As you read this, the college football season of 2013 will be over.  Florida State has been crowned the final BCS national champion.  The NFL playoffs are in full swing, with the Patriots and Colts playing in Foxboro yet again.  And all the while, even though a major lawsuit dealing with concussions was somewhat settled back in August 2013 (see N.Y. Times article), the hits keep coming.  A look at the NFL’s official injury report for Week 17 showed that 18 players on 32 teams were being treated for concussions.  In this past weekend’s wild-card playoffs, with eight teams playing, at least five concussions occurred, three on the Kansas City Chiefs alone (see SB Nation article).  Players, trainers, coaches, parents and healthcare professionals are much more aware of concussion signs, symptoms and proper management, but the nature of collision or contact sports fundamentally leads to increased head injury risk.  What is the current state of concussion research now and how can it help our patients?

Scientists at UCLA have used positron emission tomography (PET) scans to search for tau protein accumulation in the brains of living persons as a marker for chronic traumatic encephalopathy, also known as CTE (see Technology Review article).  The National Institute of Health is funding eight separate concussion studies, looking at both acute and chronic issues in concussion diagnosis and treatment.  The Institute of Medicine has recommended a large-scale effort on ongoing concussion education and awareness, including a change in the culture of sports.  A recent article from researchers at the National Institute of Neurological Disorders and Stroke shows how mild traumatic brain injury causes vascular damage and reactive oxygen species, which leads to brain parenchyma injury.  Research out of the University of Wisconsin questions whether differences in helmet brand or age affect concussion risk (see U.S. News article).

As long as sports are played, injuries will happen.  We all accept a degree of risk in the choices we make, whether for ourselves or our children.  There may be more questions than answers at this time as far as concussion prevention, but with so many areas of investigation occurring in the near future, our ability to guide our patients in making the safe and prudent choice should improve.


Stuart J. Glassman, MD

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