from 9News.com

Dylan Hearn probably has a great future ahead of him; he is wise beyond is meager years. The 7-year-old Colorado boy has a personal crusade to made sure that everyone takes concussion seriously.

And he knows what he is talking about:  He suffered two concussions in the past six months. The first was playing football, and the second happened when he ran into the dishwasher at his home (he was chasing his brother.) The injuries put him out of commission for about a month, including his favorite activities—no TV, no video games, no reading.

According to an article on 9News.com, Dylan says:

“It hurts,” said Dylan. “A lot of sick and dizzy. Sometimes, you have blackouts.”

Now, Dylan’s concussions are changing the way people around him view head injuries. For example, his baseball coach, Jeff Pigati, says that the determination of injury used to be totally in the hands of players. If they said they were feeling well enough to play, they played. But kids and athletes being what they are, they typically jumped back into the game sooner than they probably should have.  That’s what killed another boy, 15-year-old Jake Snakenberg:

Snakenberg died in September 2004 after sustaining a serious concussion in a football game. Doctors believe it was his second concussion in a week and he died of Second Impact Syndrome. Just before the game, he told everyone he was fine.

That’s why there is now a law in place called the Jake Snakenberg Act. It requires all coaches, like Pigati, to undergo concussion training to look for signs of possible brain injury.
Dylan and Alex Hearn [Dylan's mother] applaud the new measures.

[If you would like to see the online training program for coaches, click here:  CDC HeadsUp]

Now, coach Pigati watches kids for head injury and tell-tale symptoms, and he’s happy to do so. Like most coaches, Pigati takes the health of his players very seriously. He applauds the Colorado law requiring coaches to undergo concussion training.

And Dylan? He likes the law, too. Why?

“Because it’s safe,” said Dylan.

From the mouths of babes.

To read the full story on 9News.com, click here:  7-year-old applauds new concussion rules

U.S. Representative Gabrielle Giffords

The year did not start off well. On January 8, 2011, a man went on a shooting rampage in Tucson, Arizona. Six people were killed, 13 were injured, including U.S. Representative Gabrielle Giffords, who was shot in the head. The rapid response of the medical team saved the lives of a dozen people shot in the rampage, including Giffords’. Over the course of the year, her recovery has been better than anyone could have predicted, a tribute to the medical advances in brain injury treatment.

• Arizona Shooting Spree Aftermath
• Gabrielle Giffords’ Recovery Called Ideal

Long-Term Effect of Concussion

The biggest brain injury story by far is about the long-term effects of concussion, especially in athletes. This year, scientists linked multiple concussions to chronic traumatic encephalopathy (CTE), a kind of central nervous system damage that happens when people suffer repeated head injuries, typically soldiers or athletes in high impact sports, such as football or ice hockey. Early symptoms of CTE include memory problems, difficulty concentrating, and disorientation. As the disease progresses, people with CTE show behavioral problems—poor judgment, aggression, sexual compulsiveness, erratic behavior, and drug and alcohol abuse—as well as increasing nervous system symptoms, including tremors, staggering gait, deafness, and dementia. Unfortunately, the only way to definitely diagnose CTE is to examine the brain of the affected individual during an autopsy. From kids to football players to hockey teams, concussion has been the biggest TBI story of the year.

• Concussion Has Long-Term Effects for Teen Athletes
• Football Player Dave Duerson Donates Brain to Research
• NFL to Diagnose Player Concussions on the Sidelines
• Will NHL Take Action Against Concussion?
• Athletes’ Dementia: New Name for an Old Disease
• What You Need to Know About Youth Sports Concussion
• Football Players Sue League Over Concussion Risks
• Football Players Demand Better Health Monitoring
• Repeated Head Trauma Can Lead to CTE
• Kids Suffer Long-Term Effects from Head Trauma

Cheer Safety

What do you call an activity requires strength, stamina, flexibility, agility, planning, and coordination with team members?  What if the participants were required to train with weight-training and aerobic exercises?  And what if that activity was performed in gymnasiums, in stadiums, and on outdoor fields?  And what if teams competed regionally and nationally? Sounds like a sport, right? Well, not to sports authorities. Cheer (what used to be called “cheerleading”) injures participants like a sport, including some devastating head injuries. That’s why we wrote a 3-part series on cheer as a sport.

