Concussion? If In Doubt, Sit It Out

By NESITA KWAN and BJ LUTZ
Updated 9:00 PM CDT, Thu, Oct 29, 2009

Athletic Director: “Better to look out for the next 60 years instead of the next 60 minutes of a football game”

Concussion: (n) an injury to an organ, especially the brain, produced by a violent blow and followed by a temporary or prolonged loss of function.

Up to a million high school and college athletes get them every year, and as more doctors learn about the long-term effects of the injury, the more concern there is about how they may impact the teen athlete’s brain.

While college football is where the injury may be the most obvious, a new study shows that athletes on the soccer field and on the basketball court get concussions almost nearly as often.

While an athlete may seem at first immediately following a significant fall or hard hit, alert adults may want to keep an eye out for signs of concussion hours after a game is over.

A new computer program appropriately named imPACT is helping. With imPACT, students take a special computer test before the season even begins. A player will take the test a second time after an injury. Those two scores are compared, and if they don’t match up, the player is out until they do.

Experts agree: if in doubt, sit it out.

That might be one of the hardest things an athletic director like Saint Rita of Cascia High School’s Zach Blaszak has to do, but enforcing complete rest until there’s a full recovery is crucial to protecting the young brain.

Also important, according to doctors and athletic trainers, is to recognize what’s happened out there on the field or in the court, and to immediately ask the right questions.

“Are you having a headache, are you having trouble concentrating or remembering, what was the last play you were in? Can you remember what happened to you,”neurosurgeon Dr. Gail Rosseau states as possible things to ask.

At the Chicago Institute of Neurosurgery and Neuroresearch, they’ve even created a card that parents can keep in their wallets that lists the signs of concussion, and the right questions to ask (see www.cinn.org to order your Ahead of the Game concussion reference cards).

“It’s better to look out for the next 60 years instead of the next 60 minutes of a football game,” Blaszak said.

Concussions get a closer look

CINN, in conjunction with the Illinois Athletic Trainers Association, is working hard to raise the awareness of concussions in Chicagoland. We applaud the article in the Chicaogo Tribune highlighting the work being done throughout the area. We urge all parents, coaches, athletic trainers and supporters of youth sports to visit www.cinn.org and order copies of Ahead of the Game, a concussion reference tool that fits in a wallet. Order one for yourself, and one for every family on the team.

chicagotribune.com

Schools increase awareness of injuries that killed 50 young football players in 10 years, and how to diagnose them
By Mike Helfgot

Special to the Tribune

October 7, 2009

Josh Jaremko and a hard-charging linebacker butted helmets during a routine drill of the sophomore football team at Hinsdale Central High School in August — one of hundreds of collisions during that practice session.

He didn’t feel quite right, but returned to the field the following day.

“I especially did not think it was a concussion,” Jaremko said. “I just thought it was a good hit and I would be fine.”

Then he got hit in the same spot again and was diagnosed as having suffered two concussions. He was at risk of what is known as second impact syndrome, a condition where the brain swells rapidly and catastrophically when a second injury occurs before the first one heals.

Jaremko endured headaches for a couple of weeks and doctors’ visits before being cleared to play within a month.

Sports-related concussions have been in the news recently and are the subject of a new effort by athletic trainers in Illinois to make more coaches, parents and athletic directors aware of the symptoms and dangers of playing again too soon.

A 17-year-old, Drew Swank of Valley Christian High School in Spokane, Wash., suffered head injuries in a September game and died two days later. University of Florida star Tim Tebow was knocked out of a recent game with a head injury and it’s unclear when he might return to play.

A New York Times report found that from 1997 to 2007, head injuries caused deaths to at least 50 football players on the high-school level or younger. And another study has found former NFL players are far more likely than the general population to suffer from dementia.

High school players are vulnerable because their younger brains are at greater risk of serious and long-term injury because the brain tissue is less developed and more easily damaged.

The Illinois Athletic Trainers Association is teaming up with the Chicago Institute of Neurosurgery and Neuroresearch to get the word out about how to diagnose a concussion.

Some states are attempting to tackle the issue through legislation. Washington passed a law in May mandating guidelines for treatment and education for coaches and parents. Several other states are considering a similar law.

Michael Sullivan, trainers association president and athletic trainer at Downers Grove North, said State Senator Bill Brady initiated a meeting on concussions with the trainers association and the Illinois High School Association, but those groups did not recommend pursuing legislation. It would be difficult to implement and enforce, Sullivan said, and many schools would not have the resources to comply.

