Bob McKenzie on his personal experiences with concussions in sports

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Bob McKenzie (known as the TSN Hockey Insider) comments on concussions, return to play, and what should be considered at all levels of sport.

“My personal experiences with head trauma have re-enforced just how serious this issue is and how it can affect people and family on so many levels.

“It has heightened my awareness of just how common these stories are. I can’t tell you how many minor hockey games I’ve been at where I’ve seen players concussed on one shift and back out on the next shift.”

“The players themselves, the coaches, the parents, are willfully ignorant, thinking that if they don’t acknowledge the concussion problem, there is no problem.”

“…there are many who still do not understand concussions, how to identify, and how to treat them…”

Bicycle helmets: learning from Jordan

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Thanks to the Letters to the Editor – The Guardian PEI
OPINION, DAVID WONG, Commentary

I have been looking after Jordan, a 13-year-old boy, for the past few months. Last September, he rode his bicycle like many children and adults of Prince Edward Island, without a bike helmet. He did have one at home. However, he wouldn’t wear it because none of his friends were wearing it either. More importantly, the police didn’t care. No one was ever ticketed or charged for not wearing a bike helmet, although it has been the law for several years. His parents bought him the bike helmet, but couldn’t make him wear it.

That day in early September 2008 started just like any other day. He went for a bike ride. Somehow he fell, not unlike any other falls that he had before. But this time, when he got up, he was dizzy and couldn’t remember his name or where he lived. A motorist passing by saw that he was disoriented, picked him up, and took him home.
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SMARTRISK’s “The Economic Burden of Injury in Canada”

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Today marks the official release of SMARTRISK’s “The Economic Burden of Injury in Canada” report, which reveals that injury costs Canadians close to $20 billion each year. The numbers and costs are calculated both for unintentional and intentional injuries and the figures are broken down by province.

You can find PDFs of the executive summaries and the full reports on the SMARTRISK website: www.smartrisk.ca

The NABIS Seventh Annual Conference on Brain Injury

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The North American Brain Injury Society is pleased to announce that the Seventh Annual NABIS Conference on Brain Injury will be held at the Austin Downtown Hilton Hotel in Austin, Texas. This year NABIS will be holding a full-day Pediatric Symposium on Brain Injury on Wednesday, October 14, 2009, with the full Conference taking place from Thursday, October 15, through Saturday, October 17, 2009.

Bursaries Awarded to Students

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- By Yvan Michel Teasdale

On July 11th at the National Conference held at Villa St Martin in Pierrefonds, Quebec , our President Shirley Johnson and Yvan Teasdale, Chair of the Government Relations and Public Affairs Committee, presented a $2,000 Bursary to Phillip Roy, a student at the Université du Québec at Rimouski in the presence of his proud mother Manon Lefort. Phillip is pursuing a master’s degree in Management of Maritime resources.

A second $2,000 bursary will be awarded to Akira Peters of Yukon who is pursuing an Honours BA in English and History at the University of Saskatchewan.

The Selection Committee composed of Board of Directors, namely, Marina White (Nfld & L.), Larry Carlson (Sask.) and Yvan Teasdale (Que.) had the difficult task of selecting only two candidates for the second edition of a $2,000 Bursary Program awarded to brain injury survivors pursuing post-secondary education opportunities in an English or French institution or apprenticeship/trades program in Canada.

Upon learning that he would be receiving a bursary, Phillip said: ‘’I danced in joy when I learned that I qualified for a bursary’’.

Congratulations to the selected candidates! We wish them success in their endeavours and we will follow their progress with interest.

If you were not selected this year, please try again, or, if you did not apply, you should consider doing so in time for the 2010-2011 school year. If you are applying using the BIAC online application or BIAC’s application form, you must send it by April 30th of the given year. Bursary information will be posted on our website.

A rich and varied portfolio in brain bank

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By MARK KRAM
Philadelphia Daily News

kramm@phillynews.com

BEDFORD, Mass. – Up on a shelf at the Boston University Brain Bank at the Veterans Administration Hospital are a row of large jars, each with a human brain that has been set in a liquid fixative. To the casual observer, the inert matter on display looks like something on the order of strawberry yogurt. None of them is the same size or shape.

“Every one of them is different,” says Dr. Ann McKee, a neuropathologist who oversees the BU Brain Bank. “In fact, brains are like faces in that no two are ever alike.”

The BU Brain Bank is one of 40 or so in the United States – approximately 30 of which are dedicated to the study of Alzheimer’s disease, and another 10 of which specialize in the investigation of other diseases. But McKee says the BU Brain Bank is the only one that has undertaken a longitudinal assessment of athletes. In conjunction with the Sports Legacy Institute, founded by former Harvard football player Chris Nowinski and neurosurgeon Dr. Robert Cantu to study the effects of concussion, the Center for the Study of Traumatic Encephalopathy operates out of here under the supervision of McKee, who has teamed with Nowinski, Cantu and BU associate neurology professor Dr. Robert Stern as co-directors of CSTE.

Located in an unassuming brick building, which houses a staff that includes McKee and four others, the BU Brain Bank is the repository of 1,000 brains: 400 are kept as “fixed specimens” while 600 or so are stored in freezers at a minus-80 degrees. McKee says that when the brains come in, they are photographed, weighed and bisected. One part is flash frozen with dry ice and transferred to a freezer, which is jammed with plastic bags full of brain specimens that have been carefully inventoried.

“Storage is a continual problem,” McKee says. “We keep having to buy new freezers. We had some problem with one being temperamental and we had to do some juggling. But they are back up now.”

