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Ice Hockey and Brain Injuries

Ice Hockey Causes 44.3% Of All Traumatic Brain Injuries Among Canadian Kids

Ice Hockey Causes 44.3% Of All Traumatic Brain Injuries Among Canadian Kids
Monday 1 April 2013 - 12am PST




Sports Medicine / Fitness
Pediatrics / Children's Health
Neurology / Neuroscience

Health Professionals:

Nearly half of all traumatic brain injuries among children in Canada who needed to be taken to an emergency department are caused by ice hockey, researchers from St. Michael's Hospital, Toronto, reported in the journal PLOS ONE.

Dr. Michael Cusimano and team, who claim that their study is the first-of-its-kind, gathered and examined data on the causes of sports-related brain injuries among Canadian children. They also identified which preventive measures could be implemented straight away to make children's sports safer.

Lead author, Dr. Cusimano, a neurosurgeon, said:


"Unless we understand how children are getting hurt in sport, we can't develop ways to prevent these serious injuries from happening. One would think that we know the reasons why kids are having brain injuries in sports, but until know, it was based mainly on anecdotes."
Sports-related head injuries can have lingering effects on children. Researchers from the University of Oregon found that high school athletes who suffered concussion continued having problems focusing and switching tasks readily amid distractions two months after their injury.

In this latest study, the team looked at the records from The Canadian Hospitals Injury Reporting and Prevention Program, which included information on 13,000 children and teenagers who had sustained a sports-related brain injury between 1990 and 2009.

The authors categorized the young sportspeople's injuries according to their ages, the type of sport they were practicing, when the injury occurred, and what caused it (a blow by another player, an object, etc.).

Below is a breakdown of the main sports that cause the majority of sports-related head injuries among Canadian children and teenagers:
Ice Hockey caused 44.3% of all sports-related injuries among Canadian children and teenagers. Most of the injuries (nearly 70%) affected children aged over ten years as a result of being hit into boards or player-to-player contact.

It is not surprising that hockey - Canada's national sport - causes so many head injuries, Dr. Cusimano added. "This shows that body contact is still an area where we need to make major inroads to preventing brain injuries. For example, enforcing existing rules and making more effective incentives and disincentives about checking from behind could make huge improvements."

Soccer accounted for 19% of all sports-related brain injuries. Most injuries affected children in the 10-14 and 15-19 age groups. In these two age groups, the most common cause of injury was being hit by another player, being kicked in the head, and head-to-head collisions. Among kids aged 5 to 9 years, traumatic brain injuries were more likely to be caused by striking a goal post or a surface, the researchers found.

Dr. Cusimano said "There's a really straightforward solution here. Padding the goal posts could have potentially prevented a large number of these brain injuries in young children."

Baseball, which caused 15.3% of all sports-related head injuries, was also found to affect a higher percentage of younger children. Forty-five percent of all serious head injuries in baseball affected children aged under nine years.

Not being supervised by an adult, or standing too close to the batter or bat were the most common causes of injuries among childhood baseball players.

Dr. Cusimano said "These results give us a very specific prevention message for kids under nine who play baseball: make helmets and supervision a mandatory. The younger the child, the more supervision they need when using things like bats and balls. Simple rules around not being close to the batter can be taught to children and adults."

Football accounted for 12.9% of all injuries, most of which were caused by tackling. Tackling was the main cause of all rugby injuries. Rugby caused 5.6% of all sports-related head injuries.

Basketball - accounted for 11.6% of all injuries, most of them caused by players elbowing each other. The risk of injuries grew as the players got older.Dr. Cusimano concluded:


"There is a real opportunity for prevention here. Having educational programs, proper equipment, rules and other incentives that support a culture of safety in sports should be a mandate of parents, coaches, players, sports organizations, schools, sports sponsors, and other groups like governments."
The study was funded by the Ontario Neurotrauma Foundation and the Canadian Institutes of Health Research.

The American Academy of Neurology, which released its first updated guidelines on evaluating and managing athletes with concussion in 15 years, informed that over one million Americans experience sports-related head injuries (concussions) annually.