Instead, the trainers association is trying to get the word out through an informal word-of-mouth campaign and the distribution of an educational wallet card it collaborated with the neurosurgery institute to create.

One side of the card lists the symptoms for athletes (headache, sensitivity to light/noise, sluggish, dizzy, double vision, nausea, memory/concentration problem, change in sleep patterns) and the other displays the warning signs for coaches and parents (forgetful, clumsy, irritability, depression, forgetfulness).

The card can be downloaded at CINN.org.

“We’re trying to get the word out any way we can,” Sullivan said. “We’re trying to educate parents, coaches and kids on the identifiers.”

He said Illinois is typical of a national study that showed only 42 percent of the high schools in the nation have an athletic trainer on staff.

“Even within the Chicagoland area, it’s not 100 percent. Many schools hire an outreach trainer, some for game coverage, some for weekly checks. This is not meant to substitute for an athletic trainer or a physician, but at least this gives people an idea.

“There probably are not enough hours in the day for this kind of a campaign, but we can at least distribute literature that get passed on and get the word out to youth groups,” Sullivan said.

Detecting a concussion can be tricky, especially in a sport where playing with pain and discomfort is ingrained. In Brian Connor’s case, the 2009 Hinsdale Central graduate doesn’t remember feeling any — or anything immediately following a helmet-to-helmet hit in a playoff game last season. After seven plays, a teammate realized he was playing erratically and got Connor removed from the game before any more damage could incur.

“I put my head down on top of his, and the next thing I knew it was seven plays later and I’m waking up and talking to our trainers,” Connor said. “I had no idea I was out there.”

More than 3.5 million sports-related concussions occur each year in the United States, according to the U.S. Centers for Disease Control and Prevention and the Brain Injury Association of Washington. Though much is still unknown about concussions, the number continues to rise. Some schools are taking steps to react more quickly and accurately. Barrington senior Tyler Lindroth took a blow to the head in practice in early August, and before he could try to convince anyone he was fine, his coaches forced him off the field. His concussion came with two weeks of short-term memory loss, but by the end of the month, he was cleared and back on the field.

“Our school is pretty good about education on concussions,” Lindroth said. “I wanted to keep playing but they knew something was up.”

Barrington is one of 52 schools in Illinois that uses computer software from a company called ImPACT (Immediate Post-concussion Assessment and Cognitive Testing). Brain injuries don’t necessarily show up on an MRI or CT scan, but this ‘neurocognitive’ testing has proven effective in determining when an athlete with a concussion has returned to normal. The program provides a baseline test to athletes at the start of the season, which serves as a basis for comparison following a head injury. According to Barrington trainer Kevin Stalsberg, the package of 1,000 baseline tests and 100 post-injury tests costs $1,000.

“We see more concussions here,” Stalsberg said. “We’re managing three to five a week. I don’t know why that is. I’m hoping that it’s because of the education.”

Other schools can’t even afford an athletic trainer, let alone cutting-edge computer software. Harlan is among the Chicago Public Schools that does not have one.

“For football games, we have a medic on duty from the Chicago Fire Department,” said Ted Tines, Harlan’s assistant athletic director. “No one has been formally trained to look for at the signs of a concussion. We just have to go with basic common sense — dizziness, blurry vision, lightheaded. We haven’t had any cases this year.

“The board is limited with the amount of funds. I used to go to clinics, but it’s become a financial issue. Are we getting proper training? No. They would tell you they would like to send us, but it is just a financial issue.”

While some schools can’t afford baseline testing, Joseph Reda, the athletic director at Bloom in Chicago Heights, believes the price tag is reasonable enough to pursue with his board.

“I was expecting to hear 30 grand,” Reda said. “Within reason, nothing is too expensive for our kids.”

Real Sports with Bryant Gumbel sheds light on concussions in high school sports

CINN applauds the increasing media attention regarding concussions in high school sports. We continue to urge all parents, coaches and supporters of high school sports, especially those involved in football, soccer (girls and boys), wrestling, hockey and lacrosse to become acquianted with the signs and symptoms of concussion. Visit www.cinn.org to order a free concussion reference tool for yourself, your students, athletes and friends. Help CINN spread the word of the importance of quick and accurate diagnosis of concussions and their treatment.

From Real Sports Website: Description of concussion program that aired in September 2009.

