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Sudden Impact: The Hidden Danger of Concussion

8:10 PM, Oct 19, 2010   |    comments
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JACKSONVILLE, Fla. -- Each year hundreds of thousands of teens in contact sports sustain concussions, a violent shaking of the brain. The number is 140,000 in football alone.

It's all over the headlines. Congress is involved and it seems everyone is talking about concussions these days - except the kids who are getting them.

"Kids think if they say anything, they are weak or they are not tough. Just like Joey. He thought he was invincible; nothing was going to happen to him," said Tania Burns.

Her son Joey sustained a concussion in 2006 and is now unable to talk or walk. Beyond an occasional smile or a faint thumbs-up, he doesn't communicate at all. He must have 24-hour, around-the-clock-care and is fed through a tube.

A month before his injury he was just like any 16 year-old boy: full of life and invincible. One hit changed everything.

"He went really high to grab the football, got the ball and they hit him from the back and he hit head first," Burns said.

But Joey didn't stop. He got up, and played two plays more before complaining of a headache. Then the whole world went black.

Doctors gave him almost no chance to survive. The damage was extreme. "It was everywhere - kind of like when they shake a baby - his whole head..." said his mother.

"So that's the kind of short-term worst case scenario," said Chis Nowinski.

Nowinski is a former Harvard football star turned wrestler, who after sustaining his own brain injury has now made it his life's work to study the effects of concussion. He is the co- director of the Study of Traumatic Encephalopathy at Boston University School of Medicine and has written a book on the subject.

"What that young man suffered was a subdural hematoma, most likely or it could have been caused by second-impact syndrome," Nowinski said.

Cases like Joey's are admittedly rare. His injury occurred during a pick-up football game, and he wasn't wearing pads or a helmet. But Nowinski said while helmets may prevent most severe brain bleeds like Joey's, there is a more insidious element of concussion that may take years to materialize.

But is just as deadly. It's called tau.

"Tau is a protein that exists in your brain cells, but when there are too many concussive episodes that tau can change and become toxic to the cell and kill it," Nowinski said.

The first signs of damage can be anything from memory lapses, sensitivity to light, irritability. Ultimately there is loss of emotional control, severe depression and dementia.

Nowinski and his team study the brains of deceased NFL athletes. "These men had families. They had wives. They had children, depending on them, but because they were playing in a culture where you didn't talk about concussions, it took their lives."


In Nowinski's lab, the brain is sliced into very thin pieces and stained to reveal the damage. Tau appears as triangular, brown residue.

"You can see in this athlete who was only 40 years old... half of his brain cells were already dead," Nowinski said, pointing to a slide.

It is largely due to Nowinski's work that in January the NFL changed its concussion policy. No athlete who experiences a concussion can return to play in the same game.

But the precautions need to start much younger, he said.

"The trauma may stop in your teens or 20s, but the disease that started will progress and at some point in your 30s, 40s or 50s, you'll start showing symptoms because so many cells have died that your brain can't compensate anymore," Nowinski said.

Teens need to, in his words, shut it down after a concussion, he said. "No young person is ready to go after two or three days, you probably need much longer to ensure your safety."

Nowinski believes girls need to be getting this message as well. While their numbers are smaller in contact sports, percentage-wise their concussions are more numerous.

"So, for example, females in basketball get more concussions diagnosed than men do and the symptoms seems to last longer. So we're fairly certain there's an even bigger issue with females," he said.

So, what is the proper thing the do?

First, no athlete should return to play in the same game after a concussion. And there is no such thing as a minor brain injury; all concussive episodes should be treated seriously.

Place the athlete in a dark room with no stimulation. That means no videos, video games, texting, or even homework. There should be as little brain stimulation as possible.

The rest of the recovery is time, at the very least, several days before a return to action. And perhaps the most difficult, changing a culture of silence.

"The culture is a problem in that the athlete has a certain amount of pride and we glorify playing through injuries, and unfortunately we haven't carved out concussion as something that needs to be treated differently than a bruise or a sprain," said Nowinski. "That high school glory is great at the time, but it goes away very quickly and you have a lot of other things you're going to do with your life."

Tania Burns holds onto hope that her son will have other things to do with his life too one day. She hopes by telling her story, more parents will educate themselves about concussions, and that kids and coaches will start talking about it.

It pains her to think about the life her son should have. "Sixteen years old. Full of life and he's not there," Burns said.

First Coast News

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