Traumatic Brain Injury

News and articles related to Traumatic Brain Injury (TBI), Concussions, and Head Injuries
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brian
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Traumatic Brain Injury

Post by brian » Thu Oct 22, 2009 10:58 am

The following are some recent articles on Truamatic brain Injury (TBI) as related to football injuries:
A recent article in the New Yorker Magazine: OFFENSIVE PLAY How different are dogfighting and football?, Malcolm Gladwell,October 19, 2009
Also in the New York Times: Concussion Trauma Risk Seen in Amateur Athlete, Alan Schwarz,October 21, 2009
Brain damage commonly associated with boxers and recently found in deceased N.F.L. players has been identified in a former college athlete who never played professionally, representing new evidence about the possible safety risks of college and perhaps high school football. As six former N.F.L. players who died young have been found with the condition, called chronic traumatic encephalopathy, scrutiny has focused on the N.F.L. environment. This new case, an athlete who stopped playing after college, testifies more to the sport of football itself, said doctors involved in its discovery.
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In accident reconstruction we often see Truamatic brain injuries (TBI), many of the type classified as Diffuse axonal injury (DAI). DAI is the result of traumatic shearing forces that occur when the head is rapidly accelerated or decelerated, as may occur in auto accidents, falls, and assaults.
For further reading see digital snippets from the book Accidental Injury, Biomechanics and Prevention. (Click on contents and select section 'Brain-Injury Biomechanics')-Second Edition. Alan Nahum and John Melvin, Editors. Springer, New York,. 2002.
Also see Head Injury Criterion and the ATB
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brian
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Re: Traumatic Brain Injury

Post by brian » Tue Oct 27, 2009 9:33 am

A follow up on the previous NFL articles:
N.F.L.’s Dementia Study Has Flaws, Experts Say
NYTimes, Alan Schwarz, October 27, 2009
The N.F.L. and its doctors have consistently dismissed independent studies showing unusual cognitive decline in former players. They insist that a long-term study by the league’s committee on concussions, expected to be published in several years, will be the authoritative analysis.
But that study is fraught with statistical, systemic and conflict-of-interest problems that make it inappropriate to examine the issue, according to many experts in epidemiology, dementia and health policy who assessed the study’s design. Another voice belonged to a member of the House Judiciary Committee, which will hold a hearing on football brain injuries Wednesday.
“Hey, why don’t we let tobacco companies determine whether smoking is bad for your health or not?” said Representative Linda T. Sanchez, Democrat of California and a member of the Judiciary Committee. “It’s a very appropriate metaphor.”
According to previous interviews with Dr. Ira Casson, the league’s primary voice in discrediting all outside evidence, the N.F.L. study will examine 120 men ages 30 to 60 who played two seasons or more in the N.F.L. and 60 men of comparable age who played only through college and no more than one season in the league. As such, the study is focusing on possible differences between college and N.F.L. players — not between N.F.L. players and the general population, where differences would almost certainly be more detectable.
Casson said the committee handling his study included many experts in various fields with no connections to the N.F.L. He said their approach and protocols had been approved by the internal review board of Wayne State University — where two N.F.L. committee members are on the faculty, including the co-chairman David Viano — but he declined to answer questions about the study’s design.
Dr. Amy Borenstein, an epidemiologist at the University of South Florida who specializes in dementia research, was among several in her field who said the N.F.L. study’s pure numbers could not fairly examine rates of dementia or substantial cognitive decline. She said that detecting differences between the N.F.L. players and the collegians would require far more than 20 primary subjects and 10 control subjects in each standard five-year age group between 30 and 60.
“The design suffers from a total lack of statistical power to detect an effect if one truly exists,” Borenstein said.
Subjects have been solicited to participate through a mailed letter to anyone for whom the league had a current address, about 5,000 in all, and some random phone calls. Those who volunteer and pass eligibility standards are flown to Long Island for a full day of examination.
Dr. Daniel P. Perl, the director of neuropathology at the Mount Sinai School of Medicine in New York, said: “People with significant impairment are less likely to be reachable, and if they are reached, they’re less likely to respond to mail or even answer the phone. They also might not be able to get themselves to New York. The response rates will not be equivalent.”
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brian
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Re: Traumatic Brain Injury

