (That has not kept the sides from continuing to fight over the payouts, amid accusations of fraud and intimidation.)

The N.H.L., following the N.F.L.’s strategy of about a decade ago, still contests any role in the burgeoning science of C.T.E., in the courts of law and of public opinion.

Besides Parker, at least six other N.H.L. players have been found to have had C.T.E.: Reggie Fleming, Rick Martin, Bob Probert, Derek Boogaard, Larry Zeidel and Steve Montador.

Parker’s disease was classified as Stage 3 out of four stages of C.T.E., according to the scale used by researchers at the Boston University CTE Center.

“It was fairly advanced, and we called it Stage 3 because it was significant,” said Dr. Ann McKee, chief of neuropathology at the V.A. Boston Healthcare System and professor at Boston University’s School of Medicine, where she is director of the CTE Center.

The disease had spread through the brain, as it often does with age, but was especially prevalent in the medial temporal lobe, she said, “the very important areas for memory and learning.”

The CTE Center is currently examining the brains of three other former N.H.L. players. Last year, McKee said that she had found C.T.E. in the brains of three former junior players and one former youth hockey player, none of whom advanced to the N.H.L. Each committed suicide before turning 30.

“It’s very hard to deny a link, I think, at this point,” McKee said.

The N.H.L. did not respond to requests for comment on Thursday.

Hockey is the team sport with the second-most known cases of C.T.E., lagging far behind football, where the numbers have surpassed 100. (There have been more boxers and military members diagnosed, too.) But the sample size is small. That is something researchers hope to change by encouraging more hockey players to donate their brains.

On Wednesday, the longtime N.H.L. veteran Daniel Carcillo, now retired, announced that he would donate his brain, joining a growing list of hockey players that includes Hayley Wickenheiser and Angela Ruggiero, Olympic gold medalists who made the pledge this year.

Parker made no plans for a brain donation before he died from an infection related to a catheter that treated pulmonary hypertension. The subject was raised with family members just moments before Parker was to be cremated in Minnesota.

“It’s hard to make the decision at the time because you’re grieving so hard,” John Parker said. “Once my mom gave the half-O.K., we made the call.”

The C.T.E. results, recently given to the family, confirmed suspicions.

“He was fighting through more than we knew, probably,” John Parker said. “More than we could see. And he was persevering the best way he could.”

Parker was a high school star in Minnesota, a national champion at Michigan State and a gritty professional who played all or parts of five seasons in the N.H.L., ending when he was knocked out with a hit in 1991 while playing for the Hartford Whalers. It was barely noted.

His athletic rise and eventual postcareer struggles followed a now-familiar arc among many later found to have had C.T.E. — relative fame and fortune fading into an erratic postcareer life overcome by symptoms associated with brain injuries.

“There was a change in that lighthearted kid who left White Bear Lake and the one who came back from the N.H.L.,” Scott Parker, Jeff’s older brother, said.

The Parkers, with three boys, were a quintessential hockey family in suburban Minneapolis-St. Paul — broken windows in the garage from pucks flying during indoor games, a pond across the road and rinks at the high school up the street.

“One of us would always come home with a bloody nose,” Scott Parker said. “Pretty typical of outdoor hockey in the ’70s, trying to earn your stripes.”

All three brothers played in college and won national championships — Scott at Wisconsin-Eau Claire, Jeff at Michigan State and John at Wisconsin. Jeff, the middle boy, was the best player. He grew to 6-foot-3 and about 200 pounds, and could shoot a puck over the net from past the blue line as a child, his brothers said.

Before he turned 18, Parker was drafted in 1982 by the N.H.L.’s Buffalo Sabres in the sixth round, No. 111 over all. He delayed a leap to the pros to play three seasons at Michigan State. He was a strong, aggressive forward, trusted to kill penalties and spent a lot of time in the penalty box himself.

Professional coaches immediately saw an additional role for Parker. At an early practice, awaiting a face-off, he was told to fight, his family said.

“I remember him calling my mom, and he was crying,” Scott Parker said. “He didn’t want to do that. He just wanted to be a hockey player. It was a role bestowed on him.”

The grainy highlights of his pro career are filled mostly with big hits and bare-knuckle fights. Hopes to come back after being knocked down for the last time did not last long.

“Once he started to work out a little bit, he told me, ‘Something’s wrong, I don’t think I can play,’ ” John Parker said. “He went from being, ‘I’m willing to fight, I’m willing to hit someone,’ to ‘I don’t want to get hit.’ And that wasn’t him.”

Parker’s brothers said he permanently lost his sense of smell and taste — everything tasted like burned toast, he would say. Trying to explain the persistent fog in his mind, he often said his head felt “oblong.”

Parker soon exhibited many of the symptoms now associated with C.T.E., such as memory loss and impulsivity. He struggled with bright light and spent countless hours in the dark, trying to soothe his brain. He tried to finish college, Scott Parker said, “but his brain couldn’t function like that anymore.” He could not read without headaches or keep a steady schedule. He would miss appointments or show up at the wrong place. He once came to a meeting without shoes.

He lost a lawsuit filed against the N.H.L., the Whalers and the Capitals, and the arena where the last injury took place.

“By deciding to participate as a player in the hockey game, Parker voluntarily chose to accept the risk,” a judge wrote in a 1995 ruling.

Parker lost his savings and spent several years homeless around St. Paul. The family lost track of him in the late 1990s before he emerged again. He spent most of the final 15 years working odd jobs, mostly as a bartender.

Scott Parker said he spoke to Jeff on the phone about three times a week, and the conversations were mostly playbacks of stories that Jeff did not remember that he had told before.

