Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 12-13-2011, 04:29 PM #1
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Default Articles on how previous concussions make future ones more likely

I mentioned in another thread I had found various articles about increased susceptibility to head injuries following concussion, even after supposed 100% recovery. Couldn't re-find them all, but here are some. For me my PCS seems to be slowly lifting at last and I am optimistic of feeling completely normal at some point in the next 6 months. However these articles show why I will never play a contact sport again, however recovered I feel.

1. Large study in the Journal of the American Medical Association article "Cumulative Effects Associated With Recurrent Concussion in Collegiate Football Players":-

Quote:
Conclusions Our study suggests that players with a history of previous concussions are more likely to have future concussive injuries than those with no history; 1 in 15 players with a concussion may have additional concussions in the same playing season; and previous concussions may be associated with slower recovery of neurological function.
http://jama.ama-assn.org/content/290/19/2549.full

2. Men's health article discussing the above study along with various other findings and the thoughts of affected athletes:-

http://www.menshealth.com/fitness/yo...le-concussions

3. Medscape article on 'Repetitive Head injury Syndrome'

Quote:
Importantly, even if the effects of the initial brain injury have already resolved (6-18 mo post injury), the effect of multiple concussions over time remains significant and can result in long-term neurologic and functional deficits.
http://emedicine.medscape.com/article/92189-overview

4. Legal article on 'Proving Mild Traumatic Brain Injury', taking susceptibility to further concussions later in life as a legal given which makes proving blame for a specific head injury problematic:-

Quote:
However, research shows that one concussion -- even if it caused the victim no lasting symptoms -- leaves the victim at risk of permanent symptoms should he receive another concussion. That is why professional football players retire after receiving multiple concussions despite "feeling fine", and why boxers who don't retire eventually become "punch drunk."
http://www.capersonalinjurycaselawno...-brain-injury/

5. Article from British Journal of Psychiatry on PCS. This article was really helpful to me early on, but does also mention previous concussions as a risk factor:-

Quote:
Other evidence suggestive of organic factors includes the following: slower recovery with increased age (cut-off at around 40 years) ( Binder, 1986); poorer outcome and a cumulative effect of previous and successive mild head injuries ( Gronwall & Wrightson, 1975); and poorer outcome with a history of alcohol or substance misuse ( Lishman, 1988).
http://bjp.rcpsych.org/content/183/4/276.full
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Old 12-13-2011, 06:22 PM #2
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That last article written by Gronwall and Wrightson was from research done in the early 1970's. Dorothy Gronwall of New Zealand has a long history of understanding concussions. It has taken the rest of the concussion diagnostics and care communities decades to start to reach the level of understanding that she was publishing in thew 1970's. Even Dr Cantu and Dr Bailles were late to the party with their work in the 1990's. Dr Gronwall was republishing her articles in the 1990's.

Nobody has done the level of research that she did way back then. The only significant research done since hers was done by a pathologist (Bennet I Omalu MD) in Boston who discovered CTE (Chronic Traumatic Encephalopathy) in football players brains after their death.

We still have most doctors misdiagnosing and under-estimating the damage done by concussions.

Unfortunately, Dr Gronwall passed away from a brain aneurism in 2001 at the age of 70. Here is the obituary published in the newsletter of the Neurological Foundation of New Zealand
Dorothy Gronwall, PhD, OBE, died suddenly in Auckland New Zealand on 29 October 2001, at the age of 70.
Dorothy Gronwall was recognized internationally for her pioneering research on traumatic brain injury (TBI), and the extended effects of concussion, as well as for her 30 years of ongoingresearch into the epidemiology, causes, effects, management and rehabilitation of TBI. Within New Zealand she campaigned tirelessly for the victims of TBI, and established clinical neuropsychology as an advanced specialty here. She continued to work as a
clinician until her 70th birthday, and over a 30-year period improved the lives of many hundreds of patients through her assessment, counselling and
rehabilitation. In 1993 in the Queen’s Birthday Honours she was made an Officer of the Order of the British Empire for her services to clinical neuropsychology.
Dorothy supervised the research of numerous Auckland University psychology students, stimulating the careers of many research and clinical neuropsychologists. Entry to her postgraduate course inclinical neuropsychology, established in the mid-1970s, became highly competitive, in spite of its staggering workload! Student end-of-year evaluations
consistently judged the course as outstanding, and Dorothy’s fearsome teaching style was balanced by dinners in her home, where the entire class enjoyed her wonderful cuisine, as well as her delightful sense of humour. Dorothy’s neuropsychology course is still taught today, following the same demanding formula and resulting in a regular stream of students with a passion for clinical neuropsychology.
Gronwall and Wrightson’s research on TBI was pivotal in proving that the PCS was a physicallybased disorder that could result in years of difficulties for the TBI victims and their families if it was not understood and rehabilitated. It was no easy task to convince health providers of this, and Dorothy’s feistiness and bull-headedness were frequently required in the ongoing battle for TBI victims. Dorothy was an unassuming celebrity, and her reputation in the international research arena was never fully recognised in NZ.
Dorothy was a truly remarkable woman who made a deep impact on neuropsychology through her research, teaching, and clinical contributions.
She leaves behind three daughters, Karen, Sherrie and Debra, two sons-in-law, and eight grandchildren.
Our deepest sympathy goes out to them in their very
sad loss.
A trust fund has been set up to establish a “Dorothy Gronwall Memorial Prize” for the top student in Clinical Neuropsychology at the University of Auckland. This will be presented annually along with a biography of Dorothy and a list of the people and institutions that have donated to the trust in her memory. Donations may be sent to “The Dorothy Gronwall Memorial Prize Fund” at the National Office, PO Box 11 00 22, Auckland. New Zealand
Jenni A Ogden, PhD
Associate Professor in Psychology
University of Auckland

Much of my understanding of concussions was started by reading her work. The PASAT (Paced Audio Serial Addition Test) that she and her colleagues developed in the 1970's is still used today.
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Old 12-16-2011, 02:41 PM #3
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She sounds cool.

Will have a look, thanks
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Old 12-16-2011, 10:00 PM #4
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Never mind contact sports, I don't think I will ever do any winter sport (except maybe cross-country skiing) or ride a roller coaster again...

And certainly no trampoline jumping! I'm even a little afraid to skip.
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mTBI and PCS after sledding accident 1-17-2011

Was experiencing:
Persistent headaches, fatigue, slowed cognitive functions, depression
Symptoms exacerbated by being in a crowd, watching TV, driving, other miscellaneous stress & sensory overload
Sciatica/piriformis syndrome with numbness & loss of reflex


Largely recovered after participating in Nedley Depression Recovery Program March 2012:

.


Eowyn Rides Again: My Journey Back from Concussion

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