Sunday, November 28, 2010

Concussions

The human brain is a very fascinating yet very fragile thing. It floats in sea water inside your skull. It computes calculations more complex than a Cray super computer all powered by about 20 watts of electricity. By itself it has the consistency of jelly. To be able to handle it and study it's structure, it has to be treated with a chemical called formalin which makes it smell really bad.

Any bump on the head can cause injury to the brain. The skull and the cerebrospinal fluid can absorb the shock of most minor bumps and brain cells can reorganize connections that may be damaged. Where there are more serious hits on the head, it can bump against the skull and cause bruising. Depending on how often and how frequently it happens the damage can be temporary or permanent.

Wearing a helmet can absorb the force of a harder hit but no amount of covering is full proof. A hit on the head can send ripples through the brain similar to shaking a bowl of jello gelatin. Unlike the damage caused by a stroke or a tumor, it tends to be diffuse throughout the brain rather than to one specific area.

The psychological effects of concussions tend to be subtle and can be hard to recognize. In the past, the advice was just to take an aspirin and get over it. In recent decades neuopsychological testing has been able to identify these deficits and track them over time. They often include memory, reaction time, judgment, and movement in the short to long term. For a review of symptoms and treatment see this link at the Mayo Clinic.
This injury in sports is being recognized by the National Football League (NFL) as James Harrison of the Pittsburgh Steelers has been fined over $100,000 (while at the same time being paid millions for doing the very same thing) this year for hits that at worst in the past before would just draw a penalty. He may or may not be a scapegoat but at worst he is just one small facet of a much larger problem. In the NFL the players in general are bigger, faster, and stronger now than they were in the past. In the 1980s William "the refrigerator" Perry was considered a very large defensive lineman at 330 pounds (152 Kg) but now that is an average weight for his position. During that time the brain is just as fragile as it was in the past and helmets cannot adjust to new conditions. In it's drive for greater profits, the NFL is also considering making the season longer which would only make the problem worse.

The long term effects of repeated concussions can be serious. When one is younger the brain can recover from hits faster and more completely but each time it happens it gets harder to recover. Most famously Muhammad Ali kept boxing longer than he should have and now suffers from Parkinson's disease. Another sport associated with concussions is soccer (or football for my international readers) where the cumulative effects of headers over years leads to cognitive problems later in life.

The military is now recognizing the long term effects of concussions which are now becoming more common as bombs are becoming more powerful and prevalent.


Protective gear can only do so much to protect from the shock of a hit on the head. The best way to prevent concussions is to reduce the hits.



**Update** 


As the Pittsburgh Penguins prepare for the new season their star player, Sidney Crosby continues to have headaches from concussions he received playing last year which caused him to miss most of the season and all of the playoffs.  He continues to have headaches almost a year later and may affect his play again this year.  I know many fans are frustrated when they see Ben Roethlisberger returning from a concussion just two weeks after being hit but  no two brains are alike.  He can't risk putting his long term health in jeopardy.  There are more important things in life than hockey.