Written by Christian Nordqvist

Copyright: Medical News Today
Not to be reproduced without the permission of Medical News Today.

medicalnewstoday.com
Cusimano MD, Cho N, Amin K, Shirazi M, McFaull SR, et al.”Mechanisms of Team-Sport-Related Brain Injuries in Children 5 to 19 Years Old: Opportunities for Prevention”
PLoS ONE 8(3): e58868. April 2013. doi:10.1371/journal.pone.0058868

Mild Brain Injury Leaves Lasting Scar

A long-term study reveals how the brain responds to a mild impact, and could guide future intervention
Jul 16, 2014 |By Daisy Yuhas


Credit: Rugby Streaming/flickr


At Sunday’s World Cup Final, German soccer player Christoph Kramer knocked his head against an Argentine opponent’s shoulder with such force that Kramer spun to the ground and fell face down. The blow was one of many at this year’s competition, which further fueled a rising debate about concussion, the damages of fútbol versus football and the best response to head injuries.

 Part of the challenge in understanding these injuries is how varied they can be. Although much attention has gone to severe forms of traumatic brain injury (TBI) such as concussion-induced coma, far more common are the milder impacts that come from falling off a bicycle, a low-speed car accident or taking a weak punch in a fistfight. These injuries may not entail losing consciousness but rather just a brief lack in responsiveness before recovering.

Now a group of researchers in the U.K. at Newcastle University, the University of Aberdeen and the University of Edinburgh have released results of a longer-term investigation of individuals who have suffered such first-time, minor head injuries. Their findings hint that the contusions leave a lasting trace in the brain.

The team, led by Newcastle imaging physicist Andrew Blamire, scanned the brains of 53 individuals with mild or moderate TBI within two weeks of the injury. They mapped the tracts of fibers connecting brain regions in the patients as well as in 33 healthy subjects. Blamire and colleagues discovered distinct differences between the two groups. “Even in patients with mild injury, you can detect a marker of that injury,” Blamire says. That marker may distinguish mild injuries from more forceful impacts. In cases of severe TBI, brain tissue known as white matter that envelops the tracts deteriorates, effectively mashed by the impact. But Blamire identified an opposite trend in the mild and moderate cases. For these patients, the white matter fibers became even more structured. He and his colleagues hypothesize that this organization may be caused by an inflammatory response in which the brain’s glial cells leap into action, perhaps repairing damage or blocking further injury.

Along with scanning, the team also tested thinking and memory in their subjects. Compared with healthy subjects injured patients had lower scores on multiple tests in the two-week interval after their injuries, including an average 25 percent drop on a verbal fluency test, in which an individual thinks of as many words as possible that start with a given letter. The brain changes identified in imaging correlated strongly to this test, suggesting some overlap between the affected area’s function and the test’s cognitive target.

To take their findings a step further Blamire and colleagues repeated their procedure with 23 of their head injury patients one year later. As they report in Neurology on July 16, the variability between patients was high but on average the test scores had returned to the levels of healthy individuals. The brain changes, meanwhile, remained. This suggests that once the brain has sustained damage, the scars persist.

Blamire observes that lingering signs of damage could help certain patients identify a source of their earlier mental troubles—such as memory problems—in the absence of other symptoms. For people with ongoing cognitive difficulties, it could even be useful in legal scenarios, providing evidence of head trauma even after months have past.

Neuroradiologist Michael Lipton at Albert Einstein College of Medicine, who did not participate in this research, explains that the study’s results echo findings from his and other research groups. He notes, however, that the one-year follow-up is unique and agrees that the imaging findings could reflect an inflammatory response. Lipton’s group has further hypothesized that the brain changes may even predict better recovery—in essence, that the brain has rewired itself to compensate for the damage. Only further research will reveal if this is the case, however.

Over the longer term, the findings could contribute to a growing understanding of how the brain responds to collisions and concussions. “Work like this is really essential to understanding how we can intervene,” Lipton says.

Blamire agrees, explaining that eventually brain imaging could help doctors distinguish between which patients will require counseling and treatment and which will make a full recovery on their own.


Link:http://www.scientificamerican.com/article/mild-brain-injury-leaves-lasting-scar/

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