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  Concussion Awareness/CTE Prevention

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Posted January 31, 2012

What is Chronic Traumatic Encephalopathy (CTE)?
Describe the pathologist’s role in the diagnosing CTE?
What are signs of CTE?
What’s the relationship between concussions and Chronic Traumatic Encephalopathy (CTE)?
Is a child’s brain more or less susceptible to damage from a concussion?
Don’t better helmets solve the problem?
Why don’t better helmets protect the brain from injury during sports?
How many blows to the head are too many?
What are the symptoms of a concussion?
When do symptoms of a concussion appear?
If a child may have suffered a concussion, what’s the most appropriate way for parents to play it safe?
What is a warning sign of concussion if a child gets tackled?
What can parents speak with coaches about if their child plays in a youth tackle football league?
If a concussion is suspected, what is the appropriate course of action?
News stories talk about rule changes. Ivy League schools are limiting full-contact during practice. As a neuropathologist, what’s advised?

What is Chronic Traumatic Encephalopathy (CTE)?

CTE is a degenerative disease that affects the brain and is caused by repeated blows to the head. Over many years these injuries can lead to the death and loss of brain cells in areas of the brain that control memory, behavior, and mood. CTE, once thought to be suffered only by boxers, is seen in other high-impact sports as well, particularly football and sometimes hockey. There are risks of brain injury from playing high-impact sports including tackle football or hockey that were not recognized even 15 years ago. Today, athletes like former Chicago Bears’ linebacker Hunter Hillenmeyer promote research being performed by pathologists in the fight against CTE.
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Describe the pathologist’s role in the diagnosing CTE?

The pathologist is able to confirm the diagnosis of suspected CTE cases. Physicians specializing in neuropathology examine brain tissue at autopsy to assess whether collections of a protein known as tau are present in a distribution characteristic of CTE.
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What are signs of CTE?

Patients suffering from CTE often display problems with memory, behavior, and depression. Researchers now believe that these signs may be linked to repetitive brain trauma suffered years prior to symptoms appearing.
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What’s the relationship between concussions and Chronic Traumatic Encephalopathy (CTE)?

Repeated concussions can set up a person’s brain for CTE later in life. Suffering one concussion makes a child’s brain more susceptible to suffering another concussion in the future.
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Is a child’s brain more or less susceptible to damage from a concussion?

Because a child’s brain is still developing, it’s more susceptible to damage from a concussion.
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Don’t better helmets solve the problem?

No. Helmets have been shown to reduce the incidence of skull fracture, but not injury to the brain itself. Some experts believe that they make the problem worse as players think they are more protected against brain injury and concussions. This is not true.
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Why don’t better helmets protect the brain from injury during sports?

Physicians know that the brain floats inside the skull. When a head injury occurs, the brain may impact the skull, become bruised, and swell. No helmet can completely protect a player’s brain from injury.
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How many blows to the head are too many?

Any blow to the head could cause injury to the brain. Unfortunately, exactly how many blows to the head are too many blows is not yet known. More research is needed. Pathologists recommend cognitive rest after a brain injury and not returning to play until you are medically cleared by a professional.
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What are the symptoms of a concussion?

  • Headaches
  • Vision problems
    • Light sensitivity
    • Blurry or double-vision
  • Dizziness
  • Confusion
  • Nausea (sometimes)
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When do symptoms of a concussion appear?

Usually, symptoms occur immediately after a head injury. However, in some cases, the warning signs may not appear until hours or days later, and the effects can linger later in life.
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If a child may have suffered a concussion, what’s the most appropriate way for parents to play it safe?

If you think your child may have suffered a concussion, play it safe: get them off the field until they've been cleared by a medical professional. As a pathologist, I can assure you that missing one game is better than having your child risk losing his or her memory later in life.
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What is a warning sign of concussion if a child gets tackled?

Depending on the nature, force, and location of the blow to the head, concussion can manifest as mood change, loss of consciousness, confusion, or other mental dysfunction. Assessment by a medical professional is important in determining whether a concussion has occurred.
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What can parents speak with coaches about if their child plays in a youth tackle football league?

As a parent or coach, it is important to teach players not to use their head to tackle. Head tackling may lead to a concussion, and repeated hits may cause brain damage down the road. Parents and children should know the risks associated with contact sports. Also, a parent would want to make sure that the coaching staff is aware of concussion prevention, be willing to educate players with regard to how to recognize a concussion, and not let players back on the field until cleared by a medical professional.
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If a concussion is suspected, what is the appropriate course of action?

If a player suffers a concussion, they must be seen by a medical professional and be cleared to go back to play. That usually means sitting out the rest of the game or the practice until an appointment can be made for an evaluation.

Some high school teams (and all NFL teams) give the players baseline cognitive tests so that they can be tested after a suspected concussion.If the player scores lower than baseline after a hit to the head, a concussion should be highly suspected and the player needs to seek medical attention before returning to the game or practice.

News stories talk about rule changes. Ivy League schools are limiting full-contact during practice. As a neuropathologist, what’s advised?

Repetitive head trauma should not be an intrinsic part of either the game or the practices. Neuropathologists, who diagnose diseases of the brain including CTE, know that repeated blows to the head could set up a child’s brain for concussions now and possibly brain damage later in life. Limiting tackles during practices might be a way to reduce risk for players.

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