H.S. Concussions

In the violent world of football, helmet-crushing hits that cause concussions are common. While these injuries often make headlines in pro football, few realize that head injuries at other levels of the game, specifically high school, are occurring at an astounding rate and can have deadly consequences. In the last two years alone, eight kids have died from head injuries and many more have suffered catastrophic injuries following a concussion. REAL SPORTS host Bryant Gumbel takes an in-depth look at the disturbing frequency and deadly hazards of concussions in high school football.

Correspondent: Bryant Gumbel
Producer: Tim Walker

Dr. Rosseau Quoted in the Gold Health Guide

THE GOLD HEALTH GUIDE - Brain Fitness
Chief of surgery, Neurologic & Orthopedic Hospital of Chicago, Dr. GAIL ROSSEAU’s advice on keeping your brain sharp:
Stay mentally engaged. It’s the best way to keep your edge. Brain exercises are the latest fad, but anything that challenges you cognitively will help: Play Scrabble or chess, join a bridge or book club, or take classes.
Eat for your brain. Dark-colored vegetables - spinach, beets, etc. - and bright-colored fruits like berries, prunes, red grapes and tangerines in my desk.
Don’t ignore persistent headaches. Most aren’t serious, but occasionally they can signal an aneurysm or brain tumor. Three danger signs to check out promptly:
1. Headaches are worse in the morning.
2. Headaches that come on suddenly like a blinding thunderbolt
3. Headaches accompanied by nausea.

New York Times Article Reinforces Need for Concussion Awareness in Youth Sports

In light of more data on the long-term impact of concussions in athletes, the CINN concussion program urges all coaches, trainers, and parents of youth athletes to become more familiar with the signs and symptoms of concussion. Visit www.cinn.org to order CINN’s free concussion reference tool Ahead of the Game. Keep the reference card in your wallet, in your car, and distribute the cards to others involved in youth sports. Let’s work together to not only raise the awareness of concussion in youth sports, but to vigilantly pursue better diagnosis and treatment.

Dementia Risk Seen in Players in N.F.L. Study
By ALAN SCHWARZ
A study commissioned by the National Football League reports that Alzheimer’s disease or similar memory-related diseases appear to have been diagnosed in the league’s former players vastly more often than in the national population — including a rate of 19 times the normal rate for men ages 30 through 49.

The N.F.L. has long denied the existence of reliable data about cognitive decline among its players. These numbers would become the league’s first public affirmation of any connection, though the league pointed to limitations of this study.

The findings could ring loud at the youth and college levels, which often take cues from the N.F.L. on safety policies and whose players emulate the pros. Hundreds of on-field concussions are sustained at every level each week, with many going undiagnosed and untreated.

A detailed summary of the N.F.L. study, which was conducted by the University of Michigan’s Institute for Social Research, was distributed to league officials this month.

The study has not been peer-reviewed, but the findings fall into step with several recent independent studies regarding N.F.L. players and the effects of their occupational head injuries.

“This is a game-changer — the whole debate, the ball’s now in the N.F.L.’s court,” said Dr. Julian Bailes, the chairman of the department of neurosurgery at the West Virginia University School of Medicine, and a former team physician for the Pittsburgh Steelers whose research found similar links four years ago. “They always say, ‘We’re going to do our own studies.’ And now they have.”

Sean Morey, an Arizona Cardinals player who has been vocal in supporting research in this area, said: “This is about more than us — it’s about the high school kid in 2011 who might not die on the field because he ignored the risks of concussions.”

An N.F.L. spokesman, Greg Aiello, said in an e-mail message that the study did not formally diagnose dementia, that it was subject to shortcomings of telephone surveys and that “there are thousands of retired players who do not have memory problems.”

“Memory disorders affect many people who never played football or other sports,” Mr. Aiello said. “We are trying to understand it as it relates to our retired players.”

As scrutiny of brain injuries in football players has escalated the past three years, with prominent professionals reporting cognitive problems and academic studies supporting a link more generally, the N.F.L. and its medical committee on concussions have steadfastly denied the existence of reliable data on the issue. The league pledged to pursue its own studies, including the one at the University of Michigan.

Dr. Ira Casson, a co-chairman of the concussions committee who has been the league’s primary voice denying any evidence connecting N.F.L. football and dementia, said: “What I take from this report is there’s a need for further studies to see whether or not this finding is going to pan out, if it’s really there or not. I can see that the respondents believe they have been diagnosed. But the next step is to determine whether that is so.”

The N.F.L. is conducting its own rigorous study of 120 retired players, with results expected within a few years. All neurological examinations are being conducted by Dr. Casson.