Post by brian » Sun Nov 01, 2009 2:42 pm

N.F.L. Players and Union Say They Share Blame on Head Injuries
New York Times, ALAN SCHWARZ, October 31, 2009
As a House Judiciary Committee hearing examined football brain injuries Wednesday and strongly criticized the N.F.L. and its concussion committee for their research and approach, lawmakers, players and Upshaw’s successor, DeMaurice Smith, accused the union of lethargy while others sounded alarms. Although all regretted speaking ill of the dead, they said that Upshaw’s reticence at the top stunted progress and awareness below.
“They should have been the first to jump on top of the issue and press the owners to do something about it — they were asleep at the switch,” said Representative Linda T. Sanchez, Democrat of California, who before joining Congress was a top A.F.L.-C.I.O. official in Orange County. “When you’re the person negotiating the working conditions for a unit, you must look at the dangers or potential to cause injury. You’re the designated person to educate members to be aware.”
And one month ago, when a union lawyer analyzed data from the 88 Plan, a joint league-union program to reimburse retirees for medical expenses deriving from dementia, mathematical and methodological errors led him to assert that N.F.L. retirees were experiencing dementia at a rate similar to the general population. Experts in epidemiology, neurology and dementia later said that correcting for those errors resulted in a situation in which football retirees between ages 60 and 89 probably had moderate to severe dementia at four or five times the national rate.
Several players who followed last week’s hearing said they began to appreciate how they, and not just the league, held responsibility for allowing the situation to evolve as it had. Rick Jones, a former linebacker for the Cleveland Browns and the Baltimore Colts from 1977 to 1983 who now cleans windows in Birmingham, Ala., spread the blame. “We’re all culpable — players, coaches, owners, doctors,” Jones said. “We all have a hand in it. We didn’t know it. We did not know about brain injuries in my day. But the minute our union knew it was dangerous, it was their job to take care of the guys who were hurting like me, and to keep it from happening to anyone else.”
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brian
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Re: Traumatic Brain Injury

Post by brian » Mon Nov 23, 2009 10:05 am

NFL to Shift in its Handling of Concussions
NY Times, Nov 23, 2009, by Alan Schwarz
In an apparent shift in the NFL's approach to handling concussions, the league will soon require teams to obtain independent advice form neurologists while treating players with brain injuries.
Decisions on when a player should return to play after a concussion had previously been made by doctors and trainers who were employed by the team. The situation raised questions on possible conflicts of interest between the wishes of the team to get the player back 'producing' and the long term health of the players. Scientific studies and anecdotal evidence have mounted which have found a heightened risk for brain damage, dementia and cognitive decline in retired players and the league has faced harsh criticism on its handling of players with concussions.
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brian
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Re: Traumatic Brain Injury

Post by brian » Wed Nov 25, 2009 2:03 pm

Nov 25, 2009: Aland Schwarz, NY Times: NFL Head Injury Study leaders Quit
The co-chairmen of the league's committee on brain injuries resigned from the group on Tuesday. Dr. Ira Casson and Dr. David Viano, members of the committee since 1994 and co-chairmen since 2007 resigned on Tuesday.
Dr. Viano "is a specialist in injury biomechanics and impact protection in automotive crashes, sport impacts, and defense/law-enforcement actions. He is Adjunct Professor of Traffic Medicine at Chalmers University of Technology and Biomedical Engineering at Wayne State University, where he serves as the Director of the Sport Biomechanics Laboratory.
The two co-authored most of the group’s published research papers whose conclusions regarding head injuries were met with considerable criticism from medical peers. Casson has been the league’s primary voice discrediting all evidence linking football players with subsequent dementia or cognitive decline, drawing criticism from fellow scientists, players and ultimately Congress.
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MSI
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Re: Traumatic Brain Injury

