What are the NFL players being told about concussions by their own Players' Association?

I think its fascinating that the teams have physicians but that the Players' Association is advocating the use of IMPARTIAL specialists: neurologists. JR


What is a concussion?

A concussion is a type of brain injury. It occurs when the brain moves quickly enough to interrupt its function. Most concussions result in full recovery, but some can lead to more severe injuries if not recognized and treated properly.

The source of the injury is not always clear. It can come from a blow to the head or even from a blow to the body. It can come from one big hit  or from several smaller ones.

You may not always be aware that you are concussed. It is common that  concussed people do not know they are injured. Look out for the health of your teammates. Be aware of these signs and symptoms in yourself  and fellow players:
What is interesting is that the NFL plaers' association is teaming up with neurologists (the American Academy of Neurologists)


WHAT IS A CONCUSSION?

• Disorientation or confusion
• Memory loss
• Behavior or personality change
• Trouble concentrating
• Feeling sleepy or groggy
• Sensitive to light or sound
• Dizziness or nausea
• Headache

If you or a teammate have any of these symptoms, tell your medical staff immediately. Trying to play with a concussion puts  you at serious risk for further injury
.
WHAT SHOULD I EXPECT FROM MY TEAM?

IMMEDIATE EVALUATION OF A SUSPECTED CONCUSSION.
If a concussion is suspected (in either a game or practice), you should
be evaluated immediately. There is an NFL protocol for this evaluation
that can be done in under 10 minutes. If you think you may have a
concussion, report your symptoms and request this exam. DO NOT
TRY TO PLAY THROUGH THIS INJURY.


THOROUGH EVALUATION TO DETERMINE PRESENCE OF
CONCUSSION.

Not every hit that causes symptoms is a concussion and  only medical personnel can make the diagnosis. You should be evaluated  with a comprehensive neurological evaluation, ideally in a quiet, distractionfree place.

RETURN TO WORK. If you have a concussion, you should not participate  in a game or practice until you are (1) symptom free at rest and during physical exertion and (2) cleared by your team physician AND the team’s  independent neurological consultant.

 The return to work protocol should
involve several steps of increasing exertion – from a stationary bike, to
jogging, to agility work, to non-contact drills. With each step, a player must
be symptom free to move to the next step. You should never play football
after a concussion if you have not been evaluated appropriately or are still  experiencing symptoms.

WHAT ELSE CAN I DO?

You have the right to a second opinion.

It is your health and your brain. If  you are unsure about your medical condition and/or your medical care,
do not hesitate to seek additional care. There are many experts in sports  concussion that can provide the care you need.

Don’t let any question go unasked. You and your family deserve the best  information. If you would like help getting a second opinion, or have a question, call

Does second impact syndrome exist?

No one would argue about the rare and often fatal diffuse cerebral swelling following concussion. 

But, many are surprised to learn that there is little evidence to suport a "second impact syndrome". 

It is most likely that there is a genetic susceptibility to brain edema following a concussion.

See the blog by neuropsychologist Dr. Carone below for an excellent summary of the controversy.

JR

"It has often been reported that when a person suffers a second concussion (mild traumatic brain injury) before recovery from the first concussion takes place, that catastrophic brain swelling and death can result. This has been alleged to occur based on anecdotal information and when it happens (usually in young male athletes) it is referred to as “second impact syndrome” (SIS). SIS is often reported as a factual entity in the media and in the medical literature.

However, when one assess the evidence-based data for whether SIS truly exists, we are left with far more questions than answers. As Dr. Paul McCrory and colleagues (2012) put it, “The phenomenon of the second impact syndrome (SIS) continues to appear in the medical literature in spite of the lack of systemic evidence for its existence.” While McCrory's work is accessible through medical libraries, I have never seen in discussed in mainstream media coverage of SIS. Thus, a brief summary is presented below for ease of access for those who are interested....." Full blog article here

Neurology. 1998 Mar;50(3):677-83.

Second impact syndrome.

McCrory PR, Berkovic SF.

Source

Department of Medicine, University of Melbourne, Australia.

Abstract

Diffuse cerebral swelling with delayed catastrophic deterioration, a known complication of brain trauma, has been postulated to occur after repeated concussive brain injury in sports--the "second impact syndrome" (SIS). Certain current concussion management guidelines are contingent upon this assumption. We established criteria for definite, probable, and possible SIS and analyzed all published cases. A total of 17 cases were identified in which the reports described the cases as being consistent with SIS. Of these, only five probable cases of SIS were found based on our diagnostic criteria. We also studied the accuracy of recalled episodes of minor concussion in football players by their teammates because the diagnosis of SIS is usually based on such accounts. We found overreporting of recalled episodes of concussion in teammates when compared with self reports and videotape analysis. Based on case reports, the claim that SIS is a risk factor for diffuse cerebral swelling is not established. Prevention strategies for sports-related cerebral swelling are difficult to implement in the absence of established risk factors.

Curr Sports Med Rep. 2012 Jan-Feb;11(1):21-3. doi: 10.1249/JSR.0b013e3182423bfd.

Second impact syndrome or cerebral swelling after sporting head injury.

McCrory P, Davis G, Makdissi M.

Source

Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Parkville, Victoria, Australia. paulmccr@bigpond.net.au

Abstract

Second impact syndrome is believed to be the catastrophic consequence of repeated head injury in sport. The scientific evidence to support this concept is nonexistent, and belief in the syndrome is based upon the interpretation of anecdotal cases more often than not, lacking sufficient clinical detail to make definitive statements. The fear of this condition has driven many of the current return-to-play guidelines following concussion. Diffuse cerebral swelling (DCS) following a head injury is a well-recognized condition, more common in children than in adults, and usually has a poor outcome.

PMID:

 

22236821

 

[PubMed - indexed for MEDLINE]