New Study Looks At Football Helmets And Concussions

New Study Looks At Football Helmets And Concussions

Check out the new rankings at www.sbes.vt.edu/nid.php

By TIM LAMMERS

FOX CT

7:21 PM EDT, July 30, 2011

If you have a child playing high school or college football, then this story is for you. A new study looks at helmets and which ones might be the safest for your child. But not everyone agrees on the results.

Concussions have always happened in football. But only recently have we started to discover just how dangerous they really are.

"Concussions are the number one, perhaps the number one interest, and therefore the number one concern," says Dr. Carl Nissen, Elite Sports Medicine.

So it was only a matter of time before football helmets came under closer scrutiny as well.

"There is, probably, some promise that the newer helmets can reduce the rate of concussions," says Dr. Nissen.

The current standard for NFL and a lot of college, and even high school, teams comes from the National Operating Committee on Standards for Athletic Equipment (NOCSEA). So as long as you've got their seal of approval, you're good to go.

"If a helmet has been approved by NOCSAE, it is gonna meet the minimal standards, so it is gonna be a protective piece of equipment," says Dr. Nissen.

Well, a brand new study has reached some drastically different conclusions.

"The study that we're all talking about as we go into this fall's football season is the STAR criteria for helmet safety," Dr. Nissen says. "A sliding scale of one through five stars as to whether a helmet is good or bad, safe or not."

Like the five-star rated Riddell Revolution Speed. That and all the four-starr rated helmets are highly recommended.

"Their techniques are very well established," says Dr. Nissen. "Their lab does this very well."

But two helmets were not recommended for use. One of them, the Riddell VSR4, is still commonly found in the the NFL. It also has NOCSAE's approval. And NOCSAE isn't changing its stance because Virginia Tech has yet to finish real-world testing to prove that concussion rates match up with the star ratings.

http://www.courant.com/health/connecticut/ctn-new-study-looks-at-football-helmets-and-concussions-20110730,0,3685152.story

Football players - Check out Helmet Ratings

Adult Football Helmet Ratings - May 2011

A total of 10 adult football helmet models were evaluated using the STAR evaluation system for May 2011 release. All 10 are publicly available at the time of publication. Helmets with lower STAR values provide a reduction in concussion risk compared to helmets with higher STAR values. Based on this, the best overall rating of ‘5 Stars’ has the lowest STAR value. Group rankings are differentiated by statistical significance.

http://www.sbes.vt.edu/nid.php

How expensive is autism?

Here is a very sobering post by my colleague and friend, Pat Harkins MD. She walks the walk...

How expensive is autism?

Posted by Patricia Harkins in Uncategorized

The short answer is “very”.

The long answer is, well, long

Note – I use ASD to mean “autism spectrum disorder”.

Let’s start with therapy. I estimate the average ASD child needs Speech/Language therapy for about 5 years and Occupational Therapy for about 3 years. That is 16 “therapy years”. This is about $300K to the family or insurance. The cost to public schools is about $4K per year for 13 years. Cost in babysitters because they can’t go to a regular daycare is about $5K to 26K per year needed, perhaps for average of 10 years...

In our family’s case, my husband stopped being employed when our son was 3 because of his needs

....read more at

http://autismwhisperer.net/2011/07/30/how-expensive-is-autism/

'Laughing gas' sedation calms pediatric hospital patients

'Laughing gas' sedation calms pediatric hospital patients

I am at my cerebral palsy/ "Botox" clinic today in san Antonio. Its amazing to see how cal kids are with sedation. Laughing gas makes this quick and easy.

SAN ANTONIO -- Doctors at a San Antonio hospital are using a new tool to make their smallest patients more comfortable. It’s a sedation method dentists have used for years.
This is a less invasive way to sedate children for procedures. All it requires is a mask and about three minutes.

Keeping the smallest of patients calm and tranquil during procedures is no small task. Many diagnostic or therapeutic interventions require IV sedation where children are unconscious. For some patients, though, there’s another less invasive alternative.

Gas. It’s nitrous oxide, the same stuff you’d call “laughing gas” at the dentist.

