Concussions: More Than a Smack Upside the Head

Although the recent news flurries about concussions have centered around the NFL after the suicide of Junior Seau on May 2nd, the vast majority of concussion victims are ordinary citizens.

On May 21st 2012, Hall of Fame running back Eric Dickerson became the latest former superstar to sue the NFL over concussions.  Currently, there are now 81 concussion-related lawsuits filed against the NFL, which include more than 2,240 former players.  The contention of these lawsuits is that the league failed to adequately warn players that multiple head injuries can cause second-impact syndrome or chronic traumatic encephalopathy.  CTE can permanently damage athletes' brains, resulting in memory losses, concentration lapses, speech troubles, bursts of anger, bouts of depression, and unusually early symptoms of Alzheimer's and other diseases.

Although the recent news flurries about concussions have centered around the NFL after the suicide of Junior Seau on May 2nd, the vast majority of concussion victims are ordinary citizens.  Actually, the number one cause of sports-related head injuries is bike riding.  Although concussions are most often associated with athletes, law enforcement officers are certainly not immune to concussions and/or chronic traumatic encephalopathy in the line of duty or in training.  Take the example of Norfolk Police recruit John Kohn.   According to reports, Kohn was first punched in the face by a police trainer during training; he reported the incident to his wife and classmates, complaining of a headache.  Two days later he sustained additional head blows by another student and the instructor during a ground fighting session until he blacked out. Paramedics responded and he was flown to a hospital where he underwent brain surgery.  He remained in critical condition until he was taken off life support on December 18th, 2010. Doctors determined that the cause of death was due to multiple brain injuries (second-impact syndrome).  Whether he had reported his injuries to his superiors is under debate (and key to a pending lawsuit by his widowed wife). 

The Norfolk Police have made changes in their training; they now ban intentional head strikes and require additional training for instructors and recruits in identifying and reporting possible injuries.  The NFL has also repeatedly made changes related to their head injury protocol.  But is it enough?  How much damage has already been done?  Do you know enough about concussions; not only as a LEO, but as a weekend warrior?  What about chronic traumatic encephalopathy?

Concussion Overview

The purpose of the head is to protect the brain against injury. The brain weighs about three pounds, has the consistency of gelatin, and floats in cerebrospinal fluid which cushions the brain from normal daily activities.  Force to the head may result in the brain bouncing violently against the inner wall of the skull causing bleeding in the spaces surrounding the brain, bruising of the brain tissue, or damage to the nerve connections. This results in a traumatic brain injury (TBI).  Concussions have historically been referred to as a mild TBI (compared to gunshots to the head). However, there is nothing minor about a brain that has been concussed.  Research suggests that 10% of all people who experience a single concussion have life-changing symptoms. Concussions are usually caused by a blow to the head, but they can also occur when the head and upper body are violently shaken (shaken baby syndrome).  Concussions can cause loss of consciousness; however, often they do not. 

Concussions are common injuries and usually resolve spontaneously.  Most people recover fully.   In fact, many people who have had concussions never realized it.  However, every concussion injures your brain to some extent.  The brain’s functions may be altered even if there is no structural damage to the organ.  The effects of a concussion are usually temporary.

Signs, Symptoms, Diagnosis, and Treatment

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