The Concussion Blog

As we highlighted in “More Education Needed Down Under” the prevailing thought in Australia/New Zealand about head injuries is that concussion is a very bad word.  In fact the medical society is even using a term “footballer’s migraine” (FM), that is over 40 years old, to describe lasting effects of being hit in the head.  The Sydney Morning Herald and Nicky Park has just posted a story about the condition;

Footballer’s migraine, a condition that has forced Wallaby Berrick Barnes to take an indefinite break from rugby, remains a mystery to sports medicine experts.

Shane Brun from Sports Medicine Australia says the link between recurring migraine and continuous blows to the head is cloudy.

Symptoms of “footballer’s migraine” are the same as a standard migraine – throbbing head, sensitivity to light, nausea and ringing in the ears.

Of course FM remains elusive, it is extremely outdated, proposed by W.B. Matthews in 1972 the condition has been radically surpassed by a more modern condition; post concussion syndrome (PCS).  The basis of the FM diagnosis is reoccurring migraine like headaches after multiple traumatic incidents and is a condition that ONLY afflicts tackle football players;

“The footballer’s headaches are not necessarily related to a concussive state,” Dr Brun said.

“But people who tend to receive impact, yet not necessarily receive concussion, tend to get a higher incidence of headaches related to the sport.”

The above information from Dr. Brun is very confusing, especially if the world is to fall under the Zurich Guidelines from 2008.  The simple definition of a concussion or concussive state is any traumatic event that results in disruption of normal brain function.  This would include headaches, as this is a classic and hallmark symptom of a concussion.  Leading to the confusion is the later quote from Dr. Brun;

“(And) you don’t necessarily have to get a direct hit to the head to get concussion.

“The brain can move inside the head and still experience the same shock sequences without necessarily having the head banged on something.”

Dr Brun said research on the condition is very vague and brain scans don’t offer any assistance because all the signs are symptomatic.

The school of thought back in 1972 was that only contact to the head would create a concussion, yet Dr. Brun freely admits this is not the case, a much more modern and current school of thought.  They even understand that mouth gear and helmets will not attenuate the issue. But the most concerning issues are; that down under they feel that there is no long-term effects of FM and that FM is most common in young athletes.  Granted that PCS is a much more complex issue as it relates to treatment and diagnosis, at least here we understand the lasting effects of PCS, and that if anything we SHOULD NOT see this issue in youth athletes.  Yet, it is accepted in Australia.

In an aside: I have tried to contact about everyone in Australia, yet I have not been able to converse with anyone…