At North Central Baptist Hospital in Stone Oak, the pediatric sedation unit has been using this approach of the last two months with great success.

“They’re awake the whole time,” explained Dr. Daniel Sedillo, a pediatric critical care specialist. “You can talk to them and tell them to take a deep breath or to relax and once you take the gas off within two or three minutes they’re back to their playful self as they were before.”

The gas can be kept up for about half an hour and allows doctors to do everything from injections to biopsies, from spinal tapes to MRI scans.

The children have less angst and fear and the doctors have a cooperative patient to work on.

“The physicians who were doing the procedure were very happy that they were able to do the procedure comfortably without the child moving a whole lot and not having to see tears or screaming or anything like that,” Sedillo remarked.

Using nitrous oxide as a sedative means parents don’t have to worry as much about what their children eat before the procedure. The recovery to full consciousness is faster.

http://www.kens5.com/home/Laughing-gas-sedation-calms-pediatric-hospital-patients-103462504.html

Laser Cell Ablation for Epilepsy - Read Keagan's Story

Read Keagan 's Story

Laser Cell Ablation for Epilepsy

Texas Children's Hospital is the first hospital in the world to use real-time MRI-guided thermal imaging and laser technology to destroy lesions in the brain that cause epilepsy and uncontrollable seizures.

According to hospital experts, this new surgical approach offers a safer and significantly less invasive alternative to craniotomy, currently the most commonly used cranial surgical treatment for epilepsy. For high-risk patients with deep brain lesions, this new technique can be particularly life-changing because the MRI-guided laser probe utilizes a much smaller pathway through the brain to reach a deep lesion. This reduces the risk of patient complications related to contact with surrounding brain tissue. In addition, the MRI-guided laser probe is inserted through a hole in the skull that is only 3.2 mm (about the diameter of a pen) versus the removal of a larger area of skull bone for a craniotomy. Because it is a less invasive procedure, patient recovery time is much shorter.

Learn more about the procedure.

Keagan's StoryA recent example of the effectiveness of this new surgery is nine-year-old Texas Children’s Hospital patient Keagan Dysart, of Converse, Texas, who suffered from two types of epileptic seizures when he was diagnosed with a hypothalamic hamartoma in his brain. The gelastic seizure caused him to giggle and laugh uncontrollably two or three times an hour. Keagan would also periodically experience a tonic seizure, with generalized body stiffening and loss of awareness that caused him to fall asleep for sometimes up to an hour afterward.
Keagan’s case was particularly high risk because his lesion was located in the hypothalamus, near the brain stem. In this highly sensitive region, there are a myriad of potential, serious complications from surgery including loss of sight, damage to the pituitary gland, stroke from artery damage or development of diabetes insipidus (DI), a potentially fatal condition where the kidneys are unable to conserve water because of disruption to the area of the brain that releases the body’s anti-diuretic hormone.
The location, size and complexity of Keagan’s brain lesion made him an ideal candidate for the new surgical procedure, which was successfully performed in March without any surgical complications. He is now seizure-free.
View a presentation describing the breakthrough epilepsy procedure.

http://www.texaschildrens.org/CareCenters/Neuro/Neurosurgery/laser_cell_ablation.aspx

Texas Children’s Hospital pioneers use of MRI-guided laser surgery for revolutionary new epilepsy treatment

Read about the story of one of my patients!!! JR



Texas Children’s Hospital pioneers use of MRI-guided laser surgery for revolutionary new epilepsy treatment





New procedure significantly reduces risk of patient complications and recovery time



HOUSTON – (July 18, 2011) – Texas Children’s Hospital is the first hospital in the world to use real-time MRI-guided thermal imaging and laser technology to destroy lesions in the brain that cause epilepsy and uncontrollable seizures.

