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Schools Need to Become Brain Injury Conscious

posted by SK Brain Injury    |   January 16, 2012 15:00

OUT OF concerns about brain damage, the National Football League and college teams are finally taking concussions seriously. But while this cautious new attitude is admirable, it can also create a false sense of security for parents of children itching to play football, hockey, or soccer. For if concussions are the cause of brain damage, the thinking goes, then youngsters have nothing to fear as long as they avoid concussions. That’s not true. There is reason to fear brain injuries from head traumas that don’t result in concussions.

That’s the logical conclusion from the latest evidence, admittedly incomplete, from the Boston University researchers who’ve done landmark work into sports-related brain injuries. But the research, outlined in last Sunday’s Globe by Derrick Z. Jackson, should be thoughtfully reviewed by any parent, coach, or administrator of a school-sports program.

The most chilling case is that of Owen Thomas, the popular captain of the University of Pennsylvania football team, who committed suicide at age 21. His brain, studied by the BU team, showed extensive evidence of chronic traumatic encephalopathy - the degenerative condition linked to behavioral changes, dementia, and premature death in former football and hockey players. The surprise wasn’t just that Thomas was so young; it was that he had never been diagnosed with a concussion. That suggests the disease came about because of repeated sub-concussive head impacts from playing football during his adolescence and young-adult years.

Thomas’s case, combined with other research, leads Robert Cantu, the co-director of the BU center, to recommend that children younger than 14 stay away from sports that involve repeated collisions, with potential hits to the head. That’s merely one person’s advice, not yet anything close to a scientific consensus. But it’s not too early to urge parents to think the risks through carefully. No one should simply assume that if a sport is sanctioned by a school, it’s risk-free for young kids to participate.

The most common sources of brain trauma in team sports are football, soccer, and hockey. Football trauma can be reduced by having less strenuous practices, with limits on hard hitting; the sudden force of two players colliding at a high speed can jostle the brain. School football leagues, like the pros, should strictly penalize helmet-to-helmet tackling and the “launching’’ of tacklers into other players. But even with these precautions, parents should be wary: Football is a violent sport, and young players and their parents should be fully aware of the risks.

In soccer, injuries can occur when players repeatedly head the ball. The game can be played effectively without heading, and that’s an obvious way to all but remove the threat of brain trauma. Soccer leagues may reasonably await more evidence before making a major change to their sport, but limiting use of the head in practice seems like a sensible precaution, even before all the evidence is in.

Hockey is the most vexing case, because some of the worst head traumas occur in fights that have nothing to do with the playing of the game. At the youth level, bans on fighting and rules on hard checking into the boards should be strictly enforced. Meanwhile, coaches would best serve their players’ long-term hockey aspirations by emphasizing skill over aggression.

There is much more to be learned about possible links between chronic traumatic encephalopathy and youth sports. Thankfully, BU is moving ahead with its ground-breaking research. But parents, kids, and especially those in charge of youth sports programs shouldn’t wait for all the data to be in before taking precautions.

Article found in the Boston Globe

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News

Stem Cell Implants May Help Treat Brain Injuries

posted by SK Brain Injury    |   January 16, 2012 12:31

Implanted stem cells have substantially improved cerebral function in animals with brain trauma, but how they did it has remained a mystery. Now an important part of this puzzle has been pieced together by researchers.

In experiments with both lab rats and an apparatus that enabled them to simulate the impact of trauma on human neurons (brain and nerve cells), researchers at the University of Texas Medical Branch at Galveston identified key mechanisms by which implanted human neural stem cells (developing into neurons) help recovery from traumatic axonal injury.

A significant component of traumatic brain injury, traumatic axonal injury involves damage to axons and dendrites, the filaments that extend out from the bodies of the neurons, the Journal of Neurotrauma reports.

The damage continues after the initial trauma, since the axons and dendrites respond to injury by withdrawing back to the bodies of the neurons, according to a Texas statement.

"Axons and dendrites are the basis of neuron-to-neuron communication, and when they are lost, neuron function is lost," said Ping Wu, professor at UTMBG, who led the study.

"In this study, we found that our stem cell transplantation both prevents further axonal injury and promotes axonal regrowth, through a number of previously unknown molecular mechanisms."

Article found on Daily News and Analysis

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News

U.S. First Lady, Michelle Obama, Announces Brain Injury Initiative

posted by SK Brain Injury    |   January 12, 2012 10:26

First lady Michelle Obama announced Wednesday a commitment by medical schools to increase training of doctors and research of traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). The agreement is in conjunction with "Joining Forces," Obama's and Dr. Jill Biden's organization that encourages society's support of military personnel and their families.

