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4 years ago
The high speed at which hockey is played will result inevitably in some collisions. If a junior hockey player has a concussion, its presents a dilemma for him whether to continue play.

Choose one region of the brain and explain how a concussion to that region might affect the individual.

Give one point for and one point as a counter argument for why this player should not play hockey again.

Describe a technology that could be used to assess the brain area affected and the extent of damage sustained.
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wrote...
4 years ago
Choose one region of the brain and explain how a concussion to that region might affect the individual.

When traumatic brain injury occurs to the frontal area, it is impacting the brain’s largest lobe. Located at the front of each cerebral hemisphere, this lobe is responsible for conscious thought, voluntary movement, and individual personality characteristics. When you are searching for just the right word to say, it is this section of the brain upon which you rely.

Damage to this vital lobe can cause impairments in judgment, attention span and organizational ability, as well as a loss of motivation. In addition, the frontal lobes are charged with the task of regulating mood and emotions. Consequently, when they are compromised, a patient may become impulsive, act rashly, and adopt risky behaviors such as substance abuse.

To learn about the effects of multiple concussions, review this link: http://www.ncbi.nlm.nih.gov/books/NBK185336/
wrote...
4 years ago
Primary head injury can be catastrophic, but the effects of repetitive head injuries must also be considered. Second-impact syndrome (SIS), a term coined in 1984, describes the situation in which an individual sustains a second head injury before the symptoms from the first head injury have resolved.

The second injury may occur from days to weeks following the first. Loss of consciousness is not a requirement of this condition, the impact may seem relatively mild, and the athlete may appear only dazed initially. However, this second impact causes cerebral edema and herniation, leading to collapse and death within minutes. Only 17 cases of confirmed SIS have been reported in the medical literature. Thus, the true risk and pathophysiology of SIS has not been clearly established.

Importantly, even if the effects of the initial brain injury have already resolved (6-18 mo post injury), the effect of multiple concussions over time remains significant and can result in long-term neurologic and functional deficits. These multiple brain insults can still be termed repetitive head injury syndrome, but they do not fit the classification of SIS. True SIS would most likely have a devastating outcome.

A study of American high school and college football players demonstrated 94 catastrophic head injuries (significant intracranial bleeding or edema) over a 13-year period. Of these, only 2 occurred at the college level. Seventy-one percent of high school players suffering such injuries had a previous concussion in the same season, with 39% playing with residual symptoms. On the other hand, results from a study of concussion by the National Football League demonstrated no cases of SIS or catastrophic head injury in players returning to play in the same game after resolution of symptoms.

The outcome of multiple minor head injuries over a prolonged period has not been well studied and is not well understood. The preponderance of data assessing the impact of repetitive head injuries on short- and long-term neurologic (cognitive) performance has been focused on the sports of boxing and American football.

Numerous studies of professional boxers have shown that repeated brain injury can lead to chronic encephalopathy, termed dementia pugilistica. Likewise, the autopsies of 2 former professional football players with a history multiple concussions demonstrated changes that were consistent with chronic encephalopathy. Another investigation of retired professional football players showed a 3-fold increase of depression in players with a history of 3 or more concussions. Older studies of American and Australian rules football showed no effect from repetitive mild head injuries. However, more recent studies of collegiate football players showed an association between multiple concussions and reduced cognitive performance, prolonged recovery, and the increased likelihood of subsequent concussions.

Evidence has also been gleaned from other sports that involve head impact. Nonrandomized studies of soccer players who have had multiple minor concussions have demonstrated that these individuals performed worse on neuropsychologic tests compared with a control group.

Neuropsychologic testing is the standard for monitoring cognitive recovery after concussion. However, 2 studies suggest that abnormalities in visual motor and motor cortex function persist after neuropsychologic testing has normalized.[8, 20] Slower recovery in patients with a second concussion was also seen.

Basic science research is also ongoing. Experiments in concussed rats demonstrated prolonged abnormalities in metabolic markers of brain activity when a second impact was administered at 3 days. This implies there may be a metabolic window of vulnerability to a second impact that leads to chronic or prolonged symptoms. Clinically useful biomarkers for brain injury are also being investigated.
wrote...
3 years ago
Do you know the technology that can be used to asses the damage?
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