So how long are the brains preserved?

McKee says, “Indefinitely. Researchers will have access to these brains years from now.”

Seventy percent of the donated brains were afflicted with Alzheimer’s disease, 20 percent had other diseases and 10 percent are “control specimens,” which is to say they came from a person who died while considered still cognitively intact. McKee says “controls” are especially valuable, if only because they are generally so hard to come by.

“We need ‘controls’ to compare them with the diseases we see,” McKee says. “The problem is that you have to be studied during life, you have to come in periodically and be evaluated to be certain that you are functionally normally. So that takes an altruistic person.”

Up in the hallway are enlarged photographs of some of the cases McKee has worked on: One is of the brain of a boxer, another the brain of a football player and still another shows just how far brain science has come in 50 years. It is the photograph of a brain that had been savaged by a prefrontal lobotomy, a hideous procedure developed for the treatment of mental health issues and for which neurosurgeon Egas Moniz won a Nobel Prize in 1949.

“So that was where we were just 50 years ago,” McKee says. “Think of where we will be in another 50.” *

A look inside the brain

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A look inside the brain(pdf-1.5MB)

Special Report: Deadly Aftershocks: Donor List

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By Daily News

The Center for the Study of Traumatic Encephalopathy at the Boston University School of Medicine has lined up a number of professional and amateur athletes who have agreed to donate their brains upon their death. Currently, there are 116 donors (68 pro athletes, 48 amateurs). These are the names of the athletes who have allowed their names to be used publicly.

NFL
Ted Johnson
Joe DeLamielleure
Isaiah Kacyvenski
Ben Lynch
Bernie Parrish
Ralph Wenzel
Frank Wycheck
Bruce Laird
Brent Boyd
Mel Owens
Dan Pastorini
Billy Ray Smith
Ken Gray
Barry “J.B.” Brown
James Houston
Chad Levitt
David Long
Harry Jacobs

NHL
Keith Primeau
Noah Welch
Steve Heinze
Ryan Vandenbussche

NBA
Paul Grant
Malcolm Huckaby

Soccer
Cindy Parlow

Pro wrestling
Rob Van Dam
Lance Storm
Chris Nowinski
Tom Materas

Swimming -
Jenny Thompson

Boxing
Termite Watkins

Special Report: Deadly Aftershocks: NFL’s Concussion Study

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by Daily News

The NFL MTBI (mild-traumatic brain injury) Committee, which was established in 1994, is studying to determine if there are any long-term effects of concussions on retired NFL players. NFL-funded concussion research directed by the MTBI Committee has led to the publication of peer-reviewed scientific papers and helped advance the understanding of concussions and player safety. Including:

* Analysis and definition of concussions: Using 3-D analysis of game video to define the velocity and orientation of impacts that cause concussion. Reconstructing game concussions to determine the head acceleration and forces causing injury. Determining game-actual impacts that cause concussion.

* Development and enforcement of rules to promote player safety: Assisting the league in developing rules to prevent unnecessary helmet impacts and spearing of players with head-down tackles. Defining the positions and impacts most vulnerable to concussion and emphasizing the need for protecting quarterbacks, receivers and defensive backs.

* Improved testing and other helmet-related developments: Defining standardized test procedures to evaluate new helmet design and providing information to the National Operating Committee on Standards for Athletic Equipment (NOCSAE) that led it to revise and update its testing standards. Developing test equipment and protocols for evaluating the safety performance of helmets for concussion. Encouraging objective evaluation of new helmets designed to lower the risk of concussion and encouraging research to further improve helmets in the future. Sharing testing information with helmet manufacturers and NOCSAE for use in their efforts to improve helmet design and safety.

* Understanding effects and management of concussions: Evaluating injury data to determine risks and treatment for concussion, repeat injury, player return to play, and other epidemiology of concussion. Defining post-concussion syndrome as well as investigating the recovery from the injury over time. Recommending that the management and evaluation of concussions be based upon the scientific medical assessment of physicians and not on arbitrary guidelines.

Special report: Deadly aftershocks: NFL concussion management

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by Daily News

In May 2007, the NFL outlined the standards (below) for concussion management, based on consensus medical recommentations. The standards were recommended by the NFL’s independent committee on mild-traumatic brain injury (MTBI) chaired by Dr. Ira Casson, of the Long Island Jewish Medical Center and the Albert Einstein School of Medicine, and Dr. David Viano, of Wayne State University.

* Medical decisions must always override competitive considerations.

* Neuropsychological baseline testing will be required for all NFL players, using a standardized test to establish an individual functional baseline. Neuropsychological testing cannot be used by itself to make clinical decisions. For players removed from games due to concussions, repeat testing will be done during the season to track recovery and to help decide when they can return to play. These players also will be re-tested against their baseline performance the following season at training camp.

* NFL team physicians and athletic trainers are to share the most up-to-date information on state-of-the-art care and management of concussions.

* The MTBI Committee will continue to operate as an independent group. The goal of the committee remains the advancement of scientific knowledge through well-conceived research to protect the health of NFL players and improve the safety of the game.

* A brochure will be distributed to help educate players and their families about concussions, including how to recognize symptoms and recommended treatment.

* Return-to-play decisions should continue to be made by team medical personnel using their expertise and professional judgment.

* The NFL rule requiring every player to wear a chin strap that is completely and properly buckled to the helmet will be strictly enforced.

* The NFL will establish a “whistle blower” system so that anyone may anonymously report any incident in which a doctor is pressured to return a player to play from a concussion or that a player with a concussion is pressured to play.

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