KRK
  • KRK
  • Veteran Member Topic Starter
5 years ago
krk comment....let's not rush guys
Brain Injury After Concussion May Linger
— Some effects persist a year after college athletes return to play

by Judy George, Senior Staff Writer, MedPage Today October 16, 2019

https://www.medpagetoday.com/neurology/headtrauma/82776?xid=nl_mpt_DHE_2019-10-17&eun=g430804d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%20Top%20Cat%20HeC%20%202019-10-17&utm_term=NL_Daily_DHE_TopCatTestB 

Concussion recovery patterns varied for different aspects of brain physiology, with some effects persisting a year after college athletes returned to play, a longitudinal imaging study showed.

Brain activity and communication between brain regions appeared normal 1 year after athletes received medical clearance to return to play, but cerebral blood flow and white matter diffusivity showed persistent effects, reported Tom Schweizer, PhD, of St. Michael's Hospital in Toronto, Canada, and colleagues in Neurology.

"Brain recovery after concussion may be a more complex and longer-lasting process than we originally thought," said co-author Nathan Churchill, PhD, also of St. Michael's Hospital.

"There is growing concern for the long-term health risks associated with concussion. However, we still know relatively little about how the brain recovers from concussion over the long-term, which is needed to understand the potential cause of these health concerns," he told MedPage Today.

"At the moment, safe return-to-play is largely based on the resolution of symptoms, but this is an indirect measure of brain recovery," he continued. At medical clearance, "concussed athletes showed differences in brain structure and function compared to uninjured athletes, suggesting incomplete recovery. More importantly, 1 year later, some aspects of the brain looked normal, but others still showed signs of ongoing recovery."

These findings are consistent with smaller studies that have used various imaging and electrical measurement tools to assess post-concussion effects, said Robert Cantu, MD, of the Boston University Chronic Traumatic Encephalopathy (CTE) Center, who was not involved in the study.

"When someone is symptomatically completely cleared of all post-concussion symptoms and is neurologically normal on examination -- when I, as a clinician in my office, determine the eye-tracking is normal, the cognition is normal, the balance is normal, the symptom checklist is back to baseline -- I'm going to send that individual through a return-to-play protocol and allow them to return to play," Cantu said in an interview with MedPage Today.

"At that point, there are still a wide number of studies that are not yet back to normal," he continued. "It's unnerving because we worry that we're possibly not being conservative enough in terms of when we send people back based just on the neurologic exam and the symptom checklist."

But many of these measurement tools -- such as evoked potentials, diffusion tensor MRI, and functional MRI -- are not recognized by the American Board of Radiology, Cantu added. "They are not clinical tools that a doctor in his office will order up and use as a stop-go criteria."

In their study, Schweizer and colleagues looked at college athletes who played volleyball, hockey, soccer, football, rugby, basketball, lacrosse, and water polo. They followed 24 athletes with concussion and 122 without; men and women were represented equally in both groups.

All athletes completed baseline assessments with the Sport Concussion Assessment Tool 3 (SCAT3). Athletes without concussion were scanned at the start of their competitive season. Concussed athletes had functional MRI, arterial spin labeling, and diffusion tensor imaging at three time points: an average of 4 days after injury, at return-to-play, and 1 year after return-to-play. No athlete acquired a new concussion during the study.

Compared with healthy athletes, concussed players had significantly reduced cerebral blood flow 1 year later, an average decrease of 10.03 mL/100g/m (95% CI -13.38 to -7.08). At the 1 year point, concussed athletes also showed possible signs of white matter tissue swelling, but no significant effects on global functional connectivity or white matter fractional anisotropy. MRI findings were tied to clinical measures, including acute symptom severity and time to return-to-play.

"By the end of the study, the concussed athletes were determined to be fully recovered based on clinical assessment, and had otherwise fully returned to normal work and school activities," Churchill said. "This is important, as it suggests that there are long-lasting brain changes even with full clinical recovery. It also raises new questions about when -- if ever -- the brain returns to 'normal,' and whether the long-lasting brain changes we see are related to worse outcomes if the athletes sustain another concussion before recovery is completed."

