In a recent article, the Wall Street Journal reported that the NCAA, in partnership with the U.S. Department of Defense, is undertaking a 3 year $30 million dollar study pertaining to head injuries and concussions. Of note, the NCAA has already agreed to pay $75 million to settle a class action lawsuit over concussion related claims.

They intend to place sensors in the helmets where the sport requires helmets, and directly on the skin where the sport doesn’t require helmets. These sensors measure the “hit count” and the forces associated with the individual hits. They will utilize special MRI imaging, and have blood work drawn to help identify any biomarkers that may be diagnostic of concussions.

The wall street Journal reported that “If the person doesn’t drop to the ground and lie there unconscious, it’s not always clear whether they have a concussion,” said Thomas W. McAllister, chairman of the department of psychiatry at Indiana University School of Medicine, who is one of the principal investigators in the concussion study. “We rely on the athlete to self-report. Most don’t want to report.” and “The problem is athletes who want to get back in a game may inadvertently or intentionally provide misleading information.” This is not the gold standard in concussion management, we are far beyond what these statements suggest.

This study has the potential to add to our traumatic head injury database and help a lot of athletes and soldiers, but some of the NCAA responses suggest that they may be a little behind the curve on the state of the art on concussion identification and treatment. Sure we need to learn more, but we already have strategies to prevent, identify, and treat concussion in athletes.

  1. Baseline testing is an important tool to assess what may be subtle changes associated with concussions.
  2. The threshold for re-injury is lower until the concussion has resolved.
  3. There is no blood test, or conventional CT or MRI that will reliably identify concussions- yet
  4. Proper technique and coaching has been shown to reduce the number of catastrophic head and spinal cord injuries.
  5. The vast minority of concussions do NOT involve loss of consciousness.

I applaud further organized study, but lets not forget that we already know that a complete and up to date concussion education and monitoring program coupled with baseline testing and evaluation by an experienced physician for injured or possibly injured athletes has been proven to improve outcome in these injured athletes.

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