More than 100 medical schools from the American Association of Medical Colleges have committed to initiative as well as 25 schools from the American Association of Osteopathic Medicine. The announcement was made at Virginia Commonwealth University in Richmond, VA, where the medical school has been a national leader in TBI research, partnering with Hunter Holmes McGuire VA Medical Center Veterans Affairs Hospital.

"I'm inspired to see our nation's medical schools step up to address this pressing need for our veterans and military families," Obama said. "By directing some of our brightest minds, our most cutting-edge research, and our finest teaching institutions toward our military families, they're ensuring that those who have served our country receive the first-rate care that they have earned." 

"Studies show that as many as 1 in 6 veterans from Iraq and Afghanistan have reported symptoms of PTSD," Obama said. "Since the year 2000, more than 44,000 have suffered at least a moderate grade of TBI."

The Rand Corp. said in a report in 2008 that about 300,000 military service members who have returned from Iraq and Afghanistan report symptoms of post traumatic stress disorder or major depression. The report also states that only about half have sought treatment. The Department of Defense reports that 229,106 military personnel have been diagnosed with TBI since 2000.

"We all must remember in this country, the end of war marks a very long period of transition," Obama said.

Veterans and returning military personnel are asked to make sharp transitions home from combat zones, she said, and although most returning do not suffer from PTSD or TBI, the transition home is when issues and incidents bubble to the surface.

"If you are struggling, please don't be afraid to speak up. If you know someone else is struggling, encourage them to seek help. Asking for help is a sign of strength," Obama said. "It can help fight the stigma of PTSD and other mental health issues, not just for military but for all Americans."

Many military members do not seek treatment for mental and psychological illness because they worry it will harm their careers, the report from the Rand Corp. said. PTSD and depression among military personnel returning from service could cost the nation as much as $6.2 billion in the two years following deployment.

The first lady closed her remarks by encouraging the medical students, doctors, researchers in this new venture and reminding the military they will have support.

"And to all of the troops and veterans we have here, that no matter where you are, no matter what you're going through, please know that America will be there for you and your families," she said.

Article found at WNEM.com

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News

Hiding Concussion in the NHL

posted by SK Brain Injury    |   January 11, 2012 12:14

As Colby Armstrong proved, concussions remain the easiest injury to hide.

The matter of Armstrong keeping his head injury a secret from the Maple Leafs for two days in the heightened awareness of the Concussion Era is instructional. It reveals more than ever the difficulty the NHL will have in trying to curb this epidemic.

“You’ve got to remember it’s still an easy injury to mask — because you can’t see it,” said former Flyers captain Keith Primeau. “You look at an X-ray, you can see a fracture, whereas the head, it might hurt but you have the ability to continue on.”

Not only continue on, but play at a decent level.

Primeau knows that firsthand.

The Toronto native had four recorded concussions in a career that saw him play more than 900 NHL games. The concussion diagnosis was only made when his symptoms were so severe he couldn’t function as a player anymore.

“I would have never divulged that,” he said.

Sound familiar?

It was only when Armstrong became nauseous after Monday’s morning skate before a game against Los Angeles that the Leafs learned he’d suffered a concussion after hitting Ryan Kesler in a game against Vancouver on Saturday night.

You can’t blame the Leafs in this instance. One can also understand Armstrong’s motivation in hiding the injury. He’s a character player who wears an “A” on his sweater not for his scoring prowess but for the intangibles he brings to the team.

But it’s tough to deliver on that when you’ve only played in nine games so far this season and missed 32 games last season. The potential permanent damage from head injuries likely isn’t even in the equation for him at this point.

The pressure to play is much greater — and may come more from the player himself than anyone else.

“I think it’s more internal pressure and desire to compete than any other extenuating circumstances,” said Primeau. “They want to be out there performing. They don’t want what they consider to be a simple headache to be the reason they’re not.”

Dave Scatchard knows that feeling well, too. He was a grinder for 13 NHL seasons, someone who also found a way to keep going even when concussed at times. He remembers telling team officials he was having neck problems when he knew he’d suffered a head injury after getting sucker-punched after scoring a goal.

The reason he didn’t tell the truth was he feared for his job.

“No player wants to be seen as damaged goods or get a reputation as a concussion guy,” said Scatchard, who made it clear he was talking about his own experience and not about Armstrong specifically.

But the concussions eventually exact a price.

Scatchard retired last summer after five spots were found on his brain during an MRI. He has trouble with memory, can’t push his three young kids on a swing without getting dizzy and can’t get his heart rate above 135 or more symptoms return.

He has been at the Mayo Clinic this week for cognitive testing.

