This is the Reason Concussions Are Better Recognized

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Are Concussions Happening More Frequently or Better Diagnosed?

Interviewer: It seems like we hear so much more about them now versus when I was younger and playing sports. We never used to hear about the bright lights bothering people. It was always someone got their bell rung and they would get back in there. Why are we hearing so much more about the symptoms and just concussions in general now?

Dr. Maroon: Well, so much of this is associated with the documentation in 2005 by a neuropathologist in Pittsburgh by the name of Bennet Omalu who examined the brain of Michael Webster who was an all-pro center for the Pittsburgh Steelers and Mike in the last several years of his life was very depressed, very disturbed and end up living in the back of a truck. It was a tragic situation.

Interviewer: Mm-hmm.

Dr. Maroon: No one really understood this that well, but when Dr. Omalu looked at the brain he found abnormalities that were in the . . . prior to that really only associated with dementia pugilistica prize fighter syndrome.

Interviewer: Mm-hmm.

Dr. Maroon: The punch drunk syndrome. This involves a degenerative process in which there are tangles that develop in the brain that lead to degeneration somewhat like Alzheimer's disease or Parkinson's disease and this was the epinem was given to chronic traumatic encephalopathy. Since then, you can't turn on the TV or listen to ESPN or pick up a newspaper without reading about some athlete who like Tony Dorsett recently.

Interviewer: Mm-hmm.

Dr. Maroon: Was said to have this particular condition or Junior [inaudible 00:02:03], athletes who have ended their lives and actually had their brain subsequently examined in Boston by the Boston Group and this particular entity was found.

Interviewer: Mm-hmm.

Dr. Maroon: So, just a few cases actually. I think something like 63 cases reported in football. Boxing, significantly higher, but the implication has been that if you play a contact, if you play football in particular that this is something that happens at a relatively frequent rate. So, the trickledown effect from the NFL is so powerful in so many ways. Positive and negative.

Interviewer: Mm-hmm.

Dr. Maroon: The negative aspect of this is that it's impacted youth football. There are 2,200 NFL players. There are about 4.8 million kids in Pop Warner USA football, college, high school that are playing football that this has never been reported in. So, the emphasis has been on the negative which has resulted in some positive things happening about earlier diagnosis and proper management which ends up being the real key to the concussions is proper management. Not going back before the brain has had time to heal.

Interviewer: Are there different degrees of concussion?

Dr. Maroon: Well, in the past concussions were classified as Grade One, Two or Three with Grade One being mild and Grade Three being severe and often predicated on whether or not there was loss of consciousness.

Interviewer: Okay.

Dr. Maroon: We know that doesn't apply. Those are manufactured classifications that . . . you can have loss of consciousness and recover in a few days or a week or so and have absolutely no symptomatology.

Interviewer: Mm-hmm.

Dr. Maroon: You can have just a glancing blow to the head and be permanently disabled for a matter of months. So, the grades, the gradation are no longer used.

Interviewer: Mm-hmm.

Dr. Maroon: It's described on the symptoms and in the subsequent follow-up.
It wasn't long ago, nobody knew what a concussion was. Athletes and others would 'get their bell rung' and quickly get back into what ever their activity was. Today much more is known about concussions and you hear about them all the time. Why has this all changed? Dr. Joseph Maroon, head neurosurgeon of the Pittsburgh Steelers explains how concussions became the bigger issue they are today.

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