News media contact
Christy Brunton832-824-2645clbrunto@texaschildrens.org
According to hospital experts, this new surgical approach offers a safer and significantly less invasive alternative to craniotomy, currently the most commonly used cranial surgical treatment for epilepsy. For high-risk patients with deep brain lesions, this new technique can be particularly life-changing because the MRI-guided laser probe utilizes a much smaller pathway through the brain to reach a deep lesion. This reduces the risk of patient complications related to contact with surrounding brain tissue. In addition, the MRI-guided laser probe is inserted through a hole in the skull that is only 3.2 mm (about the diameter of a pen) versus the removal of a larger area of skull bone for a craniotomy. Because it is a less invasive procedure, patient recovery time is much shorter.
More than three million people in the U.S. are affected by epilepsy, including about 300,000 children under the age of 14. Uncontrollable seizures can affect a child’s memory, concentration, motor skills, school performance and quality of life. Drug therapies control seizures in about 60 percent of those with epilepsy. Invasive craniotomy, nerve stimulation and special diets are treatment options for patients who do not respond to medication.

Studies associate head injuries with dementia in later life.

Studies associate head injuries with dementia in later life.

The Wall Street Journal (7/18, A3, Wang, Subscription Publication) reports that, according to two studies to be presented today at the Alzheimer's Association International Conference on Alzheimer's Disease in Paris, concussions and other head injuries may be associated with dementia in later life and may also increase vulnerability for Alzheimer's symptoms. In the first study, researchers who analyzed data on 280,000 veterans of the military older than age 54 found that those who had a diagnosis involving traumatic brain injury faced triple the risk for developing dementia. In a second study, which involved about 500 former professional football players with the NFL who were showing symptoms of mild cognitive impairment, researchers found that the players had similar cognitive function scores as elderly people with MCI, even though the players were years younger.

An AP (7/18, Marchione) story run by at least 146 publications reports, "A large study in older veterans raises fresh concern about mild brain injuries that hundreds of thousands of American troops have suffered from explosions in recent wars. Even concussions seem to raise the risk of developing Alzheimer's disease or other dementia later in life, researchers found." The research, funded by the US Department of Defense and the National Institutes of Health, was led by Dr. Kristine Yaffe, director of the Memory Disorders Clinic at the Veterans Affairs hospital in San Francisco. Researchers working on the study "reviewed medical records on 281,540 veterans who got care from Veterans Health Administration hospitals from 1997 to 2000 and had at least one follow-up visit from 2001-2007."

According to the Wall Street Journal (7/18, Wang, Subscription Publication), Yaffe's says her findings raise concerns about the possible long-term impact of veterans' traumatic brain injuries. The Journal also took note of a separate study which found that professional football players may also be at increased risk of cognitive problems later in life. USA Today (7/18, Marcus) notes, "Yaffe says more research is needed to explore whether early rehabilitation can help reduce the risk for dementia." She added, "If you know you've had a head injury and you are approaching older age, one has to be carefully monitored and screened for cognitive dementia."

Bloomberg News (7/18, Torsoli) notes that Yaffe's research findings will be "presented at the Alzheimer's Association International Conference in Paris" on Monday, where they will "highlight another potential hazard of war. Traumatic brain injury is a 'signature wound' of the conflicts in Iraq and Afghanistan, accounting for 22 percent of casualties overall and 59 percent of blast-related injuries, said" Yaffe.

http://yourlife.usatoday.com/health/medical/alzheimers/story/2011/07/Traumatic-brain-injury-doubles-risk-of-Alzheimers/49472436/1?dlvrit=205764

High annual concussion count calls for safety - New Texas Laws

Natasha's Law to make debut this season

High annual concussion count calls for safety

By JASON McDANIEL
For the Chronicle

July 16, 2011, 11:29PM

Cartoonist Steve Moore has devoted plenty of ink to lampooning everything associated with athletic training in his nationally syndicated comic In the Bleachers.

But even he admitted questioning whether to make light of concussions during his keynote address this week at the Southwest Athletic Trainers Association's 57th meeting at the Westin Galleria.

Of course, he still does it.

The cartoon he brought featured a machine that sucks concussions out of an athlete's head, and it's funny. But his hesitation underscores the seriousness of the issue. That goes double for high school athletes, whose brains still are developing.

"If a youngster sprains his ankle, the parents, coaches and the youngsters themselves can see the swelling, they can see the limping, the fact that they're on crutches and so forth, so they can follow the injury and understand the concept," said Bucky Taylor, an athletic trainer for Mesquite ISD. "But you can't put the brain on crutches."

