Concussions an ‘epidemic’ for more than athletes

MINDUL APPROACH: Russell Fiore, standing, Brown University’s head athletic trainer, conducts a test on a student athlete aimed at identifying cerebral concussions. / PBN PHOTO/FRANK MULLIN
MINDUL APPROACH: Russell Fiore, standing, Brown University’s head athletic trainer, conducts a test on a student athlete aimed at identifying cerebral concussions. / PBN PHOTO/FRANK MULLIN

It isn’t just athletes who get concussions. People can get them from car accidents, slipping on the ice, or any number of reasons, leaving them with brain injuries that can take months and even years, in some cases, to heal.
“People who have been in this situation need to be supported,” said Dr. Michelle Mellion, an assistant professor of neurology at the Warren Alpert Medical School at Brown University. Their families need to know that mom may not be able to handle everything the same way she used to before her accident, and that healing from a concussion can be a slow process, she said.
Mellion was one of four neurological specialists who shared their knowledge about concussions at a recent public forum entitled, “Diagnosed with a Concussion, Now What?” The Oct. 24 event at the Warren Alpert Medical School, which drew a crowd of about 100 people, was the first in a series that is planned to help the public understand the nervous system and the myriad neurological problems that can occur as people age.
At the first forum, one goal was to dispel some of the misinformation about concussions that is circulating in the public now that concussions have become a highly publicized issue, Mellion said. In addition to the notion that concussions occur primarily on the playing field, one of those misconceptions is that the medical community knows more about the injury than it actually does.
What doctors and scientists understand now about concussions is just “the tip of the iceberg,” she said.
A concussion is a traumatic injury that occurs when the brain crashes into the skull either because of a blow, fall or other unexpected incident. Most people recover from concussions without any long-lasting injury, but the number of people getting concussions is significant and growing. Between 1.6 million to 3.8 million people a year get concussions in the U.S., but experts say that number is probably much higher. Mellion has called concussions an “unrecognized epidemic.”
Dr. Neha Raukar, director of the Sports Medicine Fellowship Project at Brown University, also spoke on the Oct. 24 panel and agreed concussions seem to be on the rise.
As an emergency room physician, and in her practice at the Center for Sports Medicine in East Providence, Raukar said she has been seeing more patients with concussions, as have her colleagues. The symptoms include dizziness, sleep problems, changes in vision and inability to focus. Immediately after contact, people may be dazed or have a blank stare. They may be disoriented, have slowed speech and their balance and coordination may be off. About 10 percent of concussions result in loss of consciousness.
Between 2001 and 2009, the number of emergency room visits in the United States due to concussions soared from 150,000 to 250,000, Raukar said. This was the case even though a national study on concussions in youth sports, which was released Oct. 30 by the Institute for Medicine and the National Research Council, found that student athletes are reluctant to report concussive symptoms.
“Amongst the kids, there is this culture of resistance,” said Raukar, who served on the 18-member committee of scientists and medical professionals who studied the issue.
Either they don’t want to disappoint their coaches and teammates, or they don’t want to take the time off from playing that they need to recover. Typically, complete physical and mental rest for at least a few weeks is the recommended treatment for concussion. Either way, it’s a bad situation since student athletes need their brain power to perform in school and immediate treatment for concussions is highly recommended, said Raukar. Athletes at Brown undergo a series of physical and cognitive tests after a concussion – which are compared with base line tests conducted before the season starts, as well as with a database of other Ivy League athletes – to ensure their brains have healed properly before they are allowed to return to play.
Most concussions, if reported right away and treated properly, will heal within a week or 10 days, said Russell Fiore, Brown’s head athletic trainer. But if they go undetected and untreated, for whatever reason, they can jeopardize a student’s academic career.
The study on concussions in youth sports, which was partially funded by the National Football League, brought together experts in a wide range of disciplines to examine existing data on the injury and such related issues as the efficacy of protective helmets and other athletic gear. Raukar said the committee found that there is no evidence to support claims by helmet manufacturers that their product reduced the incidence of concussion.
On another issue – whether repeated head injuries in youths can result in Chronic Traumatic Encephalopathy (CTE), the disease found in the brains of some deceased NFL players – the evidence was inclusive, the report states.
The report concluded with several recommendations, such as establishing a national database to more accurately record the incidence of concussion. The committee’s work is done, but others can work to keep the spotlight on the problem of concussions, which will hopefully result in more research dollars, according to Raukar.
“We’re hoping it’s not the end,” Raukar said. •

No posts to display