Derek Boogard is a former National Hockey League player who died at 28 of a drug overdose. His brain was examined and found to have Chronic Traumatic Encephalopathy (CTE).
Read his story here.
Category: Brain Injury
Student Athletes and Brain Injury Overview
Scientific advancements and a greater understanding of the issues that affect the health and safety of young athletes are key to reducing sports-related concussions in youth, reads Congress’s Youth Sports Concussion Act of 2013. States across the country have been quick to respond to the challenge of preventing student athlete injuries through implementing concussion management policy.
Why is this important challenge only beginning to be addressed? Previously, a concussion was assumed to happen only if a person fully lost consciousness. It turns out that experiencing a concussion or mild traumatic brain injury (mTBI) is more common than previously understood. In 2010, about 2.5 million emergency department visits; hospitalizations, or deaths were associated with TBI in the United States. Many of these injuries occur during participation in youth athletics – particularly sports such as football, soccer, basketball, judo or even cheerleading. Sports and recreational activities contribute to about 21 percent of all traumatic brain injuries among American children and adolescents [CDC].
Given the data available on mTBI, the actual incidence of injuries may potentially be higher than reported. Many less severe head injuries are treated at physician’s offices or immediate care centers, or are self-treated.
Defining Brain Injuries
The International Conference on Concussion in Sport held in Zurich, Switzerland brings leading neuroscientists from around the world to discuss and define “concussion” or mTBI. Referred to as the Zurich Guidelines, the report is considered by concussion management organizations the cornerstone reference for diagnosis and management. In 2012, during their 4th annual conference, they published the following definition of a concussion or mild traumatic brain injury:
Concussion is the historical term representing low velocity injuries that cause brain ‘shaking’ resulting in clinical symptoms that are not necessarily related to a pathological injury. It is a brain injury defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces. Several common features that incorporate clinical, pathologic and biomechanical injury constructs that may be utilized in defining the nature of a concussive head injury include –
- Concussion may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an “impulsive” force transmitted to the head.
- Concussion typically results in the rapid onset of short-lived impairment of neurological function that resolves spontaneously. However, in some cases, symptoms and signs may evolve over a number of minutes to hours.
- Concussion may result in neuropathological changes, but the acute clinical symptoms largely reflect a functional disturbance rather than a structural injury and, as such, no abnormality is seen on standard structural neuroimaging studies.
- Concussion results in a graded set of clinical symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive symptoms typically follows a sequential course. However, it is important to note that in some cases symptoms may be prolonged.
Taking Action to Minimize Risk
The definition, diagnosis and treatment of the concussion still face significant challenges and controversy. Scientists are studying potential leads for biomarkers – ways to determine through changes in body chemistry whether or not an individual has had a mTBI. Other than diagnostic specificity, development will also need to be made in evidence-based management strategies and rehabilitation.
As the awareness around the dangers of unnoticed or mistreated brain injuries in youth athletics increases, researchers and policymakers are working to minimize the risks of participation in sports. In 2014, the White House held the first Healthy Kids and Safe Sports Concussion Summit focused on advancing research on sports-related youth concussions and raising awareness of steps to prevent, identify and respond to concussions in young people. All states have some degree of concussion policy; with state-mandated management programs insuring schools and extramural athletics organizations have all the resources to treat brain injuries in a manner consistent with the most up-to-date medical understanding.
Further Reading for Parents and Athletes
When facing the difficult decisions of what to do after a traumatic brain injury, it is important to have the best information possible. A mild brain injury or whiplash could still contribute to long-term behavior and learning impediments. The period of recovery after the injury is the essential and in some cases may even require multi-disciplinary medical team. Those who are closest to the injured athlete such as parents, teachers, coaches teammates and friends will also be critical in a speedy recovery since a brain injuries are not as obvious as broken bones or other physical injuries.
CDC Heads Up (guide to concussions for parents)
Brain 101 (short documentary)
Neuro-Huddle Empower Coaches & Athletes About Concussions
The 2015 Neuro-Huddle happened at the University of Hawai`i’s Stan Sheriff Center on Friday. People from across the nation gathered to take action about the issue of sports-related concussion and head injury, and share their perspectives from many sides of the issue.
KITV4 news covered the event. Read their article, “Neuro-Huddle helps to empower coaches, athletes about concussions,” and watch Cam Tran’s video report: “New Program to help concussion victims”. From the article:
What the medical science is doing is important and what they are doing with the rules. But in the final analysis if they are not empowered to tell how they feel, and they feel suicidal they feel they are hurting so bad, then that’s what I think is the puzzle and that’s harder to get to than change the rules change the helmets and do all those things.
— Former UH football head coach Dick Tomey,
“Neuro-Huddle helps to empower coaches, athletes about concussions”
More information will be available soon at the John Wilbur Legacy website at http://www.johnwilburlegacy.com. We’ll be posting more here, too, about our efforts towards this good cause.
Supporting the Wilbur Estate with the Neuro-Huddle 2015
FIRST “NEURO-HUDDLE” EVENT TO BE HELD IN HONOLULU IS ESTABLISHED BY JOHN WILBUR LEGACY FUND
The family opted out of an NFL settlement to create the free conference to help shareholders have a meaningful discussion on the issue of brain injuries
Who: John Wilbur Legacy Fund
What: Neuro-Huddle 2015
When: January 23, 2015, from 9 a.m. – 5 p.m.
