California Personal Injury Law Case Notes : California Personal Injury Lawyer & Attorney : Kristine Meredith : The Danko Law Firm : Car Accidents & Product Liability

A study published in the September 2010 issue of Pediatrics reports the number of sports-related concussions is highest in high school-aged athletes, but the number in younger athletes is significant and rising. Visits to emergency departments for minor traumatic brain injuries occurring during organized team sports have increased dramatically over a 10-year period, and appear to be highest in ice hockey and football.

What should schools being doing to protect their students? For one thing, every coach can take the free online concussion training course offered by the Center for Disease Control. The course, which is designed for parents as well as coaches, includes video segments, quizzes and a resource center. It takes approximately 40 minutes to complete, but the time will vary because it’s interactive. The training dispels many of the “myths” about brain injuries that we’ve blogged about previously here and here.

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1. "You couldn't have suffered a brain injury if you didn't lose consciousness." 

Not so.  A brain injury results from any traumatically induced disruption in brain function.  The victim needn't have "blacked out" to have suffered a brain injury.  A disruption of brain function may be evidenced by the victim's inability to recall events immediately before or after the accident, or any feelings of being dazed or confused after an accident.

2. "You couldn't have suffered a brain injury if you didn't hit your head."  

The brain can be injured anytime the head comes to a sudden stop.  The damage occurs when the brain moves inside the skull.  No impact to the head is needed.  If the head and neck makes a sufficient whipping motion, or if the head is shaken sufficiently hard, a brain injury can result..

3.  "Children recover from brain injuries better than adults do."

In fact, children often seem to do worse than adults. The reason is that, for a child, the injury is a "double hazard."  First, the child struggles in the first year or two to recover physically from the injury, if he can.  But even if his physical condition improves, he will find himself behind his peers in school.  Unable to catch up, he may simply fall further behind. 
If you don't have any complaints, you're fine.

4. "It's just a concussion."  

Concussions, though considered "mild" brain injuries, are serious.  For most victims, their symptoms of a concussion will resolve within a year.  However, for a minority of victims -- perhaps as many as 15% -- their symptoms can persist for many years of for the rest of their lives, and can be devastating. 

5. "If you feel OK, then you're fine."

Sometimes, the symptoms of a brain injury occur right away.  Sometimes, however, they can begin weeks later.  Frequently, a victim of a brain injury will suffer a serious loss -- such as the loss of his sense of smell -- and not even be aware of it until he is tested.

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One would assume that if a TBI victim cannot remember the injury producing event, he cannot suffer flashbacks or nightmares re-experiencing the event. Right? Wrong.

Indeed, a diagnosis of a TBI generally requires a loss of consciousness. But the victim's loss of consciousnesss does not shield him from post traumatic stress disorder, or PTSD.  Apparently PTSD can occur after a TBI, but the TBI may alter the symptoms' development.  A TBI victim's symptoms may relate to events that just preceded his loss of consciousness, or to events that occurred immediately after.  The symptoms may even relate to details about the trauma-producing event itself that the victim learned about later in his recovery.

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Neuropsychologist researcher and professor Erin Bigler, PhD. recently spoke about the advances in images of post-concussion brains.  As discussed here, concussions or mild traumatic brain injuries may not show up on standard MRI or CT images.  Dr. Bigler described a new technique for analyzing MRI scans called "diffusion tensor imaging" or DTI.  This technique illustrates the direction of water flow through the fiber tracts of the brain. A comparison of images between an injured group and a control group revealed differences in the fiber tracts of injured patients.  It is believed that the head injuries caused swelling or edema in the fiber tracts, disrupting their normal ability to transmit messages in the brain.  This imaging allows researchers to determine the extent of injury between the fiber tracts.  Such research will have many applications, including diagnosing and assessing the scope of damage to a mild traumatic brain injury victim.

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