What You Should Know About Concussions

12/21/2016 01:24 pm ET Updated Dec 22, 2016

As part of the public discussion —which includes scientific research findings— I have watched the issue of concussions publicized and debated. An outcry has led to better awareness and some protective measures, but the culture still needs to catch up. We must respect and revere the fragile brain with better attention to head trauma.

Here are a couple of examples that bring this to light:

Professional Sports Are Still Missing the Mark

NFL players are still at significant risk. In addition to all the undiagnosed concussions and sub-concussive hits, it seems that even in the face of an obvious concussion, players may still be unprotected and ill-served. For example, in September of this year, the 2015 NFL MVP Cam Newton suffered some clear helmet-to-helmet hits, one of which left him lying on the ground clutching his helmet in pain. Despite the medical team presence and clear concussion protocols in place, dazed and confused, he was deemed able to continue to play! This move was widely criticized (and for good reason).

Sub-Concussive Hits Are Dangerous as Well

Sub-concussive hits to the head are generally smaller hits that rarely produce symptoms and are therefore do not lead to a diagnosed concussion. As a neurosurgeon, I have known that the danger of these events is the cumulative effect on the brain. Since the days when chronic traumatic encephalopathy (CTE) first began appearing the news, the latest studies has identified sub-concussive hits as a strong factor in addition to the known concussions in developing CTE.

You’re Never Too Young to Experience the Effect of Brain Trauma

Recently, researchers have found that in a single season of football, children experienced measurable changes in the brain, despite having no evident concussions. This was revealed in a study published in the journal Radiology in October 2016, which was conducted with male youth football players between the ages of 8 and 13. The study showed that sub-concussive hits impacted the brain axon activity that was measured in each subject. Axons are the millions of nerve fibers located in the brain’s white matter. They serve as the communication networks connecting various brain regions. In a healthy brain, there is a fluid movement of water molecules along the axons. When the water movement is more random— which was shown in this study— it has been associated with brain abnormalities.

Brain Trauma Comes From a Variety of Causes

Remember Ray Rice? He’s the NFL player who caused the initial attention to domestic violence in the league when he was caught on tape beating his fiancé. The chilling images of her knocked out cold still evoke shock. However, the irony is that while the league publicizes concussion management among its players, there was never a mention of Rice’s fiancé, and what brain trauma she surely endured with those blows to the head that were strong enough to render her unconscious.

In fact, now there is a concern being raised over brain trauma in incidents of domestic violence as well. While the focus on brain trauma has been with the military and football players, experts believe that abused women are also the victims of undetected and untreated brain trauma, making them at risk for subsequent problems of cognition, behavior and mood disorders.

As a neurosurgeon, I’ve spent my career studying and perfecting treatment of the remarkable but fragile human brain. Thus, I find it imperative that this organ —comprised of 100 billion nerve cells— be respected and protected. We’ve spent years with the public perception popularized in the sports world that a blow to the head is simply “getting your bell rung” and should just be “shaken off.” While it has come to light how understated head trauma has been, we must all work to increasingly spark consciousness of the serious depth of this problem.

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