Articles Posted in Traumatic Brain Injuries

In a recent article in the New York Times Dr. Robert C. Cantu, a professor of neurosurgery at Boston University, issued a thoughtful, yet passionate, call for parents and school officials to rethink the way we approach youth sports here in the United States.

Writing that he meets with some 1,500 concussion patients each year, Dr. Cantu lays out the case for lowering the degree and intensity of contact that younger children experience across a range of sports. “In light of what we now know about concussions and the brains of children,” he writes, “many sports should be fine-tuned.” Dr. Cantu writes that children under 14 are fundamentally more vulnerable than older teenagers or adults. “A child’s brain and head are disproportionately large for the rest of the body,” he notes. “And a child’s weak neck cannot brace for a hit the way an adult’s can. (Think of a bobblehead doll.)”

He begins the piece by focusing on football, where he believes tackling should be eliminated for children under 14, but emphasizes that head trauma, concussions and brain injuries are all more common in other sports than is popularly believed. His piece goes on to propose rule changes in soccer, ice hockey, baseball, softball, field hockey and girls’ lacrosse – many of which are not activities most of us think of as contact sports.

A lengthy article published this week in Washington’s Kitsap Sun looks at the issue of traumatic brain injuries – particularly concussions – among young athletes. As the paper notes, “the U.S. Centers for Disease Control and Prevention estimates more than 3.5 million concussions – defined as traumatic brain injuries – occur each year on ball fields and (in) sports venues across the country.”

The article focuses on the Zackery Lystedt law, a measure enacted in Washington in 2009 that prevents high school age and younger athletes “with suspected concussions from returning to the playing field without authorization from a licensed health care provider.” The law is named after a junior-high football player who suffered permanent brain damage and disability as a result of a 2006 game. The paper notes that “return-to-play legislation modeled after the Lystedt Law has since been adopted in 39 other states.”

According to SafeKids.org, Oregon’s own youth sports-focused TBI legislation, enacted about the same time as the Washington Law, offers some key safeguards but does not go nearly as far. A important difference is that Washington teens must be pulled from a game or practice if there is reason to believe that they may have suffered a concussion. Here in Oregon removing the athlete from competition or practice only becomes mandatory once they exhibit symptoms of a possible traumatic brain injury. Once an athlete has been pulled from the field both states require written clearance from a medical professional before the player can return to practices or competitions.

A recent op-ed published by The Oregonian calls for parents to take more care, and schools to take more responsibility, when it comes to preventing concussions and traumatic brain injuries among student athletes, especially younger athletes still in high school.

The column was written by James Chesnutt. He is identified in the article’s footer as a doctor and the “medical director of the OHSU sports medicine program.”

In the article he says that he is writing to encourage “all Oregon high schools to agree to a management protocol to help their student athletes deal with concussions.” He writes: “The protocol calls for schools to establish a plan to help a student recover.” This, he adds, could include time off from school following a head injury.

A lawsuit recently filed in Salem charges both doctors and prison officials with the Oregon wrongful death of a Salem man in 2010. The suit was filed by the alleged victim’s mother, according to a report in the Salem Statesman-Journal.

According to the newspaper, her son, Robert Haws, was a pre-trial detainee two years ago this month “when he got into an argument with another inmate.” The other inmate attacked Haws “hitting his head on concrete and knocking him unconscious. He died at the hospital after undergoing brain surgery and lingering for days on life support.”

At issue are “the hours following the fight and the lengthy delay in treatment for Haws’ injuries,” according to the Statesman-Journal. Haws’ mother believes that the jail staff did not give her son the attention he needed in the minutes and hours immediately after the fight. It also alleges that once Haws reached the hospital doctors treated him as if he were a patient coming down from a drug overdose despite significant evidence that he needed urgent treatment for an Oregon head trauma.

A recent article in The Oregonian offered the following somewhat surprising revelation: despite deaths from motorcycle crashes having “more than doubled since the mid-1990s” several major motorcycle-focused lobbying groups are advocating for fewer regulations and less enforcement concerning helmets.

The paper writes that lobbyists and their congressional allies want the National Highway Traffic Safety Administration to be “blocked from providing any more grants to states to conduct highway stops of motorcyclists to check for safety violations such as the wearing of helmets that don’t meet federal standards.”

Even more shockingly, “the rider groups are seeking to preserve what essentially is a gag rule that since 1998 has prevented the agency from advocating safety measures at the state and local levels, including helmet laws.” The article notes that the gag rule is supported both by grassroots-based riders groups and by lobbyists working for motorcycle makers. It is surprising to learn that just 19 states require all motorcycle riders to wear helmets – though also a relief to find that Oregon is one of them. Even more surprising, however, is the revelation that state legislatures have been rolling back helmet laws for years. The article notes that in the late 70s all but three states required everyone on a motorcycle to be wearing a helmet.

They are not slickly produced but, arguably, ought to be up for some sort of award. Throughout the long hockey season the NHL has not only been assessing tough penalties on players who cross the line in what was already a rough sport: the league has been going out of its way to explain its decisions as part of hockey’s efforts to reduce traumatic brain injuries and other serious injuries to players.