“It’s extremely, extremely frustrating,” said Scatchard. “I expected to be in a better place than I am right now.”

Crowded places are also a problem for Scatchard, which can make Christmas shopping tough.

“I was trying to pick out my wife some nail polish to put in her stocking and there were so many nail polishes,” he said. “I was trying to read each label and see the colours and everything and I just freaked out and left. I never got any nail polish. That’s what I deal with daily. Some days I feel pretty good and other days I have a really tough time.”

It can also be hard these days for Scatchard to watch the game he loves.

“When I was a young guy, I loved seeing big hits like Don Cherry Rock ’em Sock ’em and things like that and now every time I see a big hit or see a player lying on the ice, my stomach just turns. It’s just so bad for a player and I pray to God they’re going to be okay and healthy. I don’t want anybody to have to deal with these issues.”

Article found at stopconcussions.com

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News

Ken Dryden Discusses Violence and Head Shots in Hockey

posted by SK Brain Injury    |   January 8, 2012 09:54

A year ago, Sidney Crosby went down with a concussion and the way we see hockey changed. A few days ago in the World Junior Championships, Canada's junior team lost to Russia in a way it shouldn't have lost, and almost won in a way nobody should win. Each speaks to something in our nature.

Where does it come from, this fight that is in us?

Surely, it must have to do with the hard land and hard climate of our past, when illness or injury weren't allowed to keep us from the fields or the forests. That was survival. So when we created our games, we'd play them in the only way we knew how.

Or, in an indirect way, maybe the answer's as simple as the difference between a puck and a football or soccer ball. A puck is hard and small. In hockey's earliest days, when it flew out of play it could travel far and stop the action for many inconvenient seconds. It could injure someone watching. Not so a football or soccer ball. So hockey created boards to surround the ice. Low ones at first, to keep the puck in play; higher ones later when more spectators found reasons to watch the game. For hockey players from the beginning, there was no out-of-bounds. There was no escape.

So the struggle that is hockey began. At first, it was on a much smaller ice surface, seven against seven not six against six, and with no substitutions and no forward pass, there was no way to open up the clutter; no escape even to rest. For the entire game, it was body pushing against body; the boards an unmovable opponent everywhere around the perimeter. To score, a player had to get close to an opponent's net, and in the offensive zone it's as if the oval of the rink suddenly becomes a funnel, the struggle, the strain growing ever more intense.

To get to the net is a fight.

The most legendary player of hockey's first hundred years was Rocket Richard. He was not much more than average size. He possessed no blinding speed, no overpowering shot. The lingering image of him now more than 50 years after his last game is his eyes. Wide, wild, his pupils so focused on his task — to get to the net — they'd bore a hole through anything that stood in their way.

It's the Europeans who first saw this unrelenting will in Canadian players. Before European amateurs were allowed to play against the NHL's best, the Europeans saw only the Penticton Vees, Whitby Dunlops, Trail Smoke Eaters, and those who came before them. By the mid-1950s, the Europeans had closed the talent gap, they could skate and pass as well or better than their Canadian opponents, but still Canada would win. The Europeans had come to hockey late from soccer or bandy (much like field hockey on ice), games played on big, wide-open spaces with strategies, skills, and attitudes to match. Even their "Olympic-sized" hockey rinks were bigger. They'd dazzle in the open ice, but in the funnel to the net, unaccustomed to the smash of bodies, they'd look for a final pass.

Canadians first saw this fighting spirit in ourselves in the 1972 Canada-Russia series, and we only truly saw it when the series was over. Before then, Canadians saw Canadian players who looked slow and undisciplined, thuggish at times, and Russian players who looked the way we'd always seen ourselves. Then, when the eight-game series seemed finally over — after a crushing loss in what had been a very promising first game in Moscow — with the Russians leading the series three games to one with one game tied and the final three games in Moscow, things changed. We won the sixth game, then came from behind to win the seventh. In the last game, down 5-3 at the end of the second period, we scored three goals, including Paul Henderson's winning goal with 34 seconds remaining.

There was a lot not to be proud of in that series. But we were proud that we won, and we were proud that we didn't give up. In a series where one player scores the game-winning goal in the final three games and the series-winning goal in the last minute of the last game, there can be only one hero — Paul Henderson. But there were two — Henderson and Phil Esposito. Moments after the series' lowest moment, our Game 4 loss in Vancouver, Esposito had given his "speech" in a TV interview. With sweat pouring down his face and fight still oozing from him, he took on those who booed us and doubted us. He embodied what we'd show ourselves to be in Moscow — the never-quit, never-say-die Canadians others had always seen us to be.

