To Your Health
December, 2011 (Vol. 05, Issue 12)
Brain Impact: Concussion Facts
Concussions are getting the attention of the athletic world
By Robert George, DC, CCSP, CSCS
On Oct. 23, 2011, San Diego Chargers offensive guard Kris Dielman suffered a concussion during a football game against the New York Jets with 12:31 left to play.
He landed hard on the ground after a wicked collision with a Jets linebacker, then got up, wobbled and went back to playing the rest of the game, taking several more hits to the head. Neither the Chargers training staff nor the NFL referees recognized how serious his head injury was as he "waved off" his sideline training staff to return to the huddle. On the flight home to San Diego after the game, Dielman suffered a "grand mal" seizure and will most likely not play for the rest of the season.
Magnitude of the Problem
Concussions are getting much-needed attention in the press, especially given the short- and long-term cognitive loss, early-onset dementia, physical disability and even death resulting from traumatic brain injury (TBI). Chronic traumatic encephalopathy is a chronic, degenerative neurologic disease linked to repetitive head trauma and is known as an invisible killer that can make a 35-year-old brain look more like 80 years old.
There are 250,000 concussions annually in football alone. The prevalence in high-school and college athletics is a major concern, especially considering how big, fast and strong high-school and college athletes have become, and how their play emulates the professionals. This "evolution" is exacting a terrible toll regarding TBI in not only football, but also soccer, hockey, wrestling, water polo and cheerleading.
Three Purdue University professors tracked 21 football players from Lafayette Jefferson High School in Indiana. For two years they kept a record of every hit in practice and during games. They found that half of the players had neurophysiologic changes from contact. They also discovered that the repetitive hits the players were receiving had a cumulative effect on the brain and resulted in brain wave changes that mimicked concussion, even when the contact did not result in a concussion!
What is a concussion? It can be defined as "a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces" or "an immediate and transient loss of neuronal function secondary to trauma." Signs and symptoms include but are not limited to thinking deficits, lack of sustained attention; amnesia; confused mental status; dazed look / vacant stare; slurred or incoherent speech; vomiting; nausea; emotional liability; slow motor or verbal response; memory deficits; poor coordination; dizziness; headache; restlessness; nervous weakness; exhaustion; and irritability.
For many chiropractic doctors, it is more likely to see an athlete in your office after injury occurs. Recognizing post-concussion signs and symptoms that can occur days or weeks after initial injury is crucial. These signs and symptoms include but are not limited to persistent low-grade headache; lightheadedness; poor attention and concentration; memory dysfunction; unusual fatigue; irritability and low frustration tolerance; intolerance of bright lights and difficulty focusing vision; intolerance of loud noises; tinnitus; anxiety and or depressed mood; and sleep disturbances.
The brain heals slowly; the first thing to recognize is that there is no "minor" head trauma. The million-dollar question is, "Have you ever hurt your head before? Second-impact syndrome is defined as even a minor head injury to an athlete recovering from a previous concussion, mild to severe, and can lead to brain swelling or even death. Jake Snakenberg, a Denver-based freshman high-school football player, died in 2004 because of second-impact syndrome from a hit he took just one week before the second hit that killed him.