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.