1. Sports Concussion

2. Football hits

3. President Obama
“You read some of these stories about college players who undergo some of these same problems with concussions and so forth and then have nothing to fall back on. That's something that I'd like to see the NCAA think about.
” -- President Barack Obama

4. President Obama
President Barack Obama says he's a football fan but that if he had a son, considering the impact the game has on its players, he would think long and hard before allowing his son to play.
Obama tells The New Republic that football fans are going to have to wrestle with the fact that the game will probably change over time to try to reduce the violence.
The president says that some of those changes might make football, in his words, "a bit less exciting" but that it will be much better for players.
"And those of us who are fans maybe won't have to examine our consciences quite as much," he said.
The interview appears in the Feb. 11, 2013 issue of The New Republic.

5. Old school? Leather helmets? No facemasks rule changes

6. Mike Ditka
Regarding playing with old-style helmets or no helmets at all:
“I don’t think people would strike with the head as much,” Ditka said, per the Tribune-Review. “You would learn to strike with the shoulder pads if you didn’t have a helmet on your head.”

7. Joe Paterno
“I have been saying (it) for 15 years,” Paterno said. “Then, you would get back to shoulder blocking and shoulder tackling, and you wouldn’t have all those heroes out there. Guys (would) have to worry about broken noses, knocked-out teeth, which we would like to prevent, but you don’t get anything for nothing.
“We used to have one single bar; now we have a weapon.”

8. Evolution of the Helmet
Video

9. Football Helmet Reconditioning
Video

10. States with Concussion Laws

11. Mild Traumatic Brain Injury
The term _______________________(MTBI) is used interchangeably with the term _______________.
An MTBI or concussion is defined as a ______________
__________________________________________________________________________________________________
MTBI is caused by a ____________________________. ________________________________This disturbance of brain function is typically associated with normal structural neuroimaging findings (i.e., CT scan, MRI).
MTBI results in a constellation of __________________
_________________________________________________________________________________________________.
Duration of symptoms is highly variable and may last from several ______________________________, or even longer in some cases.

12. Magnitude
An estimated _______of the _________traumatic brain injury (TBI)-related deaths, hospitalizations, and emergency department visits that occur each year are concussions or other forms of MTBI.
Approximately ____________________________
___________________________________ each year.
Most of these are MTBIs that are not treated in a ______________________________________.
Blasts are an important cause of MTBI among military personnel in war zones.
Direct medical costs and indirect costs such as lost productivity from ___________________________
______________________________________in 2000.

13. Magnitude, continued
Individuals with a history of concussion are _____________________________
____________________________________
Research shows that recovery time may be _________________________________.
Symptoms or deficits that continue beyond ____________________________of post-concussion syndrome.
With proper diagnosis and management, __________________________________

14. Causes Leading causes of MTBI (seen in emergency departments)
Falls;
Motor vehicle trauma;
Unintentionally struck by/against events;
Assaults; and
Sports.
Groups at highest risk for MTBI
Infants and children (ages 0 to 4);
Children and young adults (ages 5 to 24); and
Older adults (ages 75 or older).

15. Concussion Overview
A concussion is a disturbance in brain function that occurs following either a blow to the head or as a result of the violent shaking of the head.
In the United States, the annual incidence of ________________________________
___________________________________.
Estimates regarding the likelihood of an athlete in a contact sport experiencing a concussion may be as high as __________

16. Common Signs and Symptoms

17. Physical
Cognitive
Emotional
Sleep
• Headache • Nausea • Vomiting • Balance Problems • Dizziness • Visual Problems • Fatigue • Sensitivity to light • Sensitivity to noise • Numbness/Tingling • Dazed or Stunned
• Feeling mentally "foggy" • Feeling slowed down • Difficulty concentrating • Difficulty remembering • Forgetful of recent information or conversations • Confused about recent events • Answers questions slowly • Repeats questions
• Irritability • Sadness • More emotional • Nervousness
• Drowsiness • Sleeping less than usual • Sleeping more than usual • Trouble falling asleep

18. Study Shows…
In a University of Pittsburgh Medical Center (UPMC) study of high school and college athletes with concussion, _____
__________________________________________________________________________________________________________________________________________________________________________

19. Post-Concussion Syndrome
Although the majority of athletes who experience a concussion are likely to recover, an unknown number of these individuals may experience chronic cognitive and neurobehavioral difficulties related to recurrent injury. Symptoms may include:

20. Post-Concussion Syndrome, conintued
This constellation of symptoms is referred to “___________________________" and can be quite disabling for an athlete.
In some cases, such difficulties can be _____________________________.
In addition to Post-Concussion Syndrome, _______________________
________________________________________________________________________
Has led to approximately _____________
____________________________________.

21. Concussion Assessment
Upon ruling out more severe injury, acute evaluation continues with assessment of the concussion.
First, ___________________________
________________________________________________________________________
The identification of LOC can be very tricky, as the athlete may lose consciousness very briefly and this event may not be directly observed by others.

22. Concussion Assessment, continued
By definition, _____________________
_________________________________ and the athlete is unresponsive to external stimuli.
LOC is most obvious when an athlete makes ______________________ following a blow to the head.
Any athlete with documented LOC should be managed conservatively, and return to play is ___________________.

23. Concussion Assessment, continued
Although helpful in identifying more serious concerns (e.g. skull fracture, hematoma, contusion), traditional neurological and radiologic procedures, such as CT, MRI, and EEG, are not useful in identifying the effects of concussion.
Such tests are typically _______________
______________________________________________________________________________
The reason for this issue is that concussion is a metabolic rather than structural injury. Thus, structural neuroimaging techniques are insensitive to the effects of concussion.

24. Management
At the forefront of proper concussion management is the implementation of ______
______________________________________.
Such evaluation can help to objectively _____
___________________________________________________________________, thus preventing the cumulative effects of concussion.
Neurocognitive testing __________________
_____________________________________________________________________________________________________________________

25. Management, continued
Current management guidelines (i.e. Grade 1, 2, 3 of concussion) _________
__________________________________________________________________ that are in place to manage concussion.
As a result, there are currently _______
_____________________________________________________________________________________________________.

26. Recommendations

27. Recommendations, continued

28. Treatment
The goal of concussion treatment is to allow the brain injury to heal.
Treatment of concussions differs depending on the level of severity. Concussion treatment may include:
_______. Provide adequate time for recovery from a concussion. Do not rush back into daily activities for work or school.
____________________. Avoid activities that might jolt or jar your head. Never return to a sports activity until your doctor has given you clearance. Ask when it's safe to drive a car, ride a bike, work or play at heights, or use heavy equipment.
_______________________. Do not take medicines without your doctor's permission. This is especially true with aspirin, blood thinners, and drugs that cause drowsiness. Avoid the use of alcohol or illicit drugs.
Consult with a Credentialed ImPACT Consultant for a full recovery.

29. Recovery
Athletes who are not fully recovered from an initial concussion are ______________
________________________________________________________________________
Such difficulties are prevented if the athlete is allowed time to recover from a concussion and ___________________________________
_____________________________________
No athlete ____________________________
______________________________________________________________________________

30. SCAT3
______________________________________________________________________________________________________________________________
The SCAT3 score does not independently determine the diagnosis of a concussion, nor does it independently determine the injured athlete’s recovery or return to play status.
Such determination can only be made by a medical professional who has experience in the treatment of sport concussion. 

31. Subconcussive Hits
Research