Tag Archives: TBI

When Bats Attack: New Design Should Improve Safety

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Collegiate ballplayers like this athlete from the U.S. Air Force Academy started using the redesigned bats in 2011. Image courtesy Wikimedia Commons/Danny Meyer, USAF/Public Domain

Doctors  know about concussions from football, lacrosse, hockey, and similar contact sports, but what about baseball? Apparently, aluminum baseball bats have been implicated in severe injuries and even deaths in school-aged children.

How? It comes down to physics. According to researchers at Washington University in St. Louis, the aluminum bats currently in use can cause the baseball to rebound so quickly, and with so much force, that even an attentive pitcher can’t always get out of the way in time.  In a tragic example, they cited the 2010 death of a 13-year-old pitcher in Vermont — killed by a line drive off an aluminum bat — and noted there have been other reports of similar fatalities.

To cut down on the risk of serious injuries and deaths from hard-hit line drives, the National Collegiate Athletic Association last season started mandating the use of a new style of aluminum bat. The new bat is engineered to put less energy behind the ball once it’s hit, so it is less likely to cause serious harm.

Here’s one of the researchers explaining of the features of the new bat:

This year, the new bats will be used by high school players as well. The National Federation of State High School Associations will enforce the use of the new bats, so ideally the hazards of school baseball will be limited to bug bites and sore jaws from hours of gum-chewing in the outfield.

–Heidi Splete (@hsplete on Twitter)

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Filed under Family Medicine, Pediatrics, Sports Medicine, Video

Sports concussions leave sneaky side effects

When he was a teenage lacrosse player, Dr. Brandon Cornejo suffered a mild concussion. He was awake during the trip to the hospital in his parents’ car. And he painfully recalls the resulting cognitive and emotional side effects that messed him up academically, socially, and psychologically.

Lacross sticks image by Yarnalgo (Wikimedia Commons).

The worst part, though, was that he spent 16 years not even knowing he had suffered the traumatic brain injury, because he had no memory of it. He wasn’t aware of a “before” or “after” the injury, so he didn’t know that his struggles were caused by the concussion. Instead he blamed himself, floundering in anger, confusion and depression.

Now a chief resident in psychiatry at the University of Wisconsin, Madison, Dr. Cornejo told his story at the annual meeting of the American Psychiatric Association to impress upon his colleagues the challenges of helping patients with traumatic brain injury, especially athletes.

“These mild injuries can have profound effects on your self-concept and your experience as a human being. They can change the course of your life,” he said.

In 1991, he was a straight-A student in his junior year at a college preparatory high school and the son of proud Latino parents who had never attended college themselves. He and his family were looking forward to him getting a scholarship to finance college.

Dr. Cornejo (Photo by Sherry Boschert)

After the concussion, his grades tanked. He barely got by with Cs and Ds. His girlfriend dumped him. He became very emotional. He remembers 6-9 months of bad fights with his parents. “The likelihood is pretty high that this was related to the loss of consciousness,” he said. “For years, I considered myself `not good at’ certain things because of my academic performance in my senior year.”

His behavior frustrated and shocked him. One time he exploded in “road rage,” which embarrassed him even though no one was there to witness it. Another time when he was ordering oatmeal in a restaurant, he could not recall the words for brown sugar.

“I developed a significant depression, a huge depression. In retrospect, I have a hard time distinguishing between depression produced by traumatic brain injury and depression because I wasn’t performing academically. My family was counting on” a scholarship, he said. That motivation and a lot of hard work eventually got him back on track academically, and somewhere in his freshman year of college he started to regain some self-esteem.

Years later, in 2007, his father casually said, “Remember that time you got knocked out, and we took you to the hospital?” Dr. Cornejo could dredge up only two memories — one of his coach staring down on him on the field, and the other of being in the back seat of the family car, with his mother saying, “Brandon, you’re really scaring us. Why do you keep repeating yourself?”

At the time of the injury in 1991, understanding of traumatic brain injury was just beginning to emerge, and the primary care physician who saw him for follow-up told his parents that their son should be fine, and they should keep an eye on him for a couple of weeks.

Today, Dr. Cornejo hopes that physicians would not allow young athletes with traumatic brain injury to return to play as quickly as he did, because repeat concussions carry much higher risks. He wishes that helmet designers would improve their products. And he urges all physicians to educate not only patients but their families and significant others about the potential sequelae of traumatic brain injury.

Because the patients may not remember.

–Sherry Boschert  @SherryBoschert on Twitter

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Filed under Family Medicine, IMNG, Internal Medicine, Neurology and Neurological Surgery, Pediatrics, Psychiatry, Sports Medicine, Uncategorized

Video of the Week: Is Traumatic Brain Injury a Chronic Condition?

Recent evidence suggests that traumatic brain injury is a chronic, rather than an acute condition — which can have psychological effects on patients and their families indefinitely. Dr. David K. Menon of the University of Cambridge talked with our reporter Heidi Splete about the challenges of assessing and treating TBI as a chronic disease at the annual meeting of the American Association for the Advancement of Science.

While you’re online, don’t forget to check out our newest Web sites: Family Practice News and Clinical Psychiatry News.

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Filed under Family Medicine, IMNG, Internal Medicine, Neurology and Neurological Surgery, Pediatrics, Primary care, Psychiatry, Video

Mental Health Providers: Uncle Sam Wants YOU

If the sheer volume of returning service men and women in crisis is not compelling enough reason for community-based mental health providers to join their military counterparts in the battle against post-traumatic stress disorder and traumatic brain injury, the opportunity to wear fatigues to work just might be.

“The uniforms have lots of pockets and you don’t have to shine your boots,” quipped Col. Elspeth Cameron Ritchie, M.D., M.P.H.,  the director of behavioral health proponency in the Office of the U.S. Army Surgeon General.

Image via Flickr user Nevada Tumbleweed by Creative Commons License

Clad in Army camouflage, Col. Ritchie made an impassioned recruitment pitch to clinicians and researchers attending a conference sponsored by Massachusetts General Hospital over the weekend titled “Complexities and Challenges of PTSD and TBI.”

In order to meet the increasing mental health needs of soldiers returning from Iraq (Operation Iraqi Freedom) and Afghanistan (Operation Enduring Freedom), “we have to partner with the community,” she said. While stressing that the Veterans Administration and the Department of Defense have implemented programs focused on mental health risk assessment, resiliency building, and treatment accessibility, the demand for available services far outpaces the military’s supply. In other words, she said, “We need YOU.”

And if you don’t want to wear a uniform, “there are a variety of different ways to come in,” Col Ritchie stressed. “For example, we’ve been working very closely with the U.S. Public Health Service, which is now giving us [mental health] providers at our facilities, so you could join the PHS,” she said. Or, at the very least, she urged attendees to sign up for TRICARE, the contracted health care plan  for service members and their families. “I know TRICARE is not an easy system to live with, but registering for it can let us get soldiers to you.”

The bottom line, Col. Ritchie stated, is that the U.S. military is at a crossroads with respect to meeting service members’ mental health needs “All of the low-hanging fruit has been picked,” she said. In order to meet the continuing challenges and to forge ahead, “we need to engage in a national dialogue, including the civilian community.”

—Diana Mahoney
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Filed under Family Medicine, Health Policy, health reform, IMNG, Primary care, Psychiatry, Uncategorized