In late April 2010, an NCAA panel recommended that all schools have a clear plan for what to do when a student athlete receives a head injury. The main issues are recognizing signs of mild traumatic brain injury (MTBI, also known as concussion), understanding the potential severity of every head injury, and deciding when the athlete is fit to resume playing. (Sports Illustrated/CNN)

The first week of May, it was announced that athletes at all Big Ten colleges will be required to undergo education about the symptoms of MTBI.

On May 9, 2010, Dylan Steigers died of a football-related head injury. He walked off the field after a scrimmage, vomited–a sign of concussion–then taken to the hospital. He died of subdural hematoma (bleeding on the brain). His death will surely be remembered and cited often as yet another reminder of how serious every head injury can be. (OregonLive)

At HensonFuerst, we are highly attuned to the dangers of brain trauma.  Every day we see clients whose lives have been changed forever after an accident. We support the principle of brain injury education for athletes, coaches, parents, and college administration officials.  The more we all understand about the signs and symptoms of brain injury, the more we respect the seriousness of even “mild” concussions, the more we encourage wellness over performance, the fewer disabled athletes will require a lifetime of special care.

We hope that the responsibility for recognizing when an athlete may be unfit to play is given to those who have the appropriate medical training. We say this because it was reported that “students will sign a waiver acknowledging their responsibility to be an active participant in their care.” (Dr. Jeffrey Kutcher, as reported on AnnArbor.com.)

Yes, it is important that athletes report their symptoms honestly–without fear of mockery or reprisals–but people who have a brain injury can be confused, forgetful, and disoriented. If the intention of this waiver is to get athletes to become more aware, that’s wonderful, but we hope that it is not used as a way to shield the colleges from their responsibility to protect the students.

HensonFuerst is a proud supporter of the Brain Injury Association of North Carolina (BIANC).

One of the world’s leading brain injury researchers recommends that children under age 18 should sit out of sports participation for three months after suffering a concussion. This statement was made by Dr. Bennet Omalu, co-founder of the Brain Injury Research Institute at West Virginia University, on February 1, 2010, while testifying at a House Judiciary Committee hearing on the impact of injuries in collegiate and youth football. (See AP story here.)

Dr. Omalu was the expert who discovered the condition called chronic traumatic encephalaopathy (CTE), a form of degenerative, permanent brain damage which can be caused by repeated concussions.

In an earlier committee meeting (January 2009), Dr. Omalu explained that concussions cause damage to brain structures at the cellular and sub-cellular levels. After concussion, some genes get “turned on” and cause a type of protein (APP, or amyloid precursor protein) to accumulate in brain cells and nerve fibers. APP is strongly associated with Alzheimers disease and other degenerative brain disorders.

So concussion increases APP. And APP is related to brain degeneration.

Here’s the kicker:  After a concussion, it take 3 months for all the extra APP to disappear. That’s why Dr. Omalu recommends that children stay out of sports (and other vigorous activities that could reinjure the brain) for 3 months. Adults should probably also be sidelined for that long, but it would be next to impossible to regulate when a 250-pound star football player can run back out onto the field.

Logical, right?

Except that the sports most likely to result in concussion are the same ones that value toughness and a certain degree of violence. According a report in the New York TImes (12/10/2009),

“…one day after the N.F.L. decided that no player showing any significant sign of concussion could return to a game, several players at Tustin High School in California admitted they still wouldn’t tell a trainer if they got hurt.”

And, from the DailyMe…

In the immortal words of U.S. Representative Ted Poe, R-Texas, “I mean if Congress gets involved, it would be the end of football as we know it…. We would all be playing touch football out there.”

It’s one thing to voluntarily damage your brain if you’re an adult, but we need to protect kids from activities that could cause them a lifetime of misery…or even a premature death. A single concussion can have devastating consequences. A Bellevue, Washington boy, Zachery Lystedt, is still learning to walk again after a severe concussion he got playing football when he was 13.

It is imperative that doctors, schools, coaches, and parents all cooperate for the health of our children. Concussions need to be diagnosed properly–as mild traumatic brain damage–and treated with the same care, respect, and time we give to other serious injuries. A broken collarbone means 3 months of down-time from sports. A child’s brain deserves at least the same amount of time to heal.

(For more info on APP and neurodegeneration, click here.)

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