FEATURE
Through your own interactions or those of your peers, have you found that
players attitudes have changed as well? Are they being more cautious? What online resources would you say are the best for those seeking
additional information?
There’s been a bit of a paradigm shift on player attitude. In an ideal
world, the players would be 100 percent forthright all the time. That’s
just not reality. The higher-level athletes are where I’ve noticed the
biggest difference. They are more willing to self-report and disclose
when they feel something may have happened. There are three which come to mind. The NCAA has a great facts
page on sports-related concussion. http://www.ncaa.org/about/
resources/media-center/feature/concussion-and-college-sports
Much has been made about “in the moment” testing for concussions;
do you feel the on-field SCAT5 examination is as good an assessment as
possible at this time? What does the future hold for testing during what
may be a significant moment in an athlete’s life?
I think the SCAT5 or even the computerized impact testing are good
starting points. They all serve their own unique purpose. My opinion
is, and has been, that nothing will replace a good, solid neurological
exam. That’s why it is so important that whatever specialist is doing
coverage, that person must have a good, solid foundation of how
to perform a thorough and concise examination.
The NFL seems to do a better job now. If a person gets removed
from play, they get some privacy in a tent during a sideline test.
If anything on that cursory assessment is worrisome, physicians
remove them to the locker room where they can take their time
with a thorough exam.
The Center for Disease Control has a good page as well on
concussion and traumatic brain injury. https://www.cdc.gov/
traumaticbraininjury/get_the_facts.html
Specific to female gender concussions, there is an advocacy group
known as PINK Concussions. They have a tremendous amount
of useful information on their site. http://www.pinkconcussions.
com/
Thank you to both physicians for sharing their
knowledge with our publication.
Does it matter what age a concussion takes place?
It’s variable. That’s the bottom line. For example: for reasons we don’t
understand fully, female athletes take a little bit longer time period
to return to baseline after injury. We know they respond differently,
but this does not necessarily mean they’re at further risk.
An elderly person who has a concussion, that’s a subset of individual
who take a tremendously long time to baseline. Then there’s
everything else that’s possible in between.
Tell me about therapy for a concussion.
Basically, it’s unique to each individual. There are risk factors, which
we know an individual can possess pre-injury, that can predict if
they will take longer to recover. These include a history of migraine,
ADD, ADHD, anxiety or depression. We know those characteristics
mean the brain may be wired differently and take longer to recover.
You’ve said in past interviews that you anticipate the ability to test for
CTE in living patients coming soon. Have there been any new developments
on that front in the last year?
That’s the one I’m looking forward to the most. There’s not been a
tremendous about of data in the recent months, but I expect more
is just around the corner.
APRIL 2019
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