Post by MSI » Fri Dec 04, 2009 10:09 am

Dec 4, 2009: The NFL's move to change the rules to try to limit concussion type injuries, for example to stop running backs from lowering their heads to try to blast through defenders is met with skepticism from players who fear the rule changes will change the game:Talk of Ending a Running Style Raising Concern
The slow response of the NFL to change rules and policies related to the protection of players from serious injuries also means a prolonged delay in changing the attitudes and culture of high school and college football players:New NFL Culture May Take Time to Filter Down
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brian
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Re: Traumatic Brain Injury

Post by brian » Mon Jan 04, 2010 11:58 pm

Jan 4, 2010: Ex-chair of NFL brain panel denies link to disease
By LARRY LAGE, AP
At the US House of Representatives Committee Judiciary Hearing on Legal Issues Relating to Football Head Injuries, Ira Casson, a neurologist from New York and former co-chairman of the NFL's panel on head injuries, stuck to his position that there is no proven connection between football head injuries and brain disease. "There is not enough valid, reliable or objective scientific evidence at present to determine whether or not repeat head impacts in professional football result in long-term brain damage," Casson said. Casson said more research must be done on the effects of performance-enhancing drugs on the brains of football players.
Fortunately for football players the NFL is no longer listening to Ira Cassen, and has instituted stricter return-to-play guidelines for players showing concussion symptoms; required each team to enlist an independent neurologist as an adviser; entered into a partnership with Boston University brain researchers who have been critical of the league's stance on concussions; and conducted tests on helmets. The validity of those tests was questioned by witnesses at the hearing.
Asked for his thoughts on those changes, Casson questioned the merits of the independent neurologist mandate. "We don't know if these independent neurologists have expertise in head injuries," he said. "We don't know if their opinions are going to be independent and reliable and stand up to scrutiny."
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brian
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Re: Traumatic Brain Injury

Post by brian » Tue Apr 06, 2010 1:33 pm

April 5, 2010: Case Will Test N.F.L. Teams’ Liability in Dementia
A claim filed in California by Dr Elanor Perfetto on behalf of her husband, Ralph Wenzel, contends that his dimentia at 67 is related to his NFL career.
California’s workers’ compensation system provides a unique, and relatively unknown, haven for retired professional athletes among the 50 states. The system allows hundreds of long-retired veterans each year to file claims for injuries sustained decades before even if they have not have played for California teams or be residents of the state. The only requirement is that they had to participate in at least one game in the state. That makes them eligible to receive lifetime medical care for their injuries from the teams and their insurance carriers.
There are about 700 pending cases by former NFL players. Most are related to orthopedic injuries and normally result in $100,000-$200,000 lump-sum payouts.
However cases like Dr. Perfetto's have $1 million dollar potential value and could spell hundreds of millions of dollars in liability to the NFL and their insurers.
See the full story Case Will Test N.F.L. Teams’ Liability in Dementia
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MSI
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Re: Traumatic Brain Injury

Post by MSI » Sun Jul 25, 2010 1:06 pm

July 25, 2010: New York Times article Reversal by NFL on Helmet Testing Arouses Concerns
Which included
  • "Two months after concurring with a congressman that the data was “infected” and declaring that a testing program would be abandoned, the N.F.L.’s committee on head injuries joined the league and its players union on Friday in publicly releasing the results of helmet testing that outside experts described as potentially compromising the safety of youth athletes.
    The testing program had been spearheaded throughout 2009 by the former leaders of the N.F.L. research group, all of whom resigned in the past nine months after strong criticism of their conduct from the House Judiciary Committee and outside medical experts."
    The helmet testing was suspended because of its “poor methodologies” and “inherent conflict of interest” that were “not acceptable by any modern standards.”
    “It is recognized that helmets designed to work at high-impact forces, while efficient at protecting against skull fracture, are not necessarily effective at protecting against concussion,” Dr. Cantu added. “The danger in making this public is that even though it’s not stated, some people can infer and imply from this statement that the so-called top-performing helmets are safer.
    “This document should not show up in the hands of any parent,” Guskiewicz said. “It doesn’t pertain to them. The three helmets mentioned might be the three lowest-performing helmets at the youth level. We don’t know.”
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