Top 10 for ’10: No. 9
No. 9: Sports-Related Concussions—No More Walking It Off
Despite the fact that neurologist Ira Casson, former co-chairman of the NFL’s panel on brain injury, essentially denied a relationship between repeated head injury and lasting brain damage in January,* the prevailing zeitgeist 11 months later is this: That sports-related concussions should be taken very seriously, and that safeguards should be in place to allow for recovery—at all levels of play.
Casson’s functional denial was based on the fact that scientific data are limited on the subject, but that deficiency is being answered by clinical and pathologic studies from, among others, investigators at the Center for the Study of Chronic Traumatic Encephalopathy (CTE)—the raison d’etre of which is to examine the very issue of CTE in sports and, by extension, to be an advocate for athletes who put themselves at risk of acute or chronic brain injury.
The Center’s latest, and perhaps most controversial, proposal is that the CTE associated with collision sports increases the risk of motor neuron disease (aka ALS, aka Lou Gehrig’s disease). Ongoing data from others, which were highlighted in a recent, dedicated issue of Sports Illustrated, suggest that the risk of lasting brain injury is not confined to concussed players, but that functional damage can be demonstrated in completely asymptomatic jocks who’ve sustained nonconcussive head blows.
Of course, the study of sports-related head injury is nothing new—despite the rising sensitivity to its potentially lasting consequences among NFL officials specifically and the general public, well, generally. A PubMed search with the terms “concussion” and “football” produces 273 English-language articles, dating back to 1970 (when Brett Favre was just a wee babe!). About three quarters of these articles were published within the last 10 years.
A historic gem from 1983 (“Concussion incidences and severity in secondary school varsity football players“) provides the results of a survey of more than 3000 high school football players in Minnesota, circa 1977. In the age of overtly endorsed disco and surreptitiously endorsed butt-blocking and face-tackling, the concussion rate was 19%, and nearly 70% of affected athletes returned to play the same day. A prior history of concussion was found to increase the risk of subsequent concussion 4-fold. As a result of head trauma, 6 high schoolers sustained permanent disability, ranging from “extensive” brain dysfunction to quadriplegia to death.
* In front of a House Judiciary Committee, no less.
A native East Tennessean, Barbara Martin is a formerly practicing, board-certified neurologist who received her BS (psychology, summa cum laude) and MD from Duke University before completing her postgraduate training (internship, residency, fellowship) at the Hospital of the University of Pennsylvania in Philadelphia. She has worked in academia, private practice, medical publishing, drug market research, and continuing medical education (CME). For the last 3 years, she has worked in a freelance capacity as a medical writer, analyst, and consultant. Follow Dr. Barbara Martin on Google + and Twitter.
