Chronic Traumatic Encephalopathy is a very real dangerous brain end game not just for the NFL players depicted in the movie CONCUSSION but for our children and youth, male and female, all age groups. Our children should play contact sports but they must do so in the safest environment as that parents, coaches, trainers and equipment manufacturers can create and with the guidance of medically sound standards for assessing injuries.

For those still skeptical of the serious nature of this problem or its prevalence, I offer this more recent evidence. Notwithstanding the now available data on a few NFL players, more recent findings from the Mayo Clinic data base show that human brains from 198 individuals had never played any contact sports showed ZERO evidence of CTE while 66 brains of individuals who played contact sports at high school and college level BUT never professionally showed a ONE in THREE incidence of CTE changes. Some of this more recent shows the adolescent brain is particularly susceptible to injury especially repetitive injury primarily because so many neurological pathways are still evolving in teens. We are now just beginning to understand the implications of second impact syndrome where the brain receives a second or even third insult before the healing from the first is complete. This is not solely a male problem. One third of data collecting in Ontario is from young female athletes.

We shall never achieve a Nirvana of zero brain damages but minimizing the risk is realistically achievable. The first step is awareness. I am optimistic when I see pro athletes like Pittsburgh’s QB voluntarily pulling themselves from the game. We need national standards for concussion recognition and management. Canada lags U.S. efforts in part because they are a litigation prone society and the current billion dollar suit now involving some forty four hundred former NFL players is certainly proving a driving impetus.(100 on the NHL side) But if you are on your one yard line what deterrence will a 15 yard penalty for head to head contact incur?. College ball has addresed this issue with its ”targeting” major penalty leading to ejection from the game.

Ontario is leading the advance in Canada with the “Rowan bill” for school related sports activities requiring:

>immediate removal of the athlete from play If a concussion is suspected

>medical clearance of all concussed athletes before they return to play

>mandatory concussion education for all child athletes, parents and coaches in all sports (curlers, soccer players, figure skaters can land on their unprotected head too)

<strict adherence to return-to-learn and return-to-play protocols after concussion. This requires elimination of the macho factor by the child not wanting to disappoint team members, coaches or parents.

For parents and grandparents, my best advice? ATTEND THE GAMES. Fin out from the trainers and coaches if they know about the new standards. Are the standards posted prominently in your school and community facilities? A reminder that 90% of concussions DO NOT include an actual loss of consciousness

Symptoms of concussion include dizziness, nausea, vision changes, sensitivity to light and sound? Other symptoms can include an inability to recognize surroundings, the sequence of events, a “distancing or out-there factor”. The first two can be hidden but the third is accurately objective. Balance testing does not allow cheating. Standing feet together with and without eyes closed without weaving is easy to spot. Walking heel to toe is impossible to fake as is tilting the head back without weaving. Always, if there is any doubt, seek medical advice.

Be safe…and keep it fun out there

Written by: Dr. David Carll

Providing a fresh perspective for Hamilton and Burlington

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