• Cheerleaders Are Athletes, Part One
• Cheerleaders Are Athletes, Part Two
• Cheerleaders Are Athletes, Part Three

How to Hire an Experienced Brain Injury Lawyer

TBI is a difficult, complex injury for doctors to treat…and for lawyers to pursue. If you are considering pursuing a legal case, it’s important to choose an attorney who knows the complicated ins and outs of brain injury. That’s why we’ve provided this guide:

• How to Hire an Experienced Brain Injury Lawyer

VIDEOS

In addition to blogs, we also create videos about important health, medical, and legal topics. To see all of our available videos, please visit our YouTube channel here:  HensonFuerst YouTube Channel

Here are links to some of our brain injury videos:

Symptoms of Concussion

Epidemic of Concussion in Youth Sports

Hiring an Experienced Brain Injury Lawyer

The study examined 729 children treated for TBI. Researchers tested the children 3, 12, and 24 months after their injury for their health-related quality of life, their participation in social and community activities, and their communication skills and ability to care for themselves.

The findings were surprising:  Quality of life was lower at all follow-up times. Social activities were significantly affected even after 3 months, but were improved (although not back to pre-injury levels) after a year or two. Communication and self-care abilities were lower at 3 months, and did not improve by 24 months.

The lesson:  A bump on the head can have effects that last much longer than the tears. Prevention of head trauma is key. But if injury occurs, get prompt medical attention to ensure that a serious injury doesn’t become a devastating problem.

RESOURCES

To read an abstract of the Pediatrics article, click here:  Pediatrics

To learn more about TBI, visit our dedicated web page here:  HensonFuerst Brain Injury Page

“There’s no way to know how much was damage caused by fighting as opposed to hits to the head sustained in the normal course of playing the game. Personally, though, I suspect it’s caused more by fighting,” Cantu said. “In my practice, when I’ve studied ‘enforcer-type’ guys and we discuss fights, they say roughly one in four times they get concussed. But they never bring it to the trainer’s attention. They just go to the box and try to recover enough to make it back to the bench when the penalty’s over. It’s the code. They’re afraid if they admit it, they’ll be out of a job.”

The results are in. According to an article in The New York Times, Boogaard had Chronic Traumatic Encephalopathy (CTE), a neurological disorder thought to be caused by repeated blows to the head. It can only be diagnosed after death, via autopsy and examination of the brain, but symptoms often reveal the disorder. Memory loss, mood swings, impulsiveness, addictions, and in the late stages, a person with CTE can develop symptoms that look very similar to dementia and amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease).

Boogaard’s brain was the fourth hockey player brain examined, and all four were found to have CTE. According to The New York Times:

But this was different. The others were not in their 20s, not in the prime of their careers. The scientists….told the Boogaard family that they were shocked to see so much damage in someone so young. It appeared to be spreading through his brain….

“To see this amount? That’s a ‘wow’ moment,” [Dr. Ann] McKee said as she pointed to magnified images of Boogaard’s brain tissue. “This is all going bad.”

What’s particularly scary is that other current, young hockey players could have the disease…and how many will sustain blows to the head tomorrow that will start the disease process. And yet, the NHL isn’t convinced that here is a link between hockey and CTE.  Hmmm…guess that means that they won’t be changing the rules about fighting on the ice. In fact, NHL Commissioner Gary Bettman told The New York Times:

“If you polled our fans, probably more would say they think it’s a part of the game and should be retained.”

There you go—the fans want the fights, so I guess we can tolerate a little brain damage. As Chris Nowinski, another co-director of the Boston University center, said:  ”They are trading money for brain cells.”

That says it all.

RESOURCES

To read our September blog about the call to ban fights in hockey, click here:  A Call to Ban Hockey Fights

To read the full article in The New York Times, click here:  Derek Boogaard–A Brain ‘Going Bad’

The study, which was discussed at the annual meeting of the Radiological Society of North America, found that regularly heading a soccer ball (bouncing the ball off the head) can lead to concussion-like brain injuries. According to MSN Fox Sports, the researchers scanned the brains of 38 amateur soccer players, and compared the images to the number of times they deeded the ball during the past year. Players who exceeded 1000 headers per year had “significant injury” to the brain. The damage was done to five specific areas of the brain, areas responsible for attention, memory, and vision. Functionally, players who frequently headed the ball performed worse on tests of verbal memory and hand-eye coordination.

“Heading a soccer ball is not an impact of a magnitude that will lacerate nerve fibers in the brain,” [lead author Michael Lipton] added. “But repetitive heading may set off a cascade of responses that can lead to degeneration of brain cells.”

The damage caused by soccer balls is insidious—it sneaks up on players after months or even years of normal play. This is different from the more slam-bam kinds of immediate concussion damage done in the more hard-hitting sports. But in some ways, that may make soccer more hazardous because you can’t prevent the damage without totally changing the rules of the game. This was just a small study, so it is too early make specific recommendation. Experts suggest that players try to minimize heading, especially during practice.