Canadians love this about their players. We get cut, we lose teeth, and we scarcely miss a shift. This isn't about ourselves; it's about the team. We're going to feel pain anyway; we might as well play. It's the fight that's in us. It's those boards we put up around us when we created this game that gave us no place to escape; no choice but to suck it up. It's the teeth-baring grin we show when we go into the corners and into that funnel to the net. And it's an ethic that's more important now than ever. To fans who "bleed" blue or orange or black, who feel more deeply about their team than they do about themselves, they need to know that the player with the multimillion dollar contract who wears the jersey feels the same.

And it's why most Canadian fans love Don Cherry. If anyone doubts that affection, go to CBC's nextHockey Day in Canada. I was with him three times, in Iqaluit, Shaunavon, Saskatchewan and Whitehorse. No matter how many former stars are also there or who they are, the fans want to see one person — Cherry. No question. No contest. These fans love the dynamic between Cherry and his sidekick, Ron MacLean, on Coach's Corner. MacLean is often described as Cherry's perfect foil, but in fact, the reverse is true. MacLean is Cherry's perfect setup man. Cherry goes over the top; MacLean catches him and comes back with something that seems almost reasonable — and on it goes. But beneath the shtick of outrageous clothes and bluster is a funny, entertaining character who has something to say. No one survives more than 30 years at the centre of a storm with just shtick.

Whatever Cherry's talking about, he's really talking about Canada and Canadian spirit. When European players first began playing in the NHL in any numbers, he trashed them. They weren't Canadian, not in nationality, not in spirit. Just because you wear the jersey of a hockey player, he said to them, doesn't mean you're a hockey player. Prove it. When they did, he wouldn't see it because they weren't Canadian. If they proved it a different way, not with their fists but on the scoreboard, as Wayne Gretzky and Mario Lemieux did, he wouldn't see it either.

Week after week his message carries the same basic truth: In hockey, as in any of other side theme of life he goes off into — "Hey, you kids out there" — you've got to be willing to fight. Who can argue? And to Cherry if you accept that, you've got to accept that any kind of fight or fighting is right. You've got to stand up — shoulder against shoulder; fist against fist.

This is where the debate over head shots and fighting grows confused. Giving up head shots or fighting is not giving in to do-gooders who never played the game. It's not giving in to Americans. It is not giving up something Canadian. It's not even giving up Don Cherry; certainly not his spirit. But it is taking on Cherry or anyone else on hits to the head. The surprise is that Cherry and so many former players who are now commentators defend or minimize these hits — the race for the puck, the last-second shove that catapults an opponent into the end boards and a completely unknowable fate; the cruise-by elbow or shoulder to an unsuspecting player. The hit like the one the Edmonton Oilers' Andy Sutton put on the Carolina Hurricanes' Alexei Ponikarovsky a few weeks ago. Sutton could see that Ponikarovsky couldn't see him, so this was not a knee-jerk reflex. It was entirely premeditated. He had several feet to decide what to do and chose to drive Ponikarovsky's head into the glass — because he could. But Sutton is a good guy. Good guys don't do bad things, so bad things done by good guys can't be bad things.

These are cheap shots and always were. Cherry and the others didn't play this way. Is this fight? Is this standing up? Where's the courage and toughness in this?

"Fight" is not "fighting." Fight is never giving up. Gretzky, Orr, Richard, Lemieux, Lafleur — they were great fighters. They fought with their head, hands, legs, will, and need to be special, and rarely with their fists. The toughest players aren't those who hit but those who are willing to be hit, to fight their way into open ice, to fight their way to the net, to fight expectation and disappointment to score the game-changing goal. Give up fighting and get more stick-swinging?

Who were the stick-swingers? A handful of players; almost nobody — and certainly not these players. Fight is the playoffs, the Olympics, and World Cup, where fighting and head shots are rare because the stakes are so high and the distractions so consequential that there's no place on the ice for goons. "Fight" is fighting spirit. It's Canadian hockey at its best.

After the 1972 Canada-Russia series, the skill gap between the Europeans, the Russians in particular, and Canadians seemed to grow. In the 1990s and early into this century, most of the NHL's top scorers and trophy winners were European or American. That has changed in recent years. Canadians learned that more than fight was needed.

In soccer, England had its "1972 moment" in 1953 when Hungary came to Wembley and won, 6-3. England won the World Cup in 1966, and since that time the skill level of its players has improved, but much less so than for those in the rest of the world. England keeps hoping that "English pluck" can make up the difference. It can't.

We learned in Canada what England has never learned. We learned that to win: Match them with skill; beat them with will.

