Tuesday Quick Hits


When will people and doctors understand that not only do repeat traumas to the brain while still recovering from an initial injury make the sequelae prolonged and worse, but returning to school will do the same?  As we have said over and over on this blog and in my many public speaking appearances removal from school and other cognitive activities is a MUST;

Drawing is just about all the 14-year-old high school freshman can do right now. He can’t play video games, watch TV, or use his cell phone said his mom, Michelle Hensley-Shelton. He can’t even go to school.

“He can listen to some soft music,” she said.

Michelle said it’s all because Hunter is recovering from concussions.

“Definitely two but the doctors at Baptist say that it could have been three or four,” said Michelle.

Michelle said they happened while Hunter was playing JV football. The first happened in August when Hunter was knocked out for a few seconds in practice.

“It was a pretty hard impact he took. He come down on his shoulder and he kind of went up and messed with his neck,” she said.

Hunter got checked out at the hospital and while he didn’t go back to practice for a few weeks, he did go back to school the next day.

“We learned one of the first things we probably should have done with his first concussion is not only keep him away from athletics for a few weeks, but his brain needed time to heal from schoolwork, as well,” said Michelle.

SOURCE

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Q: What exactly is tau protein and why does it matter in the concussion issue?

A: Normally occurring protein in the brain with a function, but in overabundance it has been implicated in CTE;

“Tau is a structural protein–it’s like the scaffolding of the brain cells,” says Dr. Christopher Giza, an associate professor of pediatric neurology and neurosurgery at UCLA’s David Geffen School of Medicine. “In an abnormal state it clumps together and changes the structure of the brain cell.”

But abnormal tau deposits can be seen only via an autopsy. Symptoms of chronic traumatic encephalopathy can include confusion, slow reaction time, aggression, anxiety, depression, problems controlling impulses, loss of memory and confusion, and they can progress over time.

“There’s no question that there’s a cumulative effect, but it seems that some people can sustain the same exposure and not develop the disease, or at least not manifest it,” says Dr. Charles Bernick, associate director of the Cleveland Clinic’s Lou Ruvo Center for Brain Health in Las Vegas. “But when does this start, and how early do these changes occur? Does the age when you start an activity matter? There are many questions that need to be answered.”

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There is a high school football team, a good one at that, that does not hit during practices.  I certainly think that there will be changes with regards to “full-contact” practices in the near future, however this example goes to show that just because you don’t hit in practice you can’t win;

At Orchard Park High School, football coach Gene Tundo bans full-contact hitting during practices to avoid unnecessary shots to the head.

The precautions don’t have to come at the expense of winning, either. Orchard Park finished a perfect 13-0 season on Sunday by capturing the state championship title in Syracuse.

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Jeffery S. Kutcher explains concussions and some of the issues surrounding concussions.  In related news Dr. Kutcher is now the “Concussion Czar” of the NBA, as The Association just adopted a new concussion policy;

In order to be an educator one must first educate themselves. Doctors are the educators when it comes to concussions but they themselves are just beginning to learn about them.

“We can learn so much more,” Kutcher said. “We have really only just begun to understand it.”

Doctors continue to research and learn more about concussions and the brain in general. This research is what has led to the uproar in recent years about concussions. Doctors finally understand enough to know that concussions can and sometimes do have lifelong effects on a person.

“The first factor is our increased understanding of the potential long-term effects from a concussion,” Kutcher said. “With that has come the realization that it is very difficult to examine a brain through physical examination and that there are a small number of medical professionals that have been trained to do a thorough neurological examination. That has sort of highlighted this crisis we have.”

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A very interesting question and answer session from Robert Stern, co-director of the Center for the Study of Chronic Traumatic Encephalopathy, appearing in the Times;

My son plays college football. He didn’t get much playing time, but the contact practices are intense. He’s never been taken out for a concussion, but could he have had any from head contact in practice or games? He’s very stoic about his injuries (broken tooth, strained thumb and ankle), so he wouldn’t tell us about something like a headache. I’m worried about this. Also, I had a car accident in the early 1980s where I hit the windshield (no seatbelt). I was never diagnosed with a concussion, but I’ve had neck problems ever since. Does one concussion contribute to C.T.E.-like problems? How would we know about my son’s condition or mine? Thank you.

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