According to Canadian television station CTV, brain injury specialists with the non-profit group ThinkFirst identified heading as a possible safety issue three years ago, and drew up guidelines on how to headhit the ball safely. Their number one rule was not to teach the skill too early to children.

“So anybody out there who’s listening to this who has a child less than 10, do not teach that child to head the ball. Then if they are of the appropriate age, which is 10 to 12, then they can start learning how to head the ball with the appropriate sized ball,” ThinkFirst founder Dr. Charles Tator tells CTV News.

So the general advice seems to be to delay teaching heading until a child is at least age 10, and to minimize the amount of heading done in practices. For individual soccer players, I’d recommend just using your noggin, but that would just be a horrible pun, so I’ll just say to protect your brain and minimize the use of heading.

RESOURCES

To read the full story on MSN Fox Sports, click here:  Heading soccer ball may lead to brain damage

To read the full article on CTV, click here: ‘Heading’ a soccer ball could cause brain injury

The device, which costs about $200, is endorsed by former hockey star Keith Primeau. It is currently being worn by more than a thousand youth football players in the United States, and it can also be used by hockey and lacrosse players.

Primeau, now age 39, played in the NHL for 16 years before his fourth documented concussion forced him to retire from the Philadelphia Flyers. He still feels crippling effects of his head injuries: headaches, head pressure, dizziness and fatigue.

According to an article in The Globe and Mail:

Primeau said the Impact Indicator doesn’t prevent concussions but indicates when someone should come out of a game. Information is a weapon in the fight against concussions, he said. People can have an objective measurement rather than just subjective judgment of coaches, teachers, administrators and even physicians on the sidelines.

Once the LED turns red, there is a 50% probability of a concussion. At that point, a player shouldn’t take anymore head hits. It takes the guesswork out the equation:  When the light turns red, the player should be removed from play and see a doctor.

Whether players, coaches, and team owners will ever fully adopt the new technology remains to be seen, but it seems like a no-brainer. We support measures that help preserve health and prevent brain injury. Paralympian Paul Rosen won a gold medal with Canada’s sledge hockey team. He believes that losing his leg in 1999 was easy compared with post-concussion symptoms. As he told TSN:

“Losing my leg was an absolute joke in the way I dealt with it compared to what I’m dealing with on a day to day basis,” said Rosen, who suffered a concussion after a sled hit him in the head. “Thing was, they told me to suck it up. We have to get out of this mentality, whether kids are 10 years old or playing professional hockey, is get out of that mentality of suck it up.

“One hit to the head is one hit too many.”

To read the full article in The Globe and Mail, click here:  New chin strap flashes red

To read the full article on TSN, click here:  Primeau believes helmet can cut down on concussions

According to an article in The New York Times, the coroner ruled that Barden’s death was due to a brain bleed, also known as a subdural hematoma. But while the reason for his death is known, the actual cause is still a mystery.

“There’s nothing here; there’s still nothing there; there’s nothing there; there’s nothing there — and now he’s laying on his stomach,” Jeff Charles, the head coach, said while watching the sequence frame by frame.

Apparently, Barden had no preexisting condition, no history of head trauma, and no symptoms of concussion during the game. He had a state-of-the-art Riddell Revolution helmet. On hand at the game were two certified athletic trainers, and emergency medical technicians arrived with an ambulance within minutes. And yet, a catastrophic injury resulted in an untimely death.

“You can have the perfect plan in place but if all of these things happen, it can still result in a catastrophic injury and death,” said Kevin Guskiewicz, the chairman of the department of exercise and sports science at the University of North Carolina and a leading researcher on sports concussions.

During the game, Barden told his coach that he had a helmet-to-helmet hit, and that his head hurt. When he tried to stand up, he collapsed. He went into cardiac arrest in the ambulance. Two hours after the injury, he had died.

This is a tragic story all around. The coach is considering not returning for another season, despite the fact that everyone agrees he did nothing wrong. No doubt, his teammates—and their parents—will also be reconsidering whether to continue playing football.

The lesson seems to be that any head injury is dangerous, and you can’t predict the outcome of any one hit. Barden never had a chance to say “Yeah, I already had one concussions…I think that’s enough. Time to quit.” His first hit was his final hit. The fatal hit.

All we can say is stay safe. Protect your head. Barden’s death was a fluke. Nothing could have been done differently or better. Sometimes, life is dangerous.

To read the full article in The New York Times, click here:  An ordinary football game

To learn more about legal options in the event of a traumatic brain injury, visit our website at www.lawmed.com.  If you have questions, HensonFuerst has answers.

Thomas Henson, cycling team captain

According to an article in Bike World News, two major cycling organizations have jointly released recommendations for how to treat cyclists who have sustained head trauma.

