Spotlight on Concussions

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January 5, 2011...The last time we saw Sidney Crosby play the good 'ole hockey game.

"When you get hit like that there's nothing you can do, theres no way you can protect yourself"- Sidney Crosby

When will he return? Well, that's a pretty good question. And the answer is....drum-roll please.... No-one-knows-for-sure! Enter the world of concussions. A true grey area for our grey matter. For this month's e-news, Gluckstein Personal Injury Lawyer's blogger and law clerk, Melanie Luxenberg has written a feature article about Concussions, mild brain injuries and sports. With hockey's big superstar sitting out, concussions have received a lot of well-deserved attention. People all over are now realizing that: CONCUSSIONS ARE A BIG DEAL. Regardless of whether you are a sports hero, or involved in a car accident. Medical professionals have to understand the need for a concussion protocol and follow up. Recently, Charles Gluckstein was interviewed for an article featured in the Law Times, and he had this to say:

"Only major hospitals do CAT scans and order brain injury follow up with the family watching for symptoms. Small hospitals just write down concussion, and that's a maybe... If hockey is our No. 1 passion, it is in jeopardy and in danger of losing its top star, it may improve research funding. Studies may give more information to medicine about diagnosis and also about treatment. That will help advocates to get better treatment for their clients and better insurance coverage."

Things you need to know:

  • A concussion can be caused by direct or indirect blows, or a hit to the head, violent shaking of the head, or force from a whiplash type injury.
  • With a concussion, there is usually no visible injury to the structure of the brain.
  • Therefore, the results of MRI tests or CT scans usually appear normal.
  • Symptoms may take up to 24 hours to appear!

Symptoms include:

  • Headaches
  • Neck Pain
  • Vomiting and Nausea
  • Dizziness
  • Blurred Vision/Sensitivity to Light/Noise
  • Unsteadiness
  • Confusion/Trouble Concentrating
  • Possible Loss of Consciousness

Finally, the sports world is catching up to the position where we who specialize in brain injuries from car accidents have been for many years. We understand the severity of even a mild brain injury. The term brain injury itself, or concussion is enough to make us realize that a real shift has happened in the brain and that potential long term consequences can occur. It is precisely because we can't see what is going on inside the brain with a concussion that we must encourage those who have suffered one to exercise caution. And that is why Sidney Crosby has not participated in the playoffs or joined his team since January 5, 2011. In order for him to safely play, he must be completely symptom free for a period of 10 consecutive days. Does everyone remember Steve Moore of the Colorado Avalanche? He was attacked by Todd Bertuzzi in March of 2004, suffered 3 cracked vertebrae in the neck and a concussion. He was never able to play again and still suffers from post-concussion symptoms.

Marc Savard suffered a severe concussion in March of 2010 and a moderate concussion in January of 2011. He told recently that he is having "real memory problems" and is "quite worried about it". The NHL implemented a 5-Step plan to help deal with the issue of concussions, as previously mentioned in our posting regarding Global Brain Awareness, found here. Other sports are attempting to find a way to manage the issue of concussions.

Major League Baseball has a 7 day disabled list for concussed players. 2006 American League MVP Justin Morneau of the Minnesota Twins sustained a concussion in July of 2010 and had lingering symptoms during spring training. The MLB maintains that player safety is important, and developed a special committee to study concussion protocols.

The National Basketball Association announced in early March 2011 that they were considering a formal concussion policy. Between February and March 2011, 6 NBA players missed games due to concussions. How about the National Football League? Recently, a study demonstrated that repeatedly concussed NFL players have 5 times the rates of mild cognitive impairment than the average population. The NFL has installed standardized concussion evaluation guidelines for 2011.

Scientists are investigating the long term effects of repeated concussions on the brain:

  • There is evidence that multiple concussions (even 2-3) can have a cumulative impact and affect attention and processing speed;
  • There is a relationship between repeated concussions and depression;Studies on the brains of Reggie Fleming and Bob Probert, both former NHLers showed that both men suffered from Chronic Traumatic Encephalopathy, a condition referred to as being "punch-drunk";
  • CTE has symptoms that are similar to Alzheimer's and is a progressive degenerative disease, which can only be diagnosed after death.

What physicians and medical specialist also have to consider, is treatment of concussions. It is just as important to treat concussions as it is to prevent them. Dr. Donna Ouchterlony, Director of the Head Injury Clinic at St. Michael's Hospital in Toronto appreciates the seriousness of concussions and mild traumatic brain injuries. She has conducted much research on the subject.

In her practice, her focus is on the four major components of a mild brain injury:

1. Benign Positional Vertigo (BPV), also known as dizziness;

2. Headaches;

3. Fatigue;

4. Cognitive Problems.

She cannot stress enough the importance of treated BPV early. Other members of the clinic include Dr. Cheryl Masanic and Dr. John Rutka. She recommends early intervention and treatment for all sufferers of concussions. The Head Injury Clinic also can send patients for sleep studies to handle the issue of fatigue.

If people who have suffered head injuries from car accidents could receive treatment within the first three to six months, they would benefit immensely.- Dr. Donna Ouchterlony

The rise of awareness regarding concussions and sports has helped to bring the dangers of concussions to the fore. Now we must work to bring the importance of adequate treatment and research to the fore. The brain gives us the power to think, and helps us with our regulatory functions. Why mishandle it?


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