Research From The Past


There have been some very valuable resources to this blog, one who continually provides a vast amount of information both for posting and in the comment section is Don Brady, PhD, PsyD, NCSP, LMFT.  He along with his wife, Flo, have written to often cited pieces of information on concussions.  The first is the Communique on Sport-Related Concussions from the NASP.  The second is the common myths associated with concussions.  Let us not forget some the excerpts from his dissertation.

Recently Dr. Brady has sent me a couple of articles, neither of which were earth shattering in content, rather they were interesting due to the publication dates on them.

The first is a guest editorial by Allan J. Ryan, MD and appeared in The Physician and Sports Medicine, in 1987, 25 years ago (emphasis mine);

Rimel et all found that such events may be followed for weeks or months by symptoms and disorders of brain function that can be measured objectively. Gronwall and Wrightson found that persons who have sustained concussion show a reduced information-processing rate that may persist beyond 35 days when other post concussion symptoms (such as poor concentration, irritability, and fatigue) are present. Also, 20 young adults had less information-processing ability and took longer to recover following a second concussion that controls who had sustained only one concussion.  Thus, a cerebral concussion is a serous event that is indicative of an injury to the brain, and should be taken very seriously.

Full Text of 1987 Article

==========

The second article was presented just after the latest post by Tracey Mayer and her dealings with a new neuopsych who seems to be contradictory to current medical research.  This article was written by Sabina J. Strich and titled Shearing of Never Fibers as a Cause of Brain Damage Due to Head Injury, appearing in the prestigious The Lancet in…  1961, 51 years ago!

Upon reading the article you will notice that even back then they knew about concussions;

This paper is not about concussion nor about lacerations or contusions of the brain, but about the fact that, as Garna put it in 1835, “fibres as delicate as those of which the organ of mind is composed are liable to break as a result of violence to the head”.

Strich presents the case for injury to the very nerve fibers needed for all sorts of brain usage, including but not limited to: cognitive function, motor skills and emotional well-being.  Strich uses case reports of 20 plus patients that did not survive an insults (mainly motor vehicle) to the brain that did not produce bleeds or lacerations upon investigation;

Diffuse severe degeneration of the white matter of the brain may follow a closed and apparently uncomplicated head injury, leaving the patient permanently incapacitated, and more or less demented.  The pathological findings in twenty cases surviving after head injury for 2 days to 2 years are used to illustrate this condition.

Evidence is presented that the extensive white-matter lesions, both of hemisphere and brain-stem, represent a secondary degeneration of nerve-fibers which have been stretched or torn by the shear stresses and strains set up during rotational acceleration of the head at the time of the accident.

I really appreciate the time and efforts Dr. Brady puts into this blog, all on his own.  Please find him as a great resource!

Advertisements

One thought on “Research From The Past

  1. Several early 1900’s medical literature citations re the seriousness of suffering a concussion follow:

    1935 C P Symonds, MD – Disturbance of Cerebral Function in Concussion – The Lancet

    [Concussion] symptoms will need to be estimated on their own merits.

    They may reasonably be regarded as evidence of structural damage (cerebral contusion), and, as Trotter (1923) was the first to emphasize, they quite commonly develop after a head injury without concussion [loss of consciousness].

    In every case of head injury with or without concussion, therefore, such symptoms should be watched for, and it should be remembered that a latent interval, often of some days, may precede their development.

    ————————————————————————————

    1936 Punch Drunk — Carroll, J.R. American Journal of Med Sciences

    *** Punch Drunk is said to occur among professional football players also (p. 709). ***

    Many authors have abandoned the stand that concussion is a transient disturbance of function without anatomic basis…
    (p. 709)

    There are found organic symptoms which appear to the layman as Dementia
    (p. 711)

    The occurrence of this type of degenerative brain change must be recognized and publicized rather than disregarded and discounted
    (p. 711).

    It is especially important that athletes entering into competitions in which head [brain] injuries are frequent and knock-outs are common should realize that they are exposing themselves not only to immediate injury, but also to remote [down the road] and more sinister effects
    (p. 711).

    ======================================================

    1938… Dr. A. Thorndike- New England Journal of Medicine…

    The ignorance of the laity of the serious complications that may follow a simple concussion of the brain is to be deplored.
    (p. 464)
    .

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s