According to a 37-page synopsis of the study furnished to the league, the Michigan researchers conducted a phone survey in late 2008 in which 1,063 retired players — those who participated from an original random list of 1,625 — were asked questions on a variety of health topics. Players had to have played at least three or four seasons to qualify. Questions were derived from the standard National Health Interview Survey so rates could be compared with those previously collected from the general population, the report said.

Some health issues were reported by N.F.L. retirees at normal rates (kidney and prostate problems), while others were higher (sleep apnea and elevated cholesterol) and others lower (heart attacks and ulcers), the summary said.

The researchers also asked players — or a caregiver for those who could not answer — if they had ever been diagnosed with “dementia, Alzheimer’s disease, or other memory-related disease.”

The Michigan researchers found that 6.1 percent of players age 50 and above reported that they had received a dementia-related diagnosis, five times higher than the cited national average, 1.2 percent. Players ages 30 through 49 showed a rate of 1.9 percent, or 19 times that of the national average, 0.1 percent.

The paper itself questioned the reliability of using phone surveys to assess prevalence rates of diagnosed dementia, as did several experts in telephone interviews. For example, some of those affected may not be reachable; then again, N.F.L. players may have greater access to doctors to make the diagnosis. The lead researcher, David R. Weir, said in an interview that proxies might have been handled differently in past studies.

“This suggests something suspicious,” said Dr. Amy Borenstein, professor of epidemiology at the University of South Florida. “But it’s something that must be looked at with a more rigorous study.”

Dr. Daniel P. Perl, the director of neuropathology at the Mount Sinai School of Medicine in New York, agreed with Dr. Borenstein but described the Michigan work as significant. “I think this complements what others have found — there appears to be a problem with cognition in a group of N.F.L. football players at a relatively young age,” he said.

All rates appear small. But if they are accurate, they would have arresting real-life effects when applied across a population as large as living N.F.L. retirees. A normal rate of cognitive disease among N.F.L. retirees age 50 and above (of whom there are about 4,000) would result in 48 of them having the condition; the rate in the Michigan study would lead to 244. Among retirees ages 30 through 49 (of whom there are about 3,000), the normal rate cited by the Michigan researchers would yield about 3 men experiencing problems; the rate reported among N.F.L. retirees leads to an estimate of 57.

So the Michigan findings suggest that although 50 N.F.L. retirees would be expected to have dementia or memory-related disease, the actual number could be more like 300. This would not prove causation in any individual case, but it would support a connection between pro football careers and heightened prevalence of later-life cognitive decline that the league has long disputed.

After the University of North Carolina’s Center for the Study of Retired Athletes published survey-based papers in 2005 through 2007 that found a correlation between N.F.L. football and depression, dementia and other cognitive impairment, a member of the N.F.L. concussion committee called the findings “virtually worthless.”

After initiating a fund in 2007 that provides financial assistance to retirees receiving care for dementia, the league insisted that it was doing so only because the disease “affects many elderly people” well beyond N.F.L. players. And a pamphlet that the league gives every player about concussion risks states, “Research is currently under way to determine if there are any long-term effects of concussion in N.F.L. athletes.”

“It’s time to edit that brochure,” said Kevin Mawae of the Tennessee Titans, the president of the N.F.L. Players Association. “Now it’s in their words and not just other people’s.”

Use your head - protect it

Moms’ bike-safety effort makes helmets a must

By BILL DWYER, Wednesday Journal of Oak Park and River Forest
Staff Reporter

 

 

In the past year, four River Forest children have been injured in bike accidents. That worried and even frightened River Forest moms Susan Lucci and Sue Gee. Rather than complain and wring their hands, they decided to do something. They came up with a bike-safety program - All Heads in Helmets - that not only is educational and rewarding, it may also be changing some kids’ behavior.

Lucci and Gee get the word out that, while riding a bike, you’ve got to protect your head. They focus on safety gear proven to cut the risk that kids will lose their most irreplaceable asset: their brains.

“If you had a $100,000 crystal bowl, would you ride around with it unprotected?” Lucci asked, not so rhetorically. “No, you’d protect it carefully.”

“Why are we waiting for tragedy?” Lucci asked.

Over the spring and summer, All Heads in Helmets has hosted presentations around the village, at schools, at the park district and at the library. On Saturday, Sept. 12, they held one at the Clear Sky Festival in Keystone Park.

Lucci praised the village’s elected and appointed officials, saying they’ve been very supportive of the program.

Besides education, AHIH looks to incentivize safety, rewarding a few kids seen wearing helmets with raffled prizes like iPods, iTunes gift cards and even new bikes. Dan’s Bike Shop, Barnard’s Schwinn, Panera Bread and iTunes have all contributed prizes.