Where: University of Hawai‘i, Stan Sheriff Center, Ed Wong Hospitality Room
HONOLULU, HAWAI‘I – The John Wilbur Legacy Fund with the support of Galiher DeRobertis & Waxman and the Hawai‘i Concussion Awareness Management Program (HCAMP) will host the first ever Neuro-Huddle Conference at the University of Hawai‘i Stan Sheriff Center – Ed Wong Hospitality Suite on January 23, 2015 from 9 a.m. – 5 p.m. The Neuro-Huddle is an all day event focused on bringing together stakeholders to discuss the issue of brain injuries as it relates to sports. The event is free and open to the public. Monetary donations are encouraged.
Neuro-Huddle 2015 is focused on the game of football and will share vital information on brain injury prevention, treatment, and general awareness. The late John Wilbur was an American football offensive lineman in the National Football League who played for the Dallas Cowboys, Los Angeles Rams and Washington Redskins. An anti-war and civil rights activist, Wilbur was the Players Association representative for the Dallas Cowboys and the treasurer of the NFLPA during his time with the Washington Redskins. Following his NFL career he became a business and sports leader in Honolulu. He was a professional players’ agent, coached special teams at the University of Hawai‘i, and mentored many aspiring football players and athletes, supporting many football players from the Polynesian community.
John Wilbur was a victim of Chronic Traumatic Encephalopathy (CTE) that devastated his life and family. Based on the sound clinical impression of local Neurologist, Dr. David Kaminskas, Wilbur was clinically diagnosed with CTE at the age of 69, one full year before his death while living in Hawai‘i. Dr. Kaminskas attributed the diagnosis to a decade of traumatic history from the NFL. Dr. Kaminskas is also a Clinical Assistant Professor of Neurology for the University of Hawai‘i John A. Burns School of Medicine and Director of the Center for Headache and Facial Pain and Center for Stroke and Neurologic Restoration at Hawai‘i Pacific Neuroscience. This clinical diagnosis was confirmed by autopsy following Wilbur’s death.
At the time of Wilbur’s death, his family and friends were appalled at the profound changes to his personality during the last years of his life, including a deep depression, anger and disorientation at performing once commonplace activities. His daughters, Lindsea Wilbur and Dione Smith, are key organizers of the event.
“After experiencing the debilitating, long-term effects of the undiagnosed brain injuries our father suffered after years of professional football, we want the Neuro-Huddle to showcase current research and disseminate knowledge relating to TBI in football at all levels,” said Lindsea Wilbur. “We want to support more accountability, integrity and mindfulness in the sports culture to ensure future generations continue to benefit from athletic programs without the risk of long-term injury.”
John Wilbur was one of 229 other NFL class opt-outs to the current, ongoing NFL Concussion Litigation settlement that was granted preliminary approval on July 7, 2014 by the United States District Court for the Eastern District of Pennsylvania. The class action settlement is still awaiting final approval.
Participating organizations for the 2015 Neuro-Huddle include the University of California Los Angeles Tisch BrainSPORT program, University of San Francisco Memory and Aging Center, Boston University CTE Center, Hawaii Pacific Neuroscience, and HCAMP.
HCAMP, which is a part of the University of Hawai‘i at Manoa, Department of Kinesiology and Rehabilitation Science, is funded in partnership with the State of Hawai‘i Department of Education and State of Hawai‘i Department of Health. With its support, the Wilbur family would like to turn the Neuro-Huddle into an annual forum to convene stakeholders, highlight individuals and projects, promote healing on all levels; and share research related to Traumatic Brain Injury (TBI), and Chronic Traumatic Encephalopathy (CTE) for athletes, coaches, families, fans, administrators, policymakers, caregivers and doctors. about biomechanics, diagnosis, care and treatment of TBI and CTE.
“We all need to be involved in the conversation to protect our present and future athletes. We must also honor those who suffered the unforeseen injuries that negatively impacted their lives,” said Galiher DeRobertis & Waxman’s Senior Partner Gary Galiher.
Thousands of youth athletes here in Hawai‘i and nationally are at risk for brain injury and CTE. Brains studied by Dr. Ann McKee at the VA-BU-SLI Brain Bank show repetitive brain trauma results in a build up of Tau (an abnormal protein) in football players as young as 18 years old. The Center for Disease Control calls brain injury (concussions) an “epidemic.” Chris Nowinski, co-director of the Sports Legacy Institute, cited during an Aspen Institute panel, “High school players take 2,220 hits to the head in a year.”
“Parents, players, and their coaches must take every precaution to help protect athletes from the devastating and permanent long-term effects of concussions. Let this be the beginning of a new discussion that will protect all who participate in high-impact sports,” said Galiher.
Convening leading researchers and physicians across multiple disciplines and former players and coaches from across the nation, including Hawai‘i, the John Wilbur Legacy Fund, HCAMP and Galiher DeRobertis & Waxman want to directly address sports-related concussions that continue to rise, especially in contact sports such as football. The Neuro-Huddle is a platform for sharing ideas about innovations, prevention, diagnosis and treatment.
For more information on the Neuro-Huddle 2015 visit www.johnwilburlegacy.com or to register for the event visit http://www.eventbrite.com/e/the-neuro-huddle-2015-tickets-15321037636.