The debate about head shots and fighting is not a debate about Canada, Canadian hockey, or the Canadian spirit. It's about giving up the fighting, but keeping the fight.

Article from grantland.com

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Ken Dryden | News

Gabrielle Giffords TBI Came at a Breakthrough in Brain Medicine

posted by SK Brain Injury    |   January 8, 2012 09:40

When U.S. Rep. Gabrielle Giffords was shot in the head one year ago today, many thought there was little chance she would survive, let alone open her eyes, walk or talk.

But the Arizona congresswoman, who will attend a vigil on Sunday in Tucson to remember the rampage that left six dead and wounded her and 12 others, had determination, abundant resources and, most importantly, a new era in brain medicine on her side.

"We're at an evolution today with traumatic brain injury, much like where doctors were with cancer and heart disease some 40, 50 years ago," said Dr. Geoff Manley, chief of neurotrauma at the University of California San Francisco School of Medicine. "We're just now learning that people like Giffords can not only be treated but can have meaningful recoveries."

Giffords benefited from aggressive approaches to surgery and therapy born out of wars in Iraq and Afghanistan. Military doctors found that soldiers formerly dismissed as the "expectant dead" could recover with the right treatment. That approach, unheard of less than two decades ago, played a key role in Giffords' treatment and recovery.

The world also benefited from Giffords' ordeal. The spotlight on her story brought a greater awareness to a number of areas - the importance of Level 1 trauma centers, the potential of brain trauma therapy, the grueling recovery process, the need for long-term treatment to be more available to most people and the call for more research to take the field out of its infancy.

Hundreds involved

Giffords, 41, can now walk - albeit with a significant limp. She also can talk in broken speech and understand everything said to her. She still has substantial weakness on the right side of her body, a product of being shot through the left side of her brain, but she continues to improve.

Whether she has a political future hinges on her progress.

Giffords' medical journey started in Tucson and continued in Houston and North Carolina. She moved faster than expected through a series of milestones made possible by teams of surgeons, nurses, rehabilitation therapists and other specialists and support staffs.

"You're talking hundreds of people," said Dr. Brent Masel, medical director at the Transitional Learning Center in Galveston and the national spokesman for the Brain Injury Association of America. "It's an enormous project. Repairing a life is an enormous project and it takes a while."

Months of therapy

The recovery process was long and intensive, beginning with emergency responders to the shooting and a Giffords aide who kept pressure on her head wound and held her upright to prevent choking, an act her staff credits with saving her life. She underwent multiple surgical procedures at University Medical Center in Tucson and at Memorial Hermann - The Texas Medical Center. Then she engaged in months of therapy, a process that likely would've been truncated for other patients because of their insurance companies, Masel said.

The materials used to treat and rehabilitate the congresswoman included drills and scalpels used in surgery; a computer-generated synthetic implant that replaced part of her skull; plastic piping, straps and pulleys that helped to increase strength in her weakened right side; and an adapted shopping cart that helped her relearn to walk.

It wasn't cheap. The tab for her therapy alone, which was paid for by her federal employee workers' compensation insurance, has totaled about $1.26 million since she began inpatient and then outpatient work, based on daily cost estimates from the Brain Injury Association of America.

Giffords has acknowledged that most people wouldn't be able to afford such treatment, and her staff has worked with Masel and others to draw more attention to the value of extended therapy for traumatic brain injuries, said her spokesman, Mark Kimble.

A good patient

It is largely a result of her exhaustive regimen of physical, occupational, speech and music therapies, along with her and her family's positive outlook, that has allowed her to progress more quickly than expected in her recovery, said Dr. Gerard Francisco, chief medical officer at TIRR Memorial Hermann, where Giffords has been participating in therapy since Jan. 26.

While Giffords could previously only communicate in short one- or two-word bursts, she is becoming better able to talk in full sentences, said Francisco. He said she has "good days and bad days."

'She's very fortunate'

Giffords is also able to initiate questions and converse, said Dr. Nancy Helm-Estabrooks, a speech specialist who, along with another therapist, worked with the congresswoman at no cost during a two-week intensive program in Asheville, N.C. There, Giffords engaged in a range of activities designed to challenge her to express ideas by speaking, drawing, gesturing and interacting with an iPad and laptop.

The exercises have supplemented her more than 11 months of therapy through TIRR Memorial Hermann to add to her progress, Helm-Estabrooks said.

"This underscores what we've been telling people - that brain injury recovery takes place over long periods of time and have to be supported by the appropriate rehab approach," Francisco said. "She's very fortunate that she has the resources."