One symptom associated with C.T.E. that he did not display, his family said, was wild mood swings or violent behavior. He did not ask for help or attention. He would always say that he was fine, and family and friends considered him affable and easygoing, to the end.

Parker was one of the more than 100 former N.H.L. players named as plaintiffs in a continuing class-action suit against the league, arguing that the N.H.L. concealed information from players about the risks and long-term effects of concussions. The family said Parker had no acrimony toward the N.H.L., but hoped awareness might aid future players.

That lawsuit has churned through United States District Court in Minneapolis for years. The sides now await a judge’s decision on whether it can continue as a class-action suit — which would automatically add about 5,000 plaintiffs to the case. A similar situation in the N.F.L. case in 2015 pressured the sides to reach a settlement.

In the lawsuit recently, the N.H.L. asked for records from the CTE Center’s brain research, including the names of all the athletes who donated or agreed to donate their brains. The judge denied the request last month.

The N.H.L. has long argued that it is impossible to directly link hockey and C.T.E., though an email chain from 2011 seemed to contradict that public stance. As recently as last month, Bettman reiterated his belief on a New York radio show that there is no medical evidence linking hockey and C.T.E.

In a recent interview with The New York Times, Bettman said that “the game is safer now than it ever has been,” citing evolution in things such as medical care and rule changes.

“I think there’s still a lot that people have to learn,” he said. “I get concerned when people scare players for no reason. And there have been instances of that, some of them tragic. I think people have to be very careful before jumping to conclusions.”

In an essay for The Players’ Tribune in April, the Hall of Fame hockey player and author Ken Dryden pleaded with Bettman to put an end to hits to the head in hockey. Dryden said his 2017 biography of Montador, a 10-year N.H.L. veteran who died in 2015 at age 35 and was found to have had C.T.E., was meant for an audience of one: Bettman.

The growing pressure has not moved the N.H.L. yet. Perhaps each new finding of C.T.E. nudges it closer to changing its mind.

“It’s an awful responsibility that the N.H.L. has,” said Scott Parker, who has coached high school hockey for 30 years. “If you’re going to let them bare-knuckle fight, then take care of them. Do the right thing. Take care of these kids. Give them some health care. Give them some dignity. Do they have to fight these things alone?”

The Tragic Diagnosis They Already Knew: Their Brother Died With C.T.E.
https://www.nytimes.com/2018/05/03/spor ... arker.html

http://kstp.com/medical/late-nhl-player ... e/4891905/

Medical Records Show Late NHL Player from Minnesota Suffered Severe CTE
RELATED: 5 EYEWITNESS NEWS Investigates CTE

Test results show former NHL player Jeff Parker's brain had a significant build-up of Tau. The protein causes dementia, memory loss and other symptoms and is how researchers identify CTE.
Test results show former NHL player Jeff Parker's brain had a significant build-up of Tau. The protein causes dementia, memory loss and other symptoms and is how researchers identify CTE.
Courtesy of BU CTE Center
"It was pretty damning evidence of CTE," Scott Parker, Jeff's brother, said in an interview earlier this week. "The results were worse than I think we thought."

Jeff Parker's family donated his brain to Boston University after he died of unrelated health issues at the age of 53 last September.

Ann McKee, chief of neuropathology at Boston's VA hospital and director of the CTE Center, said test results show a large, brown build-up of a protein called Tau on Parker's brain, the key indicator of CTE.

"Jeff Parker's brain was at such a stage - the disease was taking over his brain," McKee said in a phone interview from Boston Thursday. "It's very substantial brain damage….the nerve cells weren't working."

RELATED: Family of Late Minnesota Hockey Star Waiting for Results from CTE Lab

"(Jeff) was suffering, but he didn't let us know," said Scott Parker, who described his brother as a "gentle giant" who struggled with his health for years.

"He couldn't function like everybody else, (but) he had a lot of love in his heart."

Since the disease can only be detected after death, McKee said people like Parker did not know whether it caused symptoms like a lack of impulse control, progressive dementia and memory loss.

RELATED: Former NHL Player Donates Brain to Concussion Research

Earlier this year, McKee granted 5 EYEWITNESS NEWS rare access to the lab in Boston where her team has found CTE in the brains of former athletes, military veterans and teenagers.

The team's findings helped pressure the National Football League into reaching a $1 billion settlement with former players finalized last year. CTE research is also at the center of a federal lawsuit filed in St. Paul against the NHL.

In that pending suit, former players accuse the league of downplaying the risks of concussions and head hits.

A federal judge will decide in the coming months whether the lawsuit will be certified as a class-action, which would then allow all former players to seek damages.
RELATED: KSTP's "Fighting Back" Investigation

Parker, whose five-year NHL career ended in the early 1990s after a severe concussion, joined the lawsuit before his death.

He is now one of seven former NHL players, including former Minnesota Wild enforcer Derrek Boogaard, to be diagnosed with CTE after death.

RELATED: Federal Judge Dismisses Boogaard Family's Wrongful Death Suit Against NHL

NHL Commissioner Gary Bettman has said the science behind CTE is inconclusive, and that it's premature to warn players about potential health consequences as they relate to hockey.

League representatives did not return messages seeking comment Thursday.

Scott Parker said the time has finally come for the league to acknowledge the validity of the CTE research.

"I don't know how anyone can refute this evidence," he said. "That's the smoking gun."

Watch 5 EYEWITNESS NEWS AT 10 p.m. to hear more from Scott Parker and Dr. Ann McKee.

Extended Interview: Jeff Parker, Former NHL Player from White Bear Lake