On an early spring day not too many years ago, a friend was playing outfield in a corporate softball game. The ball was hit, and my friend scrambled backwards to snag it. He caught the ball, but lost his footing and fell backwards, hitting his head against the hard-packed earth.

When he came to after a few seconds of blackout, he saw double and had to be helped off the field. The team congratulated him on the catch (which, remarkably, stayed in the mitt), and then took him to the only place that made sense to them—the bar.

He did go to the hospital later that night  (dragged there by his wife), where the doctor diagnosed concussion…and then jokingly asked if he could get a videotape of the catch. No special instructions…no actual diagnostic tests…no follow-up. After all, it was “just” a concussion.

A Gray Area in Gray Matter

In a recent online publication of the medical journal Pediatrics, researcher Carol A. DeMatteo and colleagues examined diagnosis and treatment of 434 children with head injury admitted to a children’s hospital. Their results suggest something astonishing:  Children who have the same symptoms will receive different levels of treatment depending on whether they are  diagnosed as having a concussion or mild traumatic brain injury (MTBI).

A child diagnosed with concussion will be discharged from the hospital earlier and will return to school sooner than a child with the same symptoms who is diagnosed with MTBI.

This study raises two main issues. First, the medical community needs a more consistent way to diagnose head injuries. With something as serious as head injury, it seems that there must be a way to have clearer guidelines.

Second, labeling any brain injury as “concussion” is potentially dangerous. “Concussion” is not taken seriously by just about anybody, including some doctors, parents, and the patients themselves.

Not to be Ignored

A single concussion can cause significant and lasting damage in the brain. Multiple concussions can sometimes cause a disorder call chronic traumatic encephalopathy (CTE), which leads to memory impairment, emotional instability, dementia, brain degeneration, and death. At autopsy by specialists at the Boston University School of Medicine, CTE was found in the brain of former Tampa Bay Buccaneer Tom McHale—the sixth former NFL player found to have suffered from this disorder.

In the Pediatrics article, DeMatteo and colleagues conclude that “perhaps we should use the term ‘MTBI,’” instead of concussion. Maybe then, everyone will take it more seriously—doctors, athletes, coaches, parents, patients, and …yes, softball players.

HensonFuerst will be following up with more information about concussions and MTBI in future blogs. Stay tuned, and stay safe!

Reducing the number of sports-related head injuries remains a goal and a passion for the lawyers at HensonFuerst. I recently ran across this list of the sports with the highest number of head injuries treated in U.S. hospital emergency rooms in 2008 (as reported by the U.S. Consumer Product Safety Commission).
We urge all parents and participants of sporting activities to take proper precautions to prevent brain injuries. If you do sustain an injury, make sure you receive prompt medical attention.

The Top 15 Sports for Head Injury

• Cycling: 70,802
• Football: 40,825
• Basketball: 27,583
• Baseball/Softball: 26,964
• Powered Recreational Vehicles (ATVs, Go-Carts, Mini bikes, Off-road): 25,970
• Soccer: 19,252
• Skateboards/Scooters: 18,324
• Fitness/Exercise/Health Club: 14,713
• Horseback Riding: 11,749
• Winter Sports (Skiing, Sledding, Snowboarding, Snowmobiling): 11,723
• Water Sports (Diving, Scuba Diving, Surfing, Swimming, Water Polo, Water Skiing): 11,239
• Golf: 8,420
• Gymnastics/Dance/Cheerleading: 6,364
• Trampolines: 5,971
• Hockey: 5,272

NFL football legend Scot Brantley took a lot of hard hits in his eight seasons as a star linebacker for the Tampa Bay Buccaneers in the 1980s. Brantley is 51 now, and the hits are still coming—he believes his two strokes are the result of the concussion he suffered as a college senior.

The NFL is just coming around to the idea that a “mere” concussion is categorized as traumatic brain injury (TBI), and can cause long-lasting effects.

In a segment titled “Hard Hits,” Scot Brantley spoke with NPR’s Dick Gordon today (January 20, 2010) about his medical journey, and how he hopes the NFL will respond to TBI in today’s players. You can hear the interview on iTunes (search for APM: The Story).

The interview is also available at: http://www.thestory.org/archive/podcast.xml

Head injuries in football and hockey dominate the discussion of traumatic brain injury these days.  However, skiing and snowboarding should have their place in that discussion as well.  Don’t be fooled by the perception that snow is soft and therefore cannot cause a head injury.  First, snow on slopes is often packed down, and therefore harder.  In addition, obstacles such as trees, snow blowers, ski lift foundations, and other skiers going at a high rate of speed are all potential causes of traumatic brain injury.  For that reason, please wear a helmet, and parents, absolutely do not let your kids on the slopes without a helmet.  For an discussion of this issue, please click on the following link:  http://www2.med.umich.edu/prmc/media/newsroom/details.cfm?ID=1425

The media has recently placed  a major focus on head injuries in sports, and particularly football.  However, parents of girls who are cheerleaders should pay close attention as well.  Aerial maneuvers and extreme acrobatic techniques are on the rise, but injuries in cheerleading are often catastrophic because of the forces and trauma involved when something goes wrong.  Traumatic brain injury has lifelong implications, and even seemingly minor bumps to the head should be closely evaluated by a head injury professional.  For the full article, please click on the following link:  http://www.nj.com/news/times/regional/index.ssf?/base/news-18/126310593543530.xml&coll=5

I came across this editorial regarding head trauma and it reminded me of how often that we, as parents, think a bump on the head is no big deal.  As a lawyer who deals with clients who have suffered the consequences of brain injury every day, I am probably more paranoid than most.  However, many people tend to look at “bumps on the head” as something that is in the same class as a bump on the arm, and it isn’t.  If you don’t believe me, listen to a neurosurgeon and other head trauma specialists, who advocate in the article cited below that EVERY head trauma needs to be evaluated, even ones that seem minor.  Please be safe and be smart.  For the full article, please click below:  http://www.sanluisobispo.com/opinion/story/978491.html