Protecting the youth

To help protect athletes, Taylor and Dennis Hart, a part-time athletic trainer for Mesquite ISD, helped develop a bill dealing with concussions.

The bill, House Bill 2038, authored by Rep. Four Price, R-Amarillo, establishes a three-step process for dealing with concussions in student-athletes statewide.

It was signed into law by Gov. Rick Perry last month and takes effect Sept. 1, just in time for the upcoming high school football season.

The bill, dubbed Natasha's Law, calls for state-mandated education for all parties, removal from play of athletes suspected with a concussion, and guidelines for return to activity.

"A concussion is an injury to the brain, one of our most vital organs, and when a youngster sustains a concussion there's a great chance that they'll have a second and a third one, and if they haven't fully recovered — and this is a key point - from the initial concussion, and they're allowed to return to play while they're still symptomatic, incidents of a catastrophic brain injury are high, and that's what we're trying to prevent," Taylor said.

The Centers for Disease Control and Prevention says 300,000 mild traumatic brain injuries, or concussions, occur annually in the United States as a result of participation in sports.

The Sports Concussion Institute estimates 10 percent of athletes in contact sports suffer a concussion during a season, and a 2006 report estimated there are 92,000 cases of concussion in high school sports yearly.

Read more: http://www.chron.com/disp/story.mpl/sports/hso/7656691.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+houstonchronicle%2Fsphso+%28HoustonChronicle.com+--+Other+High+School%29#ixzz1SQLfrL1E

Joshua and Robin Berry Children’s Trust

This is the Facebook page that provides official updates on the status of the Berry Children, news articles, community outreach to the family and a gateway to donate money.

Description

Children of tragic car wreck victims Robin and Joshua Berry are back in Houston recovering from injuries sustained in the July 2 crash in west Texas that killed their parents. The two boys, Peter, 9, and Aaron, 8, were transferred from Lubbock to a Houston hospital late Wednesday night, July 6. Both boys are being treated for spinal injuries. The Berry's daughter, Willa, 6, is now staying with family friends in Houston. She was treated at Covenant Hospital in Lubbock for a broken arm and ankle. The children arrived home the night their parents were buried at Beth Yeshurun cemetery. Nearly 2,000 people attended the double funeral service at the synagogue

http://www.facebook.com/pages/Joshua-and-Robin-Berry-Childrens-Trust/160792453994481

Treatment-induced plasticity in cerebral palsy - MRI shows changes with treatment

Last week, I was honored with the invitation to address the Pediatrics Department at the University of Texas. I offered a review on cerebral palsy diagnosis and treatment. Here is an interesting article suggesting brain plasticity after standard treatments.

Sadly many children are not referred for multimodal treatment

Dr. Rotenberg

Pediatr Neurol. 2008 Nov;39(5):341-9.

Treatment-induced plasticity in cerebral palsy: a diffusion tensor imaging study.

Trivedi R, Gupta RK, Shah V, Tripathi M, Rathore RK, Kumar M, Pandey CM, Narayana PA.

Source

Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Abstract

Diffusion tensor imaging is used as a measure of white-matter organization to probe mechanisms underlying clinical responses. Diffusion tensor imaging and clinical assessment in 8 patients with spastic quadriparesis (mean age, 6.13 years) was performed before and 6 months after therapy (botulinum injection, followed by physiotherapy). All patients were graded on the basis of gross motor function. Serial diffusion tensor imaging was also performed on 10 age/sex-matched controls at baseline and after 6 months. Regions of interests were placed on corticospinal tracts at different levels (i.e., corona radiata, posterior limb of internal capsule, midbrain, pons, and upper medulla) and on other major white-matter tracts, in both patients and controls. A significant increase in fractional anisotropy was evident in corticospinal tracts at the level of the posterior limb of the internal capsule and periventricular white matter of the temporal lobe, relative to baseline values in the patient group. Gross motor function classification system grades improved in all patients during follow-up relative to baseline values. The increase in fractional anisotropy in corticospinal tracts, along with improved clinical motor scores, suggests plasticity of the central motor pathway after combined therapy.