Wednesday, May 12, 2010

Traumatic Brain Injuries

(blackmanlaw.com)

The following article is a collaboration between Joey's Sports Blog and CareMeridian in order to promote safety regard concussions and brain injuries in hockey.

As fans, we are glorified by the effort of our favorites players, but sometimes we neglect all the work that goes into recovering from injuries for players. Also, as fans we must remain aware of injuries and how to handle a threatening injury such as Traumatic brain injury.

Hockey is arguably one of the most physical professional sports. Hockey players are constantly getting body checked, slammed into boards, falling to the ice, slapped by a stick, hit by a dense, speeding puck or getting punched during a fight. If that isn’t bad enough, NHL hockey players take part in one of the most arduous seasons of any sport, effectively taking on harsher pain for a longer amount of time throughout the year. Risk of injury couldn’t be clearer as you all too commonly see hockey players missing their front two teeth. With all of the injuries that can occur, one of the most dangerous is a traumatic brain injury (TBI). A TBI is a silent injury that can cause harm to the mind and body of an individual. An injury to the head or brain can alter someone’s life and can even require long-term rehabilitation and care from a skilled nursing facility. These injuries are often far too common in the sport of hockey and if not properly treated can permanently leave a hockey player's life challenging than the game they play.

TBI is an injury that Philadelphia Flyers player Ian Laperriere knows all too well. In game 5 of an NHL playoff game with the New Jersey Devils, Laperriere took a slap shot to the face that immediately caused him to bleed excessively from the wound above his eye and lose sight. Laperriere was diagnosed with a brain contusion after having a MRI a few days later. While Laperriere may have originally thought that losing sight in one of his eyes was the worst of the two injuries, in reality the bigger concern could wind up being the long-term effects of the brain injury.

A concussions have been dismissed as minor injuries because the physical nature of most sports causes them to occur regularly. Nevertheless, they are still head injuries where the brain is forced to move violently within the skull and the way it functions could change permanently. When the brain moves in such a manner, it can bruise, bleed, and even tear, which can cause irreversible damage to the victim. For a sport like hockey, this type of injury is very common and, unfortunately, at times ignored. Many hockey players don't take into account the possible effects of the injury and because it might not seem like a serious problem exists at first, and they keep on skating as if nothing occurred. Their unawareness of the injury makes the it so much more dangerous because a mild brain injury can turn into a life threatening injury in a very short period of time without seeking immediate medical treatment.

Studies by the National Academy of Neuropsychology's Sports Concussion Symposium in New York have shown that since 1997, 759 NHL players have been diagnosed with a concussion. Broken down, that averages out to 76 players per season and 31 concussions per 1,000 games of hockey. That is far too frequent of an occurrence for such a serious injury. It's a frightening statistic that should send up a red flag to hockey officials that actions need to be taken to further prevent this type of injury from occurring. Hockey is made great strides in instilling injury-preventive equipment into the game, but as players become bigger and stronger the NHL must take the initiative and continue to protect the players by continuously improving equipment - especially head gear where it is important that helmets are both protective and stabilizing but allow players to play their game. This poses a difficult yet intriguing dilemma for all involved which does not all provide a pleasing solution.

The best, and sometimes only, treatment for TBI is prevention. For the National Hockey League new rules are being considered that preserve the game but also help protect the players. Rule changes concerning blindside hits, rink size (which effects players space from each other and their proximity to walls), and stronger helmet requirements all have been considered to help curb TBI and its effects. This demonstrates that the NHL is aware of the seriousness of the injury and is taking proactive steps to help prevent it from happening.

Hockey is one of the most popular sports in North America and has millions of people participating in it every year. Unfortunately, the sport comes with the risk of a TBI. With the right awareness of the injury and the necessary precautions in place, the game should be able to continue with players excited to lace up their skates and enjoy it.

In addition to understanding the impact of TBI on hockey, it is also important to understand how to recognize possible concussions and how to handle such situations when concussions unfortunately occur.

The following is an exert from WebMD.com concerning the symptoms, diagnosis, and treatment of concussions:

What are the symptoms?
It is not always easy to know if someone has a concussion. Not everyone who has a concussion passes out. A person who might have a concussion should immediately stop any kind of activity or sport. Becoming active again before the brain returns to normal functioning increases the person's risk of having a more serious brain injury.
Symptoms of a concussion range from mild to severe and can last for hours, days, weeks, or even months. If you notice any symptoms of a concussion, contact your doctor.
Symptoms of a concussion include:
  • Passing out.
  • Not being able to remember what happened after the injury.
  • Acting confused, asking the same question over and over, slurring words, or not being able to concentrate.
  • Feeling lightheaded, seeing "stars," having blurry vision, or experiencing ringing in the ears.
  • Not being able to stand or walk; or having coordination and balance problems.
  • Feeling nauseous or throwing up.
Sometimes it can be hard to tell if a small child has a concussion. If your child has had a head injury, call your doctor for advice on what to do.
Occasionally a person who has a more serious concussion develops new symptoms over time and feels worse than he or she did before the injury. This is called post-concussive syndrome. If you have symptoms of post-concussive syndrome, call your doctor. Symptoms of post-concussive syndrome include:
  • Changes in your ability to think, concentrate, or remember.
  • Headaches or blurry vision.
  • Changes in your sleep patterns, such as not being able to sleep or sleeping all the time.
  • Changes in your personality such as becoming angry or anxious for no clear reason.
  • Lack of interest in your usual activities.
  • Changes in your sex drive.
  • Dizziness, lightheadedness, or unsteadiness that makes standing or walking difficult.
How is a concussion diagnosed?
If a doctor thinks that you have a concussion, he or she will ask questions about the injury. The doctor may also ask you simple questions such as "What day is it?" to see if your brain is working normally. Then the doctor will check your strength, balance, coordination, reflexes, and sensation. Sometimes a doctor will order imaging tests such as a CT scan or a MRI to make sure your brain is not bruised or bleeding.

How is it treated?
Initial treatment for a concussion is to watch a person closely for any changes in behavior or for any new symptoms. Some people have to stay in the hospital to be watched while others can go home safely.
If the concussion happened during a sports event, be sure to see a doctor before returning to play.
If you have any swelling on your scalp, your doctor may recommend using cold packs to reduce the swelling. He or she may also prescribe a pain medicine or recommend a pain medicine that you can buy without a prescription, such as acetaminophen (for example, Tylenol) or ibuprofen (for example, Advil or Motrin).
At home, rest is the best way to recover from a concussion. Get plenty of sleep at night and take it easy during the day. To prevent a second brain injury, avoid alcohol, illegal drugs, and any activities that could lead to another head injury for a few days or even a few weeks. Your doctor may also tell you not to drive or swim for a while.
Some people feel normal again in a few hours while others have symptoms for weeks or months. It is very important to allow yourself time to get better and to slowly return to your regular activities. It is also important to call your doctor if you are not improving as expected or if you think that you are getting worse instead of better.

Thank you to Chelsea Travers (who is an outreach representative forCareMeridian, a subacute care facility located throughout the Western United States for patients suffering from traumatic brain injury, spinal cord injury or medical complexities, such as neuromuscular or congenital anomalies) and WebMD for contributions to this article.

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