Traumatic Brain Injury

About 35 years ago I applied for a job as the Director of an organization helped victims of TBI, traumatic brain injury. I had some of the qualifications they were seeking, like research and supervising staff, the advanced education, but I didn’t know anything about TBI. So I researched it before the interview. I didn’t get the job, but I never lost my interest in TBI. When I see articles about children’s sports injuries, or NFL brain trauma, or head injuries from auto accidents or falls, I always stop to read them. I’ve known two brilliant women whose careers and lives were devastated in auto accidents during their post graduate college years.

Today I saw an item about a coming conference at OSU, the annual CBI Research Day (Chronic Brain Injury) CBI Research Day | Discovery Themes, The Ohio State University (osu.edu) on March 10. I looked at the qualifications of some of the speakers and for articles they’ve published since I won’t be attending, even virtually. This item about Dr. Christine MacDonald was particularly interesting: Combat concussions worsen over time, not lessen.

“The EVOLVE study, for which she is the lead researcher, found that those who suffer combat concussions worsen over the course of their 1-year and 5-year follow-ups; 80% seek mental health assistance by the 5-year follow-up, and only 19% achieve a “sustained resolution of their symptoms.” The service members had blast or non-blast related concussions, but none had more complex or severe brain injuries.” The Invisible Wounds of War — Concussion Alliance

Electromagnetic controlled cortical impact device for precise, graded experimental traumatic brain injury - PubMed (nih.gov)

Clinical and imaging assessment of acute combat mild traumatic brain injury in Afghanistan (nih.gov)

Cerebellar White Matter Abnormalities following Primary Blast Injury in US Military Personnel (nih.gov)

Amy K. Wagner, MD, Chair for Translational Research at the University of Pittsburgh, is the keynote speaker, and Carrie Lynn Esopenko, PhD, Asst. Professor of Rehabilitation & Movement Sciences at Rutgers is the Spotlight Speaker. 

The database at the University of Pittsburgh, certainly shows some interesting statistics:  Whites (67%) are far more likely to be victims than blacks (19%), an overwhelming number are single--never married, divorced, widowed (67%), males are 73.5%, and 52% of the causes are vehicular crashes.  TBIMS_NationalDB_update.pdf (pitt.edu)

2 million children visited an ED because of a TBI sustained over 7 years

An estimated 283,000 children seek care in U.S. emergency departments each year for a sports- or recreation-related traumatic brain injury (SRR-TBI), according to a new MMWR Report. TBIs sustained in contact sports accounted for approximately 45% of all SRR-TBI ED visits. Activities associated with the highest number of ED visits were football , bicycling, basketball, soccer and playground activities.

Injuries differed by sex and age of the child. "SRR-activities associated with the highest percentage of ED visits varied by age group and sex. Football was associated with 26.8% of all SRR-TBI ED visits for males aged 0–17 years. Among males aged <5 years and 5–9 years, playground activities accounted for the most ED visits (38.2% and 19.6%, respectively). Among all females aged 0–17 years, soccer, playground activities, and basketball were the most common causes of SRR-TBI ED visits, contributing to 13.1%, 12.6%, and 11.9% of all SRR-TBI-related ED visits, respectively. Playground activities led to 42.3% of SRR-TBIs visits among females aged <5 years.

In all sports and ages, twice as many boys are injured than girls. https://www.cdc.gov/mmwr/volumes/68/wr/mm6810a2.htm?

Sports injuries reports compared

Ready for a walk around the neighborhood, April 2015

I've always been a non-athlete.  I got one C in college and it was in tennis.  The instructor was about 8 months pregnant, so I don't think she was expecting much from me, and I met her expectations.  Walking or riding my exercycle are my limits.  No golf.  No tennis. No yoga. No soccer. I meet women over 60 or 70 who at one time were serious athletes who played soccer or softball in college and on community teams or who were joggers and runners and now are in constant recovery in their later years from hip and knee problems and surgeries--and some battling obesity because they were accustomed to burning a lot of calories.   But I do read articles about sports and health because I'm sort of medical information junkie.  There are a lot of injuries. This article included summaries of several reports, one of which showed how injury statistics have been under reported because they used primarily ER statistics, but 50% get care at their doctor's office.

Girls are more likely to get injured than boys while playing the same sport. . . Football, lacrosse, and wrestling athletes were the most likely to suffer season- or career-ending injuries among boys, while gymnastics, soccer, and basketball were the most likely girls' sports to manifest these injuries. For both sexes, contact was the most common cause of major injuries. . . . yoga injury rates are increasing, especially in participants 65 and up -- who are also more prone to injury than others.. .Outside the U.S., a new study linking sports participation level with anterior crucial ligament injury risk also found contact to be the leading injury mechanism, and girls to be more injury-prone than boys while playing the same sport.  http://www.medpagetoday.com/SportsMedicine/GeneralSportsMedicine/61555