Kids can go to the library, park district and village hall and drop off the citations. Four tickets are drawn every month in June through August. A fourth drawing was held at the Clear Sky Festival; there will be another drawing in October.

While there’s the possibility police will take a tougher line in enforcement, they don’t appear inclined to do that yet. River Forest’s police chief, Frank Limon, an enthusiastic supporter of All Heads in Helmets, said he’d prefer to keep it voluntary.

“That’s the route we want to go,” he said. “We’re looking for voluntary compliance.”

Limon said his officers also liked the positive interaction that passing out the incentive citations affords them with the village’s youth, calling it a “win-win situation.”

There have been obstacles. While the program has been well accepted at the village’s two grade schools, Willard and Lincoln, it’s been more of a slog in the middle school.

“The older kids don’t think it’s cool,” said Lucci.

Whether they realize their mortality or not, older kids are getting hurt. A seventh grader was recently hit by a car backing out of a driveway and suffered broken ribs. Another child was stuck last year, suffering broken ribs, collar bone and wrist, but no head injury, despite his helmet being demolished.

Anna Gebert said her 13-year-old daughter Julia was crossing Ashland at Chicago in a crosswalk Thursday morning on her way to school when she was struck by a driver on her front wheel. Julia was knocked off her bike and sustained bruises, but no other injuries. She was wearing a helmet. Whether that saved her from head injury isn’t clear, and Gebert said that’s not the issue.

“Julia always wears a helmet,” her mom noted, acknowledging her sons do not. “They say, ‘Don’t worry, Mom, I’m not going to fall.”

But cold statistics show that’s not necessarily true.

“A child is killed in the U.S. every day,” said Gail Rosseau, a River Forest resident who is a neurosurgeon. “An adult every six hours. A person is injured every four minutes.”

“One child in seven will receive a brain injury as a result of a bike injury,” she said. There is only one sure way to protect against devastating brain injuries while on a bike - all heads in helmets all the time. Every time. No exceptions.

“It’s impossible to overstate this,” she said. “Bike injuries are the No. 1 sports-related injury in the U.S.” Unhelmeted riders of all ages, she said, are 15 more times likely to be killed in a crash than those who skulls are protected.

No one is immune, said Rosseau. It’s not how old you are or experienced or how far you are from home or even if you avoid the street. The average distance from home for bike accidents is five blocks.

Her point was underscored recently when a 59-year-old Oak Park man, a veteran cyclist, was struck by a car door as he rode his bike Aug. 31. Besides a broken foot and painful bruising to his tailbone and arm, the man suffered a serious skull fracture.

The man’s wife, who asked that their last name not be used, underscored Rosseau’s comments - she wants people to know that age and experience make little difference in a biking accident. Her husband, she said, logged over 3,000 miles last year.

“He had 3,700 miles already this year,” she said. Doctors weren’t sure of the extent of his injuries, and whether he would fully recover. While he’s doing “remarkably well,” she said, he’s still home from work and not out of the woods.

“It’s just been a horrible thing to go through,” she said. “It’s been a nightmare.”

There is, Rosseau stressed, no way to predict how and when serious accidents will happen. Staying off the street won’t guarantee safety, either.

“Many of the most serious injuries are in driveways and on sidewalks, and not in the street,” she said. “Almost 78 percent of serious bike-related head injuries occur not at an intersection.”

Like Lucci and Gee, Gebert said she’s “frightened for the kids out there.”

“There are a lot of drivers out there who are distracted.”

“These head injuries take a long time to heal,” the wife of the 59-year old cycling veteran said.

If, in fact, they ever do. The clinical realities of brain injuries are chilling.

“I’d love to be able to tell you that neurosurgeons have found the answer to this and are able to put a scrambled brain, a damaged spinal cord, back together,” said Rosseau.

“The treatment is prevention,” she said. “What you want to do is take them back in time before the accident happened, upfront, where it counts.”

Rosseau refers to studies that show the effects of rapid deceleration on watermelons.

“The brain keeps moving when the skull stops,” she said. It can literally bounce around off the inside of the skull. The brain can be literally turned into mush.

“The brain is very, very soft,” she said.

The All Heads in Helmets program will likely become formalized soon.

“The River Forest Park Board Foundation has agreed to take it under their umbrella,” said Lucci. Rosseau suggest that, while the program is an excellent addition, and police enforcement is good, it can’t replaced parental involvement.