Other techniques she gained from were a direct result of increased exposure to brain injuries during the age of improvised explosive devices in Iraq and Afghanistan. Dr. Peter Rhee, Giffords' lead trauma surgeon in Tucson who served as a military surgeon in those countries, led the procedure to remove part of Giffords' skull in the immediate aftermath of the shooting. The procedure, pioneered in the military, relieved pressure on Giffords' swelling brain that could have been fatal. It was among a series of more aggressive approaches to surgery and treatment that have been used with wounded troops and were implemented with the congresswoman. 

Manley acknowledged that treatment of traumatic brain injury still has a long way to go. Giffords has shown that recovery is possible, he noted, but now the field needs to build on the momentum - find better ways to diagnose patients and predict outcomes, produce more data on what works best and when, and pioneer even more cutting-edge treatments.

Tissue regeneration

Memorial Hermann doctors are conducting such cutting-edge research, specifically using stem cells. The research, a Department of Defense - funded trial about to enroll people who have suffered brain injuries, involves the injection of stem cells from the patients' bone marrow. Doctors hope those stem cells can regrow healthy tissue.

"Seeing patients like Gabby is really inspiring us to come up with new treatments - treatments that will return patients to normal, not just recover to a certain extent," said Dr. Dong Kim, Giffords' neurosurgeon at Memorial Hermann. "In the next 10 to 20 years, thanks to therapy that regenerates brain tissue, I think you'll see that."

Article found at chron.com

 

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News

Sidney Crosby's Concussion Trouble has Changed Hockey

posted by SK Brain Injury    |   January 6, 2012 12:00

Amid the memorabilia of a glittering career – a hockey stick, NHL jerseys, a ticket from the 2010 Olympic final and photos of his Stanley Cup ring and Olympic gold medal – is a small sculpture of the word “believe.”

But one year after the concussion that took the sport’s biggest star out of the game, it’s hard not to note the desperation lurking in the inspirational message at the sprawling sports complex in suburban Halifax where a young Sidney Crosby worked on his shot, hustled in practice and began to chase his dream, in earnest, to play for the NHL.

The youthful players at Cole Harbour Place idolize Mr. Crosby. But many of the parents who had a front-row seat to Mr. Crosby's meteoric rise are terrified now when they see their own children playing.

“After every game parents are saying ‘I’m just so glad my son got out of there without a concussion,’ ” said Glen Smith, seated high in the stands of one of the rinks, whose son plays for the Dartmouth Whalers Bantam AA. “You go to your daughter’s game and you don’t have a worry in the world. And you go to your son’s and you’re like ‘glad he made it through that.’ ”

At a mid-day practice for several local high school teams, the notion of concussions, nuanced rule changes and debate of the very nature of the game seem worlds away. But chat to some of those lining the boards, or coming off the ice, or sitting in the sparse stands, waiting for their kid, and worries that Sid the Kid will never again play the game at a professional level begin to surface. Mr. Smith said the superstar’s injury has made everyone aware of the risks faced by boys playing an ever-faster and harder-hitting sport. Some of the skaters say they have become more careful on the ice.

Officials and experts across hockey-playing nations have weighed in with suggestions, including baseline testing for concussion and calls for a ban on checking.

Paul Mason, who coached the young Crosby for four years, finishing when he was 14, said that minor hockey in Nova Scotia now uses tougher rules in cases of suspected concussions. He said the next steps could include looking at some of the equipment players wear and driving a change in culture from behind the bench.

“I think the onus is on the coaches as well,” he said in a phone interview. “They have to say, ‘as a player on my team, it is unacceptable to hit someone in the head.’ ”

Players at the Cole Harbour Place rinks Wednesday were quick to play down their own fears, though some admitted concerns and many said their parents were worried about them.

Luke Stienburg, 12, took a break from practising with his Maritime Hockey Academy team-mates to discuss the impact of Mr. Crosby’s injury. He said referees are stricter about calling penalties now and that, as a player, he’s more conscious of keeping his head up and avoiding damaging contact.

But he finds it disheartening to see the local star out of the game.

“It’s sort of hard because he was a role model to look up to,” said the right-winger, as the smell of sweat hangs over the rink and the sound of pucks hitting the boards echoes the arena. “All the players liked to say ‘you play where Sidney Crosby did.’ I think we care more here because it’s his hometown.”

Cole Harbour, a suburb of Halifax, is Crosby-country and affection runs deep. Only minutes away from the rinks is the home where he played ball-hockey and shovelled snow for neighbours. People on his street who remember him from those days are still fiercely protective, telling a reporter early in the concussion saga that they will gently steer away autograph seekers and celebrity hounds.

