For those who are interested, I highly recommend watching the 45-min press conference that Sidney Crosby (who sustained two hits to the head while playing hockey in January) and his doctors gave today. Lots of interesting and current information on his treatment and progress. Long story short: he sustained a very significant concussion, with fogginess, headaches, light and sound sensitivity, and vestibular issues. He's still experiencing headaches, but has improved a lot and his doctors (one of whom is Dr. Michael Collins in Pittsburgh) expect a full recovery. They're not providing a timeline for recovery, though.

I think it would be helpful for family members, friends and co-workers to see as well.

I watched it on www.tsn.ca, but it will no doubt be available on other websites.

apparently sid had a vestibular concussion. a lot of his symptoms were related to the inner ear. they're trying to bring back his visuo-spatial functioning. they expect him to return to 100% health.

according to neurosurgeons Michael Collins and Ted Carrick (both who were at today's press conference), "after he comes back, there will be no evidence that a concussion ever occured".

i've heard people post on here that "once concussed, always concussed", but i think that Drs. Mickey Collins' and Ted Carrick's words carry more weight.

don't give up. you all will get better.

I'm not sure the docs went that far in their response to the question about the risk of future concussions. If I remember correctly, Dr. Collins basically said that if Crosby waits until he's 100% before returning to the game, his risk of future concussions/complications would be significantly reduced. He implied that problems can arise when athletes return to play too soon. But he didn't say that Crosby's risk would be that of someone who had never sustained a concussion in the first place (and frankly, I doubt whether this is true).

Similarly, Dr. Carrick suggested that they could get Crosby's vestibular system working as well as it did prior to the injury (possibly even better, which I also found hard to believe), but - again, if I recall correctly - he didn't comment directly on the risks associated with a subsequent hit to the head.

One thing I found interesting was the talk about all the therapy and rehabilitation that Crosby has been undergoing in order to help him recover. This seems to contradict the prevailing idea that healing from a concussion simply requires time and rest. I would be interested to hear what therapies and exercises he's been doing to ameliorate his symptoms.

In a weird way, I found it encouraging that he's still dealing with headaches. If he can be at month 9 and still be coping with headaches, *and* his doctors are predicting a full recovery - well, that's good news, in a roundabout way.

Anyone know if the press conference will be replayed in full somewhere? News reports I've seen don't talk very much about the medical details of the concussion Sid had.

Here's a youtube video (in two parts) of the press conference:

http://www.youtube.com/watch?v=uCGQq9n_Jqw

http://www.youtube.com/watch?v=4BS15h1sA3s

Part three here: http://www.youtube.com/watch?v=4WxUCVT9fPU

confuused said

<i've heard people post on here that "once concussed, always concussed", but i think that Drs. Mickey Collins' and Ted Carrick's words carry more weight. >

Mickey Collins, Ph.D. has no evidence that his 'return to play' protocol causes a complete recovery. The 'complete recovery' criteria are never explained. Reading the context of such comments implies the 'completely recovered' means they are not symptomatic and appear to have all of their skills back to normal.

My "once concussed, always concussed" comment means that no matter how well one recovers, their brain will always show evidence of the concussion. It may not be readily obvious but there will be residual damage.

It will be most obvious after another concussion or sub-concussive impact. Their brain will be more sensitive to any impact or other stress. The science on this is decades old.

The key return to play criteria used by Mickey Collins is likely avoiding 'second impact syndrome' which can be deadly and regaining full coordination, judgment and executive functioning such that the athlete is not a risk due to these limited skills.

Michael Collins, Ph.D. was still in undergraduate school in 1989. He has his Ph.D. in neuropsychology.

Ted Carrick is a D.C. (doctor of chiropractic) with his Ph.D. in clinical neurology and has taught clinical neurology at two different chiropractic colleges. His goal is to restore lost function, not to specifically heal the brain.

Keep in mind that Collins specializes in sports rehabilitation. His goal is to return athletes to play. Carrick has had a specialty practice limited to the diagnosis and treatment of neurological disorders. They do not treat these athletes decades later, long after their athletic careers are over.

The anecdotes they offer never demonstrate 'complete recovery.' They may demonstrate 'return of function.' There is a big difference. Younger athletes have a better chance of 'return of function' that older subjects. The young brain is more pliable, especially up to about 25 years old. The older brain has a more difficult time relearning skills, both due to simple age and the cumulative effects of years of stresses and even minor, unnoticed injuries.

I have far more faith in Julian Bailes, M.D. and Robert Cantu, M.D. Their experience goes back decades and they are involved with research of athletes injured decades ago.

Does this mean that I believe there is no recovery from concussion? Not at all. Recovery is two fold. 1. Physical recovery from rest and retraining the brain 2. Functional recovery from learning new and different ways to accomplish tasks such as memory tricks, etc. to make up for skills that may be permanently lost due to the injury.

Either one alone will leave the person with a limited recovery.

in my opinion he shouldnt get back on the ice. theres to much risk involved

It is a tough call, no question. Some athletes have successfully returned to hockey after prolonged concussions. Others have sustained further concussions and have had significant problems later on. And as Mark points out, some of the effects may not be felt until years or decades later.

My doctor said that what we do know is subsequent concussions generally have longer-lasting and/or more severe symptoms. So if Crosby ends up being out for 10, 12, 14, 16 months or more, what effect is the next hit going to have on him?

I also wonder about Crosby's ability to withstand heavy/jarring body-checking, not just hits to the head. NHL hockey is a fast, physical game.

In any event, he's still young and has lots of time to work out what's best for his health and hockey career.

Thanks for posting the links. Very interesting.

I was surprised how his doctor mentioned that he would have zero sequela from his injury and that when fully healed he would not experience heightened symptoms from a second concussion. Really?

I'm not sure that I believe that. I agree with Mark's opinions on the matter.

I have not experienced a second concussion with a onset of PCS but with what I have read on here from people's personal experiences I would say that may be incorrect.

He also mentioned that he still has headaches and other symptoms but is still "more likely" to play this season than "unlikely". Wow! I sure hope that he waits.

I feel sick to my stomach thinking about him going back out on the ice and maybe getting hit.

Thank you again for the links!