Medicine of Cycling, an independent group of physicians and psychologists working to improve processes that can have a meaningful impact on the way care is delivered to cycling athletes, recently formed the Medicine of Cycling Concussion Task Force which aims to increase awareness of concussion and improve safety for cycling athletes. The guidelines pertain to adult athletes only, as younger riders are even more vulnerable to brain injury. These guidelines are intended to educate cycling team managers, coaches and athletes on the symptoms and management of concussion in athletes. The guidelines are not a surrogate for evaluations by appropriately trained medical professionals.

The guidelines include actions to take in the pre-season, how to evaluate for concussion after a head injury, and considerations for returning to cycling after a concussion.

If you are a serious cyclist—especially if you are a member of a cycling team—you need to read these concussion guidelines so that you, team coaches, and teammates are all on the same page when it comes to head injury.

Ride like the wind… but stay safe!

P.S.  If you would like to join the HensonFuerst Cycling Team, we are adding new riders to our group. We ride for fun, and for community support, fundraising for health organizations, and disease awareness. Cyclists of all skill levels are welcome.

RESOURCES

To read the full article in Bike World News, click here:  Medicine of Cycling releases concussion guidelines

To read the concussion guidelines, click here:  Concussions in Cyclists

CTE is a kind of central nervous system damage that happens when people suffer repeated head injuries, typically soldiers or athletes in high impact sports, such as football or ice hockey. Early symptoms of CTE include memory problems, difficulty concentrating, and disorientation. As the disease progresses, people with CTE show behavioral problems—poor judgment, aggression, sexual compulsiveness, erratic behavior, and drug and alcohol abuse—as well as increasing nervous system symptoms, including tremors, staggering gait, deafness, and dementia. Unfortunately, the only way to definitely diagnose CTE is to examine the brain of the affected individual during an autopsy.

The organization that is at the forefront of research into CTE is the “brain bank” run by the Boston University Center for the Study of Traumatic Encephalopathy (CSTE). Some athletes who believe they may have CTE donate their brains to the brain bank for examination after their death. That was the case with former football pro Dave Duerson, who committed suicide by shooting himself in the chest to preserve his brain for examination and diagnosis. (To read more about Dave Duerson’s story, click here: Football Player Donates Brain to Research.)

WHAT’S NEW THIS WEEK

An article in The New York Times reported that former NHL star Rick Martin had CTE when he died last March of a heart attack at age 59. What makes this revelation a game-changer is that Martin was not known for being an on-ice fighter, and he only had one known concussion, way back in 1978. His head ht the ice, and he experienced immediate convulsions.

“Rick Martin’s case shows us that even hockey players who don’t engage in fighting are at risk for C.T.E., likely because of the repetitive brain trauma players receive throughout their career,” said Chris Nowinski, a director at the center and co-founder of the Sports Legacy Institute, which seeks to advance the study, treatment and prevention of brain trauma in athletes.

The thought is that although Martin had only one documented concussion, he had several more head impacts—trivial, but cumulatively damaging.

For everyone, the message is simple:  Protect your head!  This new information suggests that any blow to the head could contribute to long-term problems. You never know which blow with be the one to send your brain over the edge to permanent, progressive damage.

To read the full article in The New York Times, click here:  Former Star Had Disease Linked to Brain Trauma

An article in the Deseret News recounts the experience of mom Erin Stewart, whose preschooler gave her a concussion:

Motherhood is rough. I’m not talking about emotions here. I’m talking physically rough. I’m talking just-got-back-from-the-doctor-with-a-minor-concussion rough. Seriously. My preschooler gave me a concussion.

In what will forever be known in our family as the day mom officially became a wimp, my 4-year-old daughter slammed her head into the back of mine. She was fine; I screamed in pain. A week of headaches later, I went to the doctor (despite my husband’s mockery) and was told I likely have a concussion.

This article is humorously written, but also educational. Concussions don’t just happen to football or hockey players, skateboarders, or daredevils. Concussions also happen to moms… or grandpas… or anyone who has a brain. All it takes is a blow to the head, even if the blow is delivered by a little girl.

Where Erin was mistaken—and where the article fails—was when she waited a week to seek treatment for her constant headaches. (All the worse if she really delayed her visit to the doctor for fear of more mockery from her husband.)

A concussion is also known as mild traumatic brain injury (MTBI). While the symptoms are often mild and temporary, some concussions are serious. Depending on the exact nature of the injury, the symptoms of concussion can last many long months.  After multiple concussions, some people can develop permanent, debilitating neurologic symptoms that mimic Lou Gehrig’s disease.

So, read this article for the humor Ms. Stewart intends, but keep in mind it’s lesson, also:  Concussions can happen to anyone, and often occur when we least expect it. And sometimes they are caused by cute little girls.