Brain Injury Trauma
American football player Dave Duerson killed himself, and left his brain to science so that research could be done to determine the impact the sport had on his diminished health, which including lapses in memory, the mood swings, the piercing headaches on the left side of his head, the difficulty spelling simple words, and blurred eyesight. He asked, “Please see that my brain is given to the NFL’s brain bank.” He hoped that the findings would help in recovery trauma.
The “brain bank” is the Center of the Study of Traumatic Encephalopathy. What the doctors found when examining Duerson’s brain was shocking. According to Dr. Ann McKee, a neuropathologist who jointly heads the lab at the Center, “This is an extreme case,” she says, “but it is also very characteristic.” She points to the triangular hole, consisting of the lateral ventricles, which shows tremendous disruption. According to Dr. McKee, there should be a membrane separating the two ventricles, but it has been so battered by the footballer’s repeated blows to the head that only the thinnest of filaments is left. The two oval holes are the ventricles of the temporal lobe and they too are extremely enlarged to compensate for tissue lost from the lobes themselves, another classic sign of having your head bashed repeatedly. “The temporal lobes are crucial to memory and learning and you can see they are very, very small, as miniaturized as possible.”
Dr. McKee goes on to say: “This is a brain at the end-stage of disease. I would assume that with this amount of damage the person was very cognitively impaired. I would assume they were demented, had substantial problems with their speech and gait, that this person was Parkinsonian, was slow to speak and walk, if he could walk at all.”
The National Football League (NFL) over the last several years has been taking a lead in research in traumatic brain injury (TBI). A study commissioned by the NFL reported 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.
Recommendations made as a result of a study to the League to help mitigate the consequences of TBI in football and assist in recovery trauma include:
- Conduct prospective longitudinal studies evaluating the value of clinical tests, serum biomarkers, imaging, and electrophysiological tests in a) differentiating players with and without traumatic brain damage, b) detecting the effect of preventive/therapeutic interventions, and c) predicting long-term cognitive and behavioral outcomes.
- The need for MRI and PET studies to determine in vivo morphological and functional correlates of physical impacts, concussions and long-term post-TBI cognitive decline.
- The need to implement MRI and electrophysiology studies to identify mechanisms of neural plasticity following MTBI.
- The development of a longitudinal concussion and “hits” database to capture prior and present episodes, quantify symptoms, document evaluations for return to play and document rehabilitation strategies.
According to the Centers for Disease Control and Prevention, unintentional injury kills more people between the ages of one and 44 than any other disease or illness. In fact, more years of potential life are lost due to injury than to heart disease or cancer. Here are some common causes and stats to consider:
- Drowning is the fourth most common cause of unintentional injury death for all ages, ranking first among person’s ages 25 to 44 and second for ages five to 44.
- Falls are the second-leading cause of accidental deaths for persons age 45 to 75 and the number-one cause of unintentional death for persons 75 years of age and older. Alcohol and drug use are directly or indirectly responsible for 75-80% of these injuries, and require trauma recovery.
- About 1.4 million people in the United States have Traumatic Brain Injuries (TBI) each year. Of these, 50,000 of die and 235,000 are hospitalized and require trauma recovery. A TBI is caused by a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain. Not all blows or jolts to the head result in a TBI, with the severity of a TBI may range from “mild,” (a brief change in mental status or consciousness to “severe (extended period of unconsciousness or amnesia after the injury).
- A breakdown of the leading causes of TBI is as follows: about 28% of the cases result from falls; about 11% of the cases result from assaults; about 20% of the cases result from motor vehicle-traffic crashes; and about 19 % of the cases result from being struck by/against.
- In every age group, TBI rates are higher for males than for females.
- Males up to 4 years of age have the highest rates of TBI-related emergency department visits, hospitalizations, trauma recovery care, and deaths.