Tackling damage of concussions

NFL, critics ponder long-term problems of multiple head injuries

October 14, 2007|By Ken Murray | Ken Murray,Sun reporter

Even though the NFL revised guidelines on managing concussions in the offseason, league critics believe it hasn't gone far enough to reduce the risk of permanent or long-term injury.

Recent concussions suffered by Trent Green of the Miami Dolphins and Jon Kitna of the Detroit Lions serve as cautionary tales, those critics say.

Green suffered his second severe concussion in 13 months last Sunday when he took a knee to the right side of his head. He is out indefinitely.

Kitna was removed from a Week 2 game, only to return in the second half to lead the Lions to a win over the Minnesota Vikings.

"Kitna shows that anything goes, everybody can go back in the game, and [the NFL] is not going to follow any national guidelines," said Dr. William Barr, chief of neuropsychology at the NYU School of Medicine. "Green shows there is a cumulative effect [with multiple concussions]."

The NFL held a medical conference in June to explore concussion management. Invited were physicians and athletic trainers from every team, representatives from the NFL Players Association and experts from outside the league, including Barr.

The upshot was that the league said a player should have normal neurological test results before returning to play, and that a player who suffered loss of consciousness would not be allowed to return to the same game.

Dr. Julian Bailes, chairman of the department of neurosurgery at West Virginia University and an invitee to the NFL summit, thinks the NFL should not allow any player who has endured a concussion to return to the same game.

"The latest research shows you can't grade a concussion at the time it occurs," Bailes said. "A lot of times a player will have a brief loss of consciousness and not have aftereffects. And a lot of times, they're not knocked out, but have ongoing symptoms for days or weeks.

"What's the point in returning to play the same day? It's like saying you can have a brain injury at 2 o'clock and it's OK to go back at 3 to hit your head some more."

Barr said that the mere fact there is speculation Green's latest concussion will end his career lends credence to the belief there is cumulative damage with multiple concussions.

"If multiple concussions aren't a big deal, why is that even coming up?" Barr asked. "It is a big deal. We all know why he got that concussion."

The NFL's concussion committee conducted a six-year study and drew the conclusion there was no cumulative damage incurred.

Dr. Andrew Tucker, the Ravens' team physician and a member of the committee, said he wasn't prepared to say definitively there is no cumulative damage.

"I'm not saying that, and I don't think our committee would say that," Tucker said. "We have to be consistent with what our data says. In that six-year period, it was reassuring that the players who suffered repeated concussions did not demonstrate any decrease in function over that time, based on physical examinations and neuropsychological testing.

"But any of us who take care of athletes who sustain concussions are interested in the possibility that [concussed] athletes may have trouble down the road."

The concussion committee recently launched a study of retired players to determine the risk of long-term damage with repeated concussions.

ken.murray@baltsun.com

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