“He’s the local boy,” said David Bedford, who played goalie for 18 years in Nova Scotia, rising to Midget AAA, as he waited with his four-year-old son for a skating class at Cole Harbour Place. “He’s something of an icon here. Once the face of the NHL gets hit and put out, everyone pays attention.”

Mr. Bedford is keen for his young children to play hockey. But he notes that his son was in a helmet as soon as he was old enough to slide down a snowy hill.

That concern about head injuries is visceral throughout this building. Strangers will spark up conversations with “do you think he’ll be back” and even people with children far too young to play hockey are concerned.

Nick Blair and Jen Appleby are the parents of Carter Blair, only 16 months but already excited at the sight of the Sidney Crosby memorabilia cases. The boy sleeps with a small plastic hockey stick and his parents would love him to play the game. They’re hopeful the attention generated by Mr. Crosby’s injury will ultimately help clean up the sport.

“For every parent ... instead of it being at the back of your mind, it’s putting up front the risks that you take,” Mr. Blair said. “By the time [Carter] is playing it’ll be a different game than it is now.”

Article from the Globe and Mail

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News

Hormonal Dysfunction and Brain Injury

posted by SK Brain Injury    |   January 6, 2012 09:38

Over 7 years ago, Dr. Mark L. Gordon began his crusade promoting the relationship between head trauma and the progressive loss of life-promoting hormones. Dr. Gordon began lecturing to physicians at national and international medical conferences, presenting thousands of compelling studies about the causes and effects of traumatic brain injury on quality-of-life issues.       

Dr. Gordon, working with professional boxers, mixed martial artists, retired football players, motocross racers, and now veterans suffering with "Post-Traumatic Stress Disorder," has found the majority are suffering with one or more hormonal insufficiency or deficiencies noting that each had experienced at least a minimal traumatic brain injury (mTBI).

In 2006, after giving a lecture on mTBI, Dr. Gordon was approached by ESPN: Outside the Lines to provide the framework for a program looking at Sports and TBI. On January 21, 2007, Dr. Dan Kelly, a neurosurgeon and expert on TBI, and Dr. Mark Gordon provided the science and clinical aspects of hormonal dysfunction arising out of TBI.

A number of well-known sports celebrities, each with documented TBI and under Dr. Gordon's care, shared their experiences before and after hormone replenishment. 

Whether the trauma was mild, moderate, or severe it still altered the brain's ability to regulate the patient's hormones leading to increased risk of heart attack, stroke, emotional instability, drug and alcohol abuse, depression, anxiety, mood swings, memory loss, fatigue, confusion, amnesia, poor cognition, learning disabilities, decreased communication skills, poor healing, frequent infections, poor fracture healing, poor skin quality, increased body fat, decreased muscle strength and size, infertility, and loss of sex drive.

Also in 2007, Dr. Gordon's book The Clinical Application of Interventional Endocrinology was published, offering medical documentation to support the causes, clinical findings, laboratory testing, specific hormone replacement strategies, and the outcomes for Traumatic Brain Injury associated with hormonal dysfunction.

Recently, Dr. Gordon was featured on the cover of Life Extension Magazine (Jan. 2012) with an interview article on "Using Hormones to Heal Traumatic Brain Injury." In this piece, Dr. Gordon shares his views on how the medical community is presently addressing patients with TBI and presents one of many cases where a young man was being treated with three anti-depressants that did not control his depression. When he was found to be significantly deficient in one of the major hormones, replacement allowed him to be weaned off his traditional medication by his psychiatrist (within 6 months). Two years after the fact, he is living a quality of life that was previously unobtainable.   

This paradigm shift from treating hormonally deficient individuals experiencing both cognitive and behavioral problems with medications that mask the symptoms to a treatment protocol that focuses on replenishing the missing hormone(s) is starting to catch on. The relationship between behavior and hormones is indelibly connected, answering why many of the traditional medications fail.

As indicated in the Life Extension article, Dr. Mark L. Gordon has a grant from Access Medical Laboratories of Jupiter, Florida to provide free hormonal testing to veterans of the Gulf War and Law Enforcement. Again, the consultation and laboratory fees are at no cost to you or anyone for that matter.

Article found at sacbee.com


Read more here: http://www.sacbee.com/2012/01/03/4159326/traumatic-brain-injury-hormonal.html#storylink=cpy

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Eric Lindros' Comeback from Post-Concussion Syndrome

posted by SK Brain Injury    |   January 2, 2012 15:00

When Eric Lindros sat out the 2000-01 season for the Flyers, demanding to be traded after recovering from a disease (post-concussion syndrome) that had not been officially recognized or even known to the NHL, the fans turned on him.
 