“Kids are 10 to 20 times more likely to wear a helmet if their parent do so,” she said. “Kids really do what you do, and not what you say.”

 

 

GUARDING THE BRAIN

September 21, 2009

By TONY GRAF tgraf@scn1.com
Sideline safety is more important than gridiron glory if a high school football player has just suffered a concussion on the field, say two groups conducting a public awareness campaign on the issue.

Getting back in the game is not toughness or heroism. In fact, a young player who returns to the playing field the same night has the potential to harm a developing brain — creating effects that are still not completely understood, said Joe Cunnane, head athletic trainer at Lockport Township High School.

The two groups conducting the campaign are the Illinois Athletic Trainers Association and the Chicago Institute of Neurosurgery and Neuroresearch. As a member of the association, Cunnane is on board with the effort. The groups are raising awareness about the potential for concussion, the need for monitoring, and the importance of “sitting it out.”

But don’t the pros sometimes return to the game in football, hockey or other sports? Some young players may ask that question, but their situation cannot be compared with that of older, professional athletes, Cunnane said.

“One of the biggest mistakes that happens is that we watch athletes in professional sports, for instance, have a concussion and potentially return to the same game — and we make this person to seem like they may be a hero,” Cunnane said.

“The reality is: If that athlete is a 25-year-old man, he has a much different brain than a 17-year-old boy,” he said.

Simply put, there are too many unanswered questions about the impact a concussion has on the developing brain, Cunnane said.

Given the uncertainties, the two organizations are calling on all high school athletic departments to develop more stringent procedures on screening for and monitoring concussions:

The procedures being urged include:

• If there is a suspected concussion, a player should be benched for the game or until fully evaluated by a medical professional;

• Every high school should have a concussion testing mechanism in place. This may be as simple as a battery of questions or as advanced as a software program to measure concussions;

• There should be a team approach in handling concussions involving the athletic trainer, coach, physician, parent and teachers. This is especially important because concussions may not be symptomatic until several hours, or even days, after the hit.

Awareness campaign
This month, the two groups released a statement alerting high schools, parents and athletes about the dangers of returning to a game too soon.
“Studies show that young, high-school-age players who get back in the game and are hit again are at risk of ‘Second Impact Syndrome,’ a condition where the brain swells rapidly and catastrophically after a person suffers a second concussion before symptoms from an earlier one have subsided,” the statement said. “This syndrome has led to severe neurological problems and, in some rare cases, death.”

So though physicians may not fully understand the effect, there is evidence of an effect, Cunnane said.

Lockport seminars
Cunnane teaches in the physical education department at Lockport. He has been head athletic trainer for 16 years in the district.
In 2000, Lockport Township High School began hosting a concussion seminar, sponsored by the Illinois Athletic Trainers Association. Five such seminars were held in the earlier part of this decade. Athletic trainers from Illinois and other states attended. Top-level speakers from all over the country visited to discuss the issue.

At the seminars, one of the goals was improving the use of neurocognitive baseline testing.

In essence, a preseason evaluation — or baseline test — is conducted regarding the cognitive function of the brain. Later in the year, if the school suspects that a student athlete has suffered a concussion, that student’s cognitive functions will be tested again. Experts then can see if functions have been affected.

“This has become one of the gold standards in helping us make better return-to-play decisions in the last 10 years or so,” Cunnane said.

The most common symptom of concussion is a headache, Cunnane said. But recent studies show that amnesia, or memory loss, tends to be an indicator of a significant concussion that would require a longer recovery process, he said.

Visit www.cinn.org to order a wallet reference card that details the signs and symptoms of concussions. Consider ordering one — the cards are free — for every family on your team!

Illinois Athletic Trainers and Doctors Tackle Concussions

Hinsdale, IL, Sept. 4, 2009 -Ted Hirschfeld, athletic trainer for Hinsdale Central, is joining other Illinois athletic trainers and doctors, in a campaign to head off serious concussions in young athletes that may affect them later in life. Officials of the Illinois Athletic Trainers Association (IATA) and neurosurgeons at the Chicago Institute of Neurosurgery and Neuroresearch (CINN) are requesting that Illinois high schools have more stringent procedures on screening for and monitoring concussions.

Concerned about recent research indicating a younger, less developed brain that is concussed more than once is more prone to future neurological impairment than an older, mature brain, the IATA and CINN have created an awareness campaign to better educate coaches and athletic trainers that concussions should be taken very seriously.

They are recommending the following:

• If there is a suspected concussion, a player should be benched for the game or until fully evaluated by a medical professional.

