Something to think about during playoffs

Slate’s Shankar Vedantam:

Newfound concern about the wellbeing of football players has focused on the tip of a very large iceberg. Parents, schools, and athletes worry that thousands of amateurs each year may be suffering head injuries similar to the ones that make us gasp during NFL games. But there’s a worse possibility: The most serious brain injuries at all levels of the sport are going completely undiagnosed and undetected. It gives me no pleasure to say this. I am a fan who eagerly awaits game day and the ultimate redemption of my long-suffering team.

Today we worry more about high-impact strikes to the head than about repetitive blows of moderate intensity. We think the only players who suffer brain injuries during collisions are the ones who later look dazed, or who can’t keep their balance, or who suffer from slurred speech and vision.

The Purdue research changes all that. Many brain injuries suffered by football players do not produce the “shell-shock” symptoms we associate with concussions. The damage caused by these hits is just as evident when you study players in brain scanners or give them tests that measure sophisticated aspects of brain functioning, but are not picked up by trainers on the sidelines.

The finding about a new group of brain injuries came about, like many discoveries, by accident. Purdue biomedical engineering professor Eric Nauman and his colleagues were studying garden-variety concussions among high-schoolers—hits similar to this one and this one and this one during NFL games.

Nauman and his colleagues wanted to compare changes in the brains of football players who had suffered concussions with the “normal” brains of football players who were concussion-free. But when they scanned the concussion-free players a few weeks into the season and compared these pictures to the same players’ preseason scans, they found that many had long-lasting brain changes.

“At first we thought our scanner was broken,” Nauman said during a recent presentation of his findings to a group of journalists. “Then we realized this was a new group of impaired players.”

Nauman calculates there are about 1 million high-school football players in any given year in the United States. There are some 67,000 reported concussions, and probably about as many that go unreported because fans, coaches, and parents don’t want a star athlete pulled from a game. But among the supposedly injury-free remainder, the Purdue researchers believe tens of thousands of athletes routinely suffer serious brain injuries from high-impact collisions intrinsic to the game.

Giffords’ prognosis

Via MSNBC’s  JoNel Aleccia:

“She’s still critically ill,” said Dr. Alex Valadka, a neurosurgeon and spokesman for the American Association of Neurological Surgeons. “We get excited when people hold up a couple of fingers, but that’s a long way from higher functioning.”

Doctors at University Medical Center in Tucson, Ariz., said they were cautiously optimistic about Giffords’ prognosis a day after she was shot at point-blank range at a public gathering in a supermarket parking lot. Dr. G. Michael Lemole Jr., chief of neurosurgery, said he removed a large piece of Giffords’ skull to accommodate swelling caused after the bullet traveled — back to front — the entire length of the left side of her brain.

Lemole said Giffords is likely to remain in intensive care for a week or so, in the hospital for a couple more weeks and then face a long rehabiliation period. He didn’t want to speculate about her chances for recovery.

“We’ve seen the full gamut,” he said.

People who suffer penetrating traumatic brain injuries often develop paralysis and cognitive problems. The left side of the brain is typically responsible for speech and controls the right side of the body, Valadka explained, noting that most people are right-handed.

Giffords was fortunate that the bullet did not cross the geometric center of the brain, said Lemole. Early reports indicated she might have been shot in one temple with the bullet exiting the other, but Lemole said the single shot entered in the back and exited the front.

One is brought to mind of Phineas Gage; someone walked away from his accident, but it was not the Phineas Gage his intimates had known.