As the season began the league hired Brendan Shanahan, a recently retired player known for his toughness throughout a long and distinguished NHL career, as its Senior Vice President of Player Safety. Enforcing new rules governing blind-side hits, hits to the head and other dangerous maneuvers, Shanahan has spent the season handing out suspensions both for moves that would have been legal a year go and for others that were never legal, even in the rough-and-tumble world of the NHL.

What is different is that these disciplinary actions are not announced merely with press releases from the league office. Every one of these suspensions is explained by Shanahan himself in videos posted on the league’s website. In these videos Shanahan replays video of the infraction in slow motion, usually from several angles, and explains in detail the reasoning that led both to a decision to suspend a player and to the particular punishment he has meted out. There’s nothing quite like it anywhere else in professional (or college) sports.

An excellent online article at Motherlode, the New York Times’ parenting blog, considers the question of fighting and youth hockey. I have written on a number of occasions about the risk here in Oregon of traumatic brain injuries and spinal cord injuries in sports, especially at the college and pro levels and in heavily physical sports such as football and hockey.

The Times article, however, looks closely at the question of youth hockey. This level of the sport needs to receive more attention not only because it involves children, but also because children are more prone to injuries than highly trained (and better-equipped) professionals. On a deeper level, youth sports also require our attention because it is here that young athletes establish habits that can be extremely difficult to break as children become teens and teens become adults.

As Motherlode notes, the NCAA long ago proved that you can have exciting hockey games without fighting, “but youth hockey has so far followed the lead of the National Hockey League and allowed – even tacitly encouraged – fighting in some youth leagues for players from 16 to 20.” Now, however, the article notes that USA Hockey and Hockey Canada are both considering rule changes that would effectively outlaw fighting in non-professional leagues throughout North America, possibly as early as next season.

An important article recently published in Science Daily offered details of a new study providing the first scientific evidence linking traumatic brain injuries to post-traumatic stress disorder. This development is especially important because it confirms something that many people who follow the issue have, until now, known only anecdotally.

Through numerous books and movies PTSD has come to be associated with war and other trauma-inducing disasters. The new study, published in the journal Biological Psychiatry, however, offers “the first evidence of a causal link between traumatic brain injury and an increased susceptibility to post-traumatic stress disorder,” according to Science Daily.

The article notes that “the reasons for this correlation are unknown.” It is not possible at this time to say whether the apparent link between traumatic brain injuries and PTSD is physical or psychological. The fact that the source of the link is difficult to determine is, however, less important than the fact that it exists. The first step in beginning to recover from an Oregon traumatic brain injury is to understand the long-term consequences that may accompany the injury. Only by doing this can victims move past the initial shock of the injury and begin the healing process.

Six months after a Portland bicycle and car crash landed him in intensive care, retired football star Joey Harrington is working to put that experience to good use, according to Bike Portland. Harrington plans to combine his celebrity with his experience as an Oregon bike accident victim to promote children’s bicycle safety.

Bike Portland reports that the fundraiser, the “Bridge to Breakers – Helmets for Kids” ride, will be a 100-mile group ride on September 30. According to a statement released by the Harrington Family Foundation “the foundation would like to channel the attention from this accident to educate our community to the hazards associated with bicycle travel with the aim of reducing and preventing injuries to children.”

The injuries the former Oregon and NFL star suffered last August brought attention to Portland bicycle safety issues. He was clipped from behind by a passing car and, according to newspaper reports around the time of the accident, only avoided a severe Oregon traumatic brain injury because he was wearing a helmet.

This story from Seattle is worth noting because it highlights one of the things bike riders in an urban environment fear most, and one of the types of Oregon and Washington bicycle accident that is most easily preventable – and one for which there is never really any good excuse.

According to West Seattle Blog, a local online publication, a cyclist in the Seattle area was hospitalized yesterday after “a car door opened in front of him causing him to flip over the door.” Quoting local police, the blog reports that despite the fact that he was not wearing a helmet the rider, a 30-year-old man, “remained conscious and responsive but could not remember the accident,” when police and emergency services personnel arrived to help him. He was taken to a local hospital “in stable condition.” The fact that the victim could not remember the accident is an especially worrisome sign – indicating a possible traumatic brain injury.

Several notable issues arise from this short item. The Washington bicycle accident is a reminder of how dangerous riding in a city can be – even a city as bike-friendly as ours are here in the Pacific Northwest. The victim in this accident appears to be extremely lucky, especially granted that he was not wearing a helmet. It is worth adding that the accident he experienced – being launched head-first over the handlebars – is just about the most dangerous kind of bike accident a rider can be involved in. That is why it is especially important that drivers always remember to look carefully before opening a car door. Checking one’s mirror alone is not sufficient: people getting out of a car need to turn around and look directly behind and beside the vehicle. We are all aware of our cars’ blind spots when they are moving. That awareness should not cease just because the car is parked.

50 SW Pine St 3rd Floor Portland, OR 97204 Telephone: (503) 226-3844 Fax: (503) 943-6670 Email: matthew@mdkaplanlaw.com
map image