Journal supplement discusses past, present and future of sports concussions


September 29, 2014

Topic: concussions

The journal Neurosurgery just released a 16-page supplement called “Current Concepts in Sports Concussions” on the development of concussion research.

The journal Neurosurgery just released a 16-page supplement called "Current Concepts in Sports Concussions" on the development of concussion research. The journal was written and distributed by the Congress of Neurological Surgeons. 

Lead editor Gail Rosseau, M.D., has years of experience when it comes to sports concussions. Rosseau also sits on the Board of Directors for USA Football and ThinkFirst. The supplement's other contributors include experts in head-injury prevention and sports-related head injuries.

Difficulty defining a concussion
Though plenty of research related to sports concussions has been done through the years, one small factor has not changed: creating a clinical diagnosis definition for concussions that separates them from other types of head injuries. Some of the current criteria for diagnosing a patient with a concussion include brain bruises, a skull fracture or delayed consciousness after experiencing a brain hemorrhage or infection.

"The neurosurgeon's commitment to treating traumatic brain injury is implicit, providing a safe haven for all patients regardless of the severity of the injury or the time of day or night that they arrive in the emergency department. The unifying message among the cutting-edge science and statistics is that neurosurgeons are committed to advancing the clinical understanding and efficacy of all aspects of sports concussion through advocacy and education, patient care, on-field interventions, prevention, and groundbreaking research," Rosseau said in a statement.

New research from the supplement
Some of the standard signs of a concussion are the neurological difficulties patients experience after a forceful blow to the head. The New Neurometabolic Cascade of Concussion consistently updates physicians on the acute neurometabolic changes that happen after a traumatic brain injury. The publication's authors believe the possible connections between neurobiology and the initial signs and symptoms after a concussion occurs that could indicate a long-term impairment.

Several studies on animals have proved that the severity of brain inflammation plays a significant role in the duration of the concussion and whether the patient might endure long-term symptoms. More recently, research has shown that continual concussion symptoms may occur because the brain's form has slightly changed, even if images of the brain look normal. New neuroimaging techniques may be able to identify these small formation changes and help make a more informed outcome prediction.

The review The Postconcussion Syndrome in Sports and Recreation: Clinical Features and Demography in 138 Athletes discusses a condition commonly seen among young athletes. The publication's authors investigated 33 sports, with many of the cases occurring in ice hockey. Twenty percent of the PCS cases happened after the first concussion and another 20 percent happened after a second concussion. Most of the patients experienced seven symptoms on average. Some of these symptoms included dizziness, headaches, memory disorders, concentration issues and difficulty balancing.

Approximately 63,000 mild concussions occur each year to high school athletes, predominantly in football. Research has proven that repeated concussions can lead to neurological problems later on. However, there is not a proven method for predicting long-term impairment. The publication The Long-term Effects of Repetitive Mild Head Injuries in Sports examines the outcomes of repeated concussions, such as second impact syndrome.

Looking forward
"While there are still great strides to be made in the field, this supplement offers encouragement that considerable progress has been made on many fronts regarding the clinical understanding of sports concussion and prevention. It is our hope that one day, professional and amateur athletes, as well as millions of average people pursuing recreational activities they love, can do it safely each and every day, without the fear of head injury," Rosseau concluded.

People who believe they may have a concussion should see a health professional immediately, the U.S. Centers for Disease Control and Prevention advised. If a concussion occurs during a sporting event, the 4-step plan should be implemented. Those four steps are: 

  • Removing the injured athlete from the game
  • Having the player evaluated immediately by a health care professional
  • Telling the parent or guardian of the athlete about the injury
  • Keeping the athlete rested until he or she is cleared for play. 

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