When he was traded to the Rangers that summer, it seemed 60-40 with fans against him in his years-long battle with the Flyers and general manager Bob Clarke.
 
At the time, I never envisioned that he would be welcomed back with the kind of love and devotion I saw Saturday at the Alumni Game.
 
That he drew a louder, longer standing ovation than Bernie Parent, perhaps the most beloved Philadelphia athlete of the 1970s, was stunning to me and others who have been around the game all these years.
 
The reason for that ovation, I believe, is not rooted in a simplistic explanation that fans simply forgive or forget.
 
It’s more complicated.

For starters, most of today’s generation of Flyers fans weren’t adult season ticket-holders for much, if not all of the Lindros Era. There’s a whole, new generation that were kids watching him. A generation that wasn't even born when he began playing. Those who were there then and remain here were bitterly divided between supporting the club and supporting Lindros in his numerous battles with Clarke.
 
A generation has come and gone. Everyone involved from back then has moved on. Even Clarke himself has said repeatedly that Lindros belongs in the Hockey Hall of Fame, and no one would have thought he’d say such a thing in 2001.
 
But the biggest reason I feel Philadelphia again embraced Lindros is that anyone watching today’s game now understands that concussions and post-concussion syndrome is the No. 1 enemy facing hockey.
 
It has ruined lives – Pat LaFontaine, Paul Kariya, Keith Primeau -- and endangered careers – Sidney Crosby.
 
We didn’t understand then what we do now about this disease and we still don’t fully comprehend it’s dramatic after-effects.
 
That, to me, has changed the public perception of Lindros in Philadelphia and everywhere else. People now see him as being at the forefront of this terrible disease when, back then, they questioned his sincerity to play hurt which is the axiom of hockey.
 
Their view of how he played through and suffered through concussions has been altered.
 
“That’s a good point,” Rick Tocchet told me. “I think maybe that has a lot of people thinking differently [about him] now. A good point.
 
“Concussions are an individual thing. You can’t judge people on concussions. Sidney Crosby is the best player in the league and who knows if he is ever gonna get back.”
 
Regardless of why things have changed, it was great to see the Big E once again embraced by a city to which he gave so many quality years.
 
And it was even better seeing him laughing and joking with Clarke.
 
Time doesn’t always heal all wounds, but in this case, time and knowledge about concussions seems to have allowed it to happen.


Article found at CSNPhilly.com

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The Effects After a Brain Injury

posted by SK Brain Injury    |   January 2, 2012 12:00

The events that occur with major brain injuries and head trauma may be very similar to a rare but devastating ocean-related disaster. The initial trauma is the first insult to the brain, but what happens in the hours and days afterward may be even worse.

Neurological events called "brain tsunamis" occur several days after severe head trauma and may be responsible for inducing brain damage, according to a new study. Preventing these tsunamis or "killer waves" could help patients with severe head trauma avoid further brain damage and possibly retain most of their brain function.

The "brain tsunamis" are actually large population of brain cells that undergo massive depolarizations. Much like the weather-related tsunamis, these large waves of depolarizations spread slowly but persistently throughout the brain, causing widespread brain dysfunction.

These wave-like depolarizations have been studied in brain trauma patients for decades. But the new research showed for the first time that brain tsunamis are responsible for causing further brain damage in afflicted patients. The brain tsunamis drew the attention of the U.S. military as head injuries became a very common injury among veterans of the Iraq and Afghanistan wars.

The study is a collaboration between Kings College Hospital in London and the University of Cincinnati School of Medicine in Ohio. The researchers followed 103 people across seven different centers worldwide who underwent neurosurgery following major head trauma. Fifty-eight of those patients experienced the "brain tsunami" event, leading to a spread of cell depolarizations within the cortex.

The researchers measured the extent of the depolarizations by placing a linear strip of electrodes on the surface of the brain as the patient underwent neurosurgery. The patients were then followed for the duration of their post-operative care, to see whether the outcome of the neurosurgery was favorable.

The investigators hope that their results may alter the long-term treatment of brain trauma patients in a way that could possibly lead to better outcomes. Previous studies have identified other ways to improve outcomes in humans with brain injury.

In this case, the researchers hope that the spreading cortical depolarizations could somehow be stopped before they start in trauma patients undergoing surgery. So far, however, the investigators have not speculated how that could be achieved.

"Our ability to monitor and understand what happens in the brain after a severe injury hasn't advanced significantly in decades. The brain is like a black box, but the process of spreading depolarizations now gives us a window into that box," said principal investigator, Jed Hartings, of the University of Cincinnati College of Medicine.

The study was published in the journal Lancet Neurology.

This article found at www.theatlantic.com

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