New research from the Center for the Study of Traumatic Encephalopathy (CSTE), at the Boston University School of Medicine has shown that repeated concussions can cause brain damage.
That brain damage, known as chronic traumatic encephalopathy (CTE), was detected in the brain tissue of former NFL players who died young -- some as early as their 30s or 40s. Researchers at the CSTE concluded former NFL player Tom McHale, who died in 2008 at the age of 45, as well as an 18-year-old athlete (the youngest case to date) who suffered multiple concussions, suffered from this brain damage as a result of their injuries.
Dr. Ann McKee, a neuropathologist at the Veterans Administration Hospital in Bedford, Massachusetts, and co-director of the CSTE, says the beginnings of brain damage in an 18-year-old brain was a "shocking" finding. "We think this is how chronic traumatic encephalopathy starts," said McKee. "This is speculation, but I think we can assume that this would have continued to expand." The damage affects the parts of the brain that control emotion, rage, hyper-sexuality, even breathing, and recent studies find that CTE is a progressive disease that eventually kills brain cells.
So how do we know if injuries our children get "on the court" or "in the field" will lead to brain damage-- a damage that affects part of the brain that controls emotion, rage, hypersexuality, and even breathing??? According to Dr. Cara Natterson, the issue with long-term effects usually has to do with repetitive concussions.
How do you know if your child has suffered a concussion that is truly damaging and will have long term effects?
There aren't many studies specifically in children, but the lessons being learned from adult studies are being applied to kids, especially teenagers. Among pediatricians, the importance of staying out of sports/play until the concussion is completely healed has been emphasized. This is because repeat concussions seem to have cumulative effects and they result in increased vulnerability to additional injury. While no one completely agrees upon when it's safe to return to play, everyone agrees that the child should be completely symptom-free (at rest and during play), he should have a normal neurological examination done by a physician, and if an image (like a CT or MRI) is performed, it should look normal.
How do you know if your child has suffered from a concussion?
The definition of a concussion is a trauma-induced alteration in mental status that may or may not involve a loss of consciousness. There are many different scales used to measure the severity of a concussion. Certainly a concussion with loss of consciousness is almost always more severe than one without.
Are there certain sports that are more dangerous than others?
According to a review of pediatric sport-related concussion published in the Journal Pediatrics in 2006, "nearly all athletic endeavors pose some risk of concussive injury. Among the more commonly played high school sports, football and ice hockey have the highest incidence of concussion, followed by soccer, wrestling, basketball, field hockey, baseball, softball, and volleyball."
Are non-contact sports like gymnastics or cheerleading just as dangerous?
Non-contact sports like cheerleading and gymnastics aren't necessarily as likely to result in concussion, but by the same token they aren't exempt from risk either. Also from the pediatrics article: "in certain sports, the risk of injury depends upon the position played and in most sports, higher rates of concussions are seen in games (compared with practices) except possibly volleyball and cheer leading."
How can parents protect their kids from developing CTE and still allow them to participate in sports?
I think this is really the key question. Every sport has some risks-- certain sports just have more of them. Helmets are used with much greater frequency these days (remember when we all skied without them? Not so long ago...) And they are designed with greater sophistication. Protective measures are increasing in many sports, from the rules of play to the actual equipment worn by players. I think that all parents need to be aware of the risk of concussion, particularly in contact sports, and to weigh those risks as they decide which sports to choose for their children.
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