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Rochester researchers delve into concussions
March 01, 2006Better tests needed for fuller view of head injuries, study says
Concussion patients with a normal head CT scan may believe they are free of brain injury, but CT scans often miss damage at the molecular level, warns a University of Rochester Medical Center study.
In fact, when doctors examine the nerve cells of concussion patients the pattern of brain injury is identical for mild and severe concussions, said lead author Jeffrey J. Bazarian, M.D., a brain injury expert and an attending physician in the Emergency Department at Strong Memorial Hospital, of the University of Rochester Medical Center.
In an article in the February Academic Emergency Medicine journal, Bazarian and colleagues said that a more accurate and rapid diagnostic test for concussion could lead to better treatment in the short term and might also prevent long-term neurological problems.
"Unfortunately, the widespread use of the CT scan as the primary tool for diagnosing head injuries has biased the way we think about concussions," Bazarian said. "For many people, a more significant axonal injury has occurred, and this underlies the problems they have with motor skills and memory, and may also be a risk factor for later development of Alzheimer's and Parkinson's diseases."
More than 1.2 million Americans seek emergency room care annually for mild head injuries. Doctors routinely use a Computed Tomography (CT) scan of the head to rule out bleeding on the brain or other symptoms of a brain injury. Many patients with a normal CT test go home. But an estimated 320,000 individuals, or one-quarter of those patients, continue to suffer from symptoms such as forgetfulness, headaches and other cognitive defects that persist beyond one year.
Bazarian and colleagues reviewed the medical literature to look for ways to improve the care of brain-injured patients. Their findings show:
n Although the CT scan is used most often in the United States to diagnose head injuries, other tests such as the Magnetic Resonance Imaging (MRI), Functional MRI, Single Photon Emission Computed Tomography (SPECT) scans or Positron Emission Tomography (PET) scans are more precise tools.
n Testing a patient's verbal skills, memory and coordination after a head injury is useful. The literature shows that athletes with head injuries consistently perform worse on tests for memory, listening skills, and reaction time, even when the concussion was mild and the CT scan was normal.
n After a blow to the head, doctors can sometimes diagnose a brain injury by detecting brain-specific proteins in the blood. Yet currently available brain biomarkers are poor predictors of patient outcome after concussion. Better blood tests are needed for use on athletic fields, in clinics, or at the scene of a mass casualty incident, the authors said.
"Among coalition forces in Iraq, where brain injury has been called the signature wound of the war, undiagnosed brain injury in combat leaders may expose them and their troops to increased risk on the battlefield," Bazarian added. "This has given the development of an accurate and portable means of diagnosing brain injury a new sense of urgency."
University of Rochester Medical Center
In an article in the February Academic Emergency Medicine journal, Bazarian and colleagues said that a more accurate and rapid diagnostic test for concussion could lead to better treatment in the short term and might also prevent long-term neurological problems.
"Unfortunately, the widespread use of the CT scan as the primary tool for diagnosing head injuries has biased the way we think about concussions," Bazarian said. "For many people, a more significant axonal injury has occurred, and this underlies the problems they have with motor skills and memory, and may also be a risk factor for later development of Alzheimer's and Parkinson's diseases."
More than 1.2 million Americans seek emergency room care annually for mild head injuries. Doctors routinely use a Computed Tomography (CT) scan of the head to rule out bleeding on the brain or other symptoms of a brain injury. Many patients with a normal CT test go home. But an estimated 320,000 individuals, or one-quarter of those patients, continue to suffer from symptoms such as forgetfulness, headaches and other cognitive defects that persist beyond one year.
Bazarian and colleagues reviewed the medical literature to look for ways to improve the care of brain-injured patients. Their findings show:
n Although the CT scan is used most often in the United States to diagnose head injuries, other tests such as the Magnetic Resonance Imaging (MRI), Functional MRI, Single Photon Emission Computed Tomography (SPECT) scans or Positron Emission Tomography (PET) scans are more precise tools.
n Testing a patient's verbal skills, memory and coordination after a head injury is useful. The literature shows that athletes with head injuries consistently perform worse on tests for memory, listening skills, and reaction time, even when the concussion was mild and the CT scan was normal.
n After a blow to the head, doctors can sometimes diagnose a brain injury by detecting brain-specific proteins in the blood. Yet currently available brain biomarkers are poor predictors of patient outcome after concussion. Better blood tests are needed for use on athletic fields, in clinics, or at the scene of a mass casualty incident, the authors said.
"Among coalition forces in Iraq, where brain injury has been called the signature wound of the war, undiagnosed brain injury in combat leaders may expose them and their troops to increased risk on the battlefield," Bazarian added. "This has given the development of an accurate and portable means of diagnosing brain injury a new sense of urgency."
University of Rochester Medical Center
Concussions Current Events and Concussions News RSSBrain injured athletes may benefit from hypothermia research
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New national study finds more than half of cheerleading injuries in US due to stunts
Whether rallying the crowd at a sporting event or participating in competition, cheerleading can be both fun and physically demanding. Although integral to cheerleading routines, performing stunts can lead to injury.
Member of NFL Hall of Fame diagnosed with degenerative brain disease
The Center for the Study of Traumatic Encephalopathy (CSTE) at Boston University School of Medicine (BUSM) announced today that a recently deceased member of the NFL Hall of Fame suffered from the degenerative brain disease Chronic Traumatic Encephalopathy (CTE) when he died, becoming the 10th former NFL player diagnosed with the disease.
First former college football player diagnosed with CTE
The Center for the Study of Traumatic Encephalopathy (CSTE) at Boston University School of Medicine (BUSM) announced today that a deceased former college football player who died at age 42 was already suffering from the degenerative brain disease, Chronic Traumatic Encephalopathy (CTE).
Football injuries in US high school athletes more severe during kickoff, punting
Injuries can occur during a sporting competition at any time. However, new research finds that during football, injuries sustained at the beginning or middle of a game are more severe compared to injuries sustained during the end or in overtime.
Concussion experts: For kids -- no sports, no schoolwork, no text messages
When it comes to concussions, children and teens require different treatment, according to international experts who recently published consensus recommendations.
Minor league hockey players unable to identify concussion symptoms, study says
When Chicago Blackhawk's leading scorer Martin Havlat returned to the ice for game four of the Western Conference Final after sustaining a concussion only two days earlier, questions were raised surrounding his swift return.
UCLA study shows traumatic brain injury haunts children for years
Traumatic Brain Injury (TBI) is the single most common cause of death and disability in children and adolescents, according to the Centers for Disease Control. Now, according to a new study by UCLA researchers, the effects of a blow to the head, whether it's mild or a concussion, can linger for years.
Children with concussions require follow-up care before returning to play, say researchers
Children hospitalized with concussions should wait until they are seen by a clinician in a follow-up exam before returning to regular sports or playtime activities, according to researchers at The Children's Hospital of Philadelphia.
Classifying concussions could help kids
It's estimated that more than a half million kids in the U.S. go to the hospital each year with a concussion.
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