• Every high school should have a concussion testing mechanism in place. This may be as simple as a battery of questions or as advanced as a software program to measure concussions.

• There should be a team approach in handling concussions involving the athletic trainer, coach, physician, parent and teachers. This is especially important because concussions may not be symptomatic until several hours, or even days, after the hit.

“I think many players and coaches don’t realize how dangerous a concussion really is,” says Dean Karahalios, MD, CINN neurosurgeon who is a champion for the cause of concussion prevention. “A brain injury is so different than any other injury because you can’t measure the full potential of the damage for days or even years to come. Because of this, we created an awareness campaign to educate football players, coaches, parents and teachers about the signs and symptoms of a concussion and the importance of “sitting it out.”

“In the past, football players were told to suck it up and get back in the game,” saysTed Hirschfeld, IATA Board Member and Athletic Trainer for Hinsdale Central High School. “But there are too many unanswered questions about the impact a concussion has on the developing brain. We are trying toeducate coaches, players and parents that sitting out a game or two could make the difference in a young player’s life.”

Studies show that young, high-school age players who get back in the game and are hit again are at risk of “Second Impact Syndrome,” a condition where the brain swells rapidly and catastrophically after a person suffers a second concussion before symptoms from an earlier one have subsided. This syndrome has led to severe neurological problems and in some rare cases, death.

Members of the IATA and CINN physicians are offering a wallet-size tool to help players, coaches, parents and teachers better identify and monitor concussions in high school athletes. The card is available as an educational tool for those who work with young athletes to assist in identifying signs of a concussion or other brain injury and to prevent further harm to the youngster. The purpose of the card is twofold: One side features warning signs that the coach or parent can observe and symptoms the athlete may report following a concussion; the other outlines a mental status test the coach or parent can initiate with the athlete they suspect of having a concussion. The wallet resource also includes a phone number at which a CINN concussion expert may be reached if, and when, help is needed. For more information, or to order the card, log on to www.cinn.org or email: info@cinn.org.

High schoolers at higher risk for concussions

Fast fact

The Chicago Institute of Neurosurgery and Neuroresearch, along with trainers across the state, recently created a wallet-sized card to help coaches and parents identify and monitor high school athletes suspected of having a concussion. For more information, visit www.cinn.org.

September 17, 2009

By PATRICK MOONEY pmooney@scn1.com
For as progressive as football has become, it still amounts to trying to knock the snot out of the guy in front of you.

Four- and five-receiver sets have placed a premium on speed and athleticism, the ability to play the entire width of the field, nearly 54 yards. Players care more about health and nutrition — today Bear Bryant could never get away with forbidding them from drinking water during practice. Technology has changed the way the game is analyzed, enjoyed and understood.

» Click to enlarge image Naperville Central’s Conor Philbin (foreground) gets pumped up with his teammates before a rivalry game with Neuqua Valley on Sept. 4 at North Central College. “If anybody tells you they had a concussion (and) it’s not in the back of their head, they’re wrong,” Philbin said. And he knows.
(Danielle Gardner/Staff Photographer)
Fast fact

The Chicago Institute of Neurosurgery and Neuroresearch, along with trainers across the state, recently created a wallet-sized card to help coaches and parents identify and monitor high school athletes suspected of having a concussion. For more information, visit www.cinn.org.
But all that hasn’t eliminated its underlying violence.

In a sense, Bill Hughes’ career path began as a 90-pound, 14-year-old freshman at Homewood-Flossmoor, where he sustained three concussions in two days. Hughes woke up in a hospital after the third one.

The Naperville Central trainer is now in his 37th year responding to these crises.

“When I started, I had kids that would get dinged, and 15-20 minutes (later they) claimed they felt fine,” Hughes said. “I sent them through the sideline assessment and if they passed everything, I handed them their helmet back and they kept on playing. Now how many of those kids are still having results of head trauma? I don’t know.

“The more research they do, the scarier it gets.”

Several former NFL players — and more than one from the Pittsburgh Steelers organization — who have died in recent years have been found with significant brain damage. These were middle-aged men close to dementia.

Micky Collins, a Steelers team physician, helped develop the ImPACT software used by Central the past several years. It’s a computerized test that gauges memory and reaction times. If a red circle flashes on the screen, click the mouse right. If it’s a blue square, click left.

“There’s no right or wrong. It just kind of shows how that kid’s brain processes,” Hughes said. “We run a baseline test on all incoming freshmen in football and soccer. (We keep) a hard copy and we throw that in the file.