This study had several limitations, the authors noted. Exertion and subconcussive impacts after return-to-play may have influenced results. In addition, athletes with concussion had MRIs only after injury, and not at baseline.
In Luce tua Videmus Lucem KRK
Cheesey
5 years ago
I’ve had several concussions in my life growing up. None were from playing football. I can’t help but wonder if it had something to do with my Ménière’s disease and the migraines I suffer from now. That and the short term memory loss I also have.

Porforis
5 years ago
Had one mild to moderate concussion and while it's hard to tell long-term, it's very likely and my personal opinion that I lost like 5% of my mental sharpness long-term from that. Luckily no other long term symptoms thusfar but seriously people, protect your heads.
KRK
  • KRK
  • Veteran Member Topic Starter
5 years ago
This one is near and dear to me.....set the wayback machine to 1975....Butler Bowl, Indianapolis

I was playing tight end and in the wedge on kickoff return. I was the guy who was supposed to catch crappy/short kicks, but most of the time block. I am about 6'3" and weighed, at the time 245.

This LB came down for Butler and was hauling ass. As I was taught to do, I lead with my head and hit him right in crown of his head. He went down, and I was out on my feet...literally.

They walked me over to the bench and just sat my ass down to view the rest of the game. The next thing I remembered, I was on the bus on the way home in incredible pain. My GPA went from 3.3 to 1.5.

Thank God, I had coaches who cared more about the players than the wins. The shut me down for the balance of the year. The first day of contact my Junior year, I got another one...I was done.

Porforis pointed out

it's very likely and my personal opinion that I lost like 5% of my mental sharpness long-term from that.

I believe I did as well, at a minimum, for the near term. Learning helps repair the brain so I try to learn (re-learn) languages, do cross-words, and each good fats (avacados, nuts, red meat) as the brain is >60% fat.
In Luce tua Videmus Lucem KRK
Porforis
5 years ago
I don't know whether I had too many cognitive problems in the short term - mainly because the physical symptoms for like 4-6 months were killer. For like 2 months, I couldn't focus on anything for longer than an hour or so without an increasingly bad headache and a form of profound fatigue I have not experienced before or since that would not go away without an extended time of lying down and doing nothing. It gradually got less and less severe after that, and after about 10 months I was more or less able to do whatever I could before the concussion for as long as I needed to.

Sadly, when I got my concussion I was 3 weeks from ending my previous job, I really needed to maintain a good relationship with the company, and we were (as usual) getting completely throttled, so 50+ hour weeks immediately after the concussion definitely didn't help. Working 10-12 hour days when you only physically can handle a couple hours a work at a time max without a 30+ minute break sure wasn't fun to try to swing. Under other circumstances, and even if this happened again under the same circumstances, I definitely would have gotten evaluated and taken as much time off to rest my brain as possible, consequences be damned. It definitely didn't help my recovery and I paid for it.

On the plus side, it had the unintended side effect of seriously helping me with a nervous overthinking problem of mine. Hard to constantly think about every possible way a situation could go automatically when your brain physically can't handle it for months.
KRK
  • KRK
  • Veteran Member Topic Starter
5 years ago
Porforis, you are my brain damaged brother!!!

How ironic as we still two of the brightest bulbs on the site 😂

How smart must we have been BEFORE it happened.
In Luce tua Videmus Lucem KRK
Cheesey
5 years ago
What about me???
I feel so left out!

Porforis
5 years ago

What about me???
I feel so left out!

Originally Posted by: Cheesey 



I mean, you're kind of our brain damaged genius weird uncle.
Cheesey
5 years ago

I mean, you're kind of our brain damaged genius weird uncle.

Originally Posted by: Porforis 



I take that as a compliment!!!😂

Cheesey
5 years ago
Hey!!!
When was THIS thread started!?!?

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