“And so then during the four years, if they ever get dinged, we bring them back in. We go through our assessment of them and after they experience seven symptom-free days, we’ll take them back to the library and give them the test again.

“Until they can get back to that baseline score that they got before they were concussed, we won’t let them play.”

A study conducted by researchers from the University of Illinois published in July found that high school football players are at a greater risk for concussions than college ones.

Besides receiving less uniform medical coverage and attention, prep athletes sustain greater head accelerations after impact. College players experienced blows to the front of the helmet 10 percent less frequently and with less force. They are also more physically mature and better able to withstand the hits.

Last year, during the first sophomore game of the season, Central free safety Conor Philbin led with his helmet and the collision with a Waubonsie Valley running back left him with a concussion.

After the helmet-to-helmet tackle, Philbin had trouble walking. His vision was blurry, and he could smile on only one side of his face. He couldn’t stand the noise during the varsity game and left with a headache at halftime that night.

Philbin eventually passed the computer test, but admitted that it took most of last season to stop playing tentative. There are no lingering effects — though the junior has missed time this year after suffering a fracture of the radius during preseason practice.

But Philbin has learned to pump air into his helmet to keep it tight and braced for the next crash.

“If anybody tells you they had a concussion (and) it’s not in the back of their head, they’re wrong,” Philbin said.

CHICAGO INSTITUTE OF NEUROSURGERY AND NEURORESEARCH TO JOIN NORTHSHORE UNIVERSITY HEALTH SYSTEM

CINN will continue as Chicago’s leader in providing subspecialized neurosurgical
and neuromedical care

CHICAGO, IL, August 19, 2009 – It was announced today that the physicians of the Chicago Institute of Neurosurgery and Neuroresearch Medical Group (CINN) will be joining NorthShore University HealthSystem (NorthShore) headquartered in Evanston, IL. The CINN physicians, including neurosurgeons, physiatrists, neurologists and neurointerventionalist, who have earned this group international recognition, will continue to provide the Chicagoland market with advanced neurosurgical and neuromedical care.

Through its 23-year history, CINN has been widely regarded as one of the region’s leading providers of medical care for patients suffering from brain and spine disorders. CINN physicians are highly experienced in providing innovative treatments for patients with brain tumors, have pioneered innovative surgical spine solutions such as artificial discs, and have championed new treatments for stroke and abnormalities of the blood vessels in the brain.

Recognizing the importance of a robust and stable strategic partner as national health care reform takes shape, CINN chose NorthShore due to its commitment to advancing neurosurgical patient care through investment in new technologies and programs, their excellence in synergistic specialties such as orthopedics, oncology and neurology, as well as the system’s strong network of primary care physicians.

“We look forward to bringing our innovative multidisciplinary patient care model to the NorthShore system,” said Dr. Leonard J. Cerullo, founder and medical director of CINN, “Our goal will remain to provide patients with the most technologically advanced, yet compassionate, care available.”

A hallmark of CINN’s patient care philosophy is the availability of world-class neurosurgical care in close proximity to a patient’s family, friends and support structure, whenever possible. As such, CINN’s commitment to its operations in Elmhurst, Vernon Hills, Harvey, Tinley Park, Skokie, Oak Lawn and downtown Chicago will remain. CINN’s outpatient services and administrative headquarters at the Neurologic & Orthopedic Hospital of Chicago will move to NorthShore’s Glenbrook and Skokie Hospitals.

The agreement is conditioned on obtaining appropriate government approvals, and is expected to close by the end of the year. Medical services at the Neurologic & Orthopedic Hospital of Chicago will continue until that time.

CINN patients with questions about their appointments can email CINN at info@cinn.org or call 773-250-0400.

The Chicago Institute of Neurosurgery and Neuroresearch Medical Group is one of the nation’s leading groups of physicians dedicated to the diagnosis, treatment and rehabilitation of people with brain and spine disorders. Founded in 1987, CINN is one of the Midwest’s largest teams of neurosurgeons, physiatrists and neurologists known for their pioneering treatments in minimally invasive techniques. Through a network of seven locations throughout Chicagoland, CINN is a market leader in treating patients with brain tumors and spine disorders.

NorthShore University HealthSystem, based in Evanston, IL, is an academic health system affiliated with University of Chicago’s Pritzker School of Medicine. Its integrated delivery system includes Evanston, Glenbrook, Highland Park, and Skokie Hospitals as well as the NorthShore Medical Group, Research Institute and Foundation.
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