What We Know, and Don’t Know, About Concussions
As area physicians and legislators grapple with the long-term impacts of concussions, one Northwestern doctor admits much of it remains mysterious
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In some cases, the so-called second-impact syndrome can be fatal.
During a football game last October, an opposing player head-butted Jordan Sawyer, a six-foot-two, 220-pound offensive lineman at Chicago’s Walter Payton College Prep High School. “There was one giant blow where my head just hurt,” he says. “[It] was really killing me.”
At the time, Sawyer, then 17, didn’t think much of it. After all, unlike his friends who had suffered a concussion, he did not feel dizzy or throw up. So he put some ice on his head and played the second half of the game.
That weekend, Sawyer’s mother, Marla Kushner, a volunteer team doctor at the school, made sure her son took a cognitive test—and the results showed that he had a concussion. The following Monday in school, the normally nimble linguist had trouble focusing on words. That same day, Sawyer saw a neurologist, and for a while, he took it easy. But three weeks later, during drills with his team, he received a second concussion. The doctor told him he needed to take six weeks off from football (which was winding down for the season anyway). “Otherwise,” Sawyer says, “I’d risk brain damage.”
Scared, he listened. “I realized I could really screw myself over,” acknowledges Sawyer, who heads to Michigan State this fall. “I haven’t played any contact sports since then.”
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Each year, more than 1.5 million people in the United States suffer a concussion with loss of consciousness. “Concussions are ubiquitous,” says Christopher Randolph, director of the neuropsychology service at Loyola University Medical Center.
But those blows are far from innocuous. They can cause headaches, confusion, and trouble with concentration, memory, balance, and coordination. (In Sawyer’s case, the mental aftereffects continued for weeks.) Preliminary evidence suggests that repeated concussions can lead to the onset of dementia-related symptoms—a major problem for athletes in high-impact sports such as football. A study coauthored by Randolph found that 61 percent of retired professional football players had had at least one concussion and that 24 percent had had three or more. With the February suicide of the former Bears safety Dave Duerson—who shot himself in the chest in order to preserve his brain for future study—concussions are getting even more attention.
“Concussions are indeed a mystery,” says Hunt Batjer, chairman of the department of neurological surgery at Northwestern Memorial Hospital and cochair of the National Football League’s medical committee for head, neck, and spine injuries. “There are a thousand things we don’t know.” Among them: “How can a condition that presents clinical symptoms that are unassociated with obvious structural changes ultimately lead to permanent neurological damage?”
But there is one thing about which Batjer is certain. “Does repetitive brain injury put you at risk for permanent neurological problems?” he asks. His answer: an unequivocal yes.
There lies the problem. Loyola’s Randolph notes that, beginning in high school, about 4 to 5 percent of football players will get a concussion each year—and repetitive blows to the head are even more commonplace in professional and college football. “The average college football player can sustain over 1,000 blows to the head in excess of 10 Gs every year,” he says, explaining that that’s the equivalent of a robust slap to the head. (Hits in the range of 100 to 150 Gs are not uncommon in the National Football League.) “I think the issue is the quantity of cumulative impact overall,” Randolph adds. “Your brain is meant to take a certain amount of punishment. But the more concussions you have, the more likely you are to have another one”—which is why he suggests that high-school and college football coaches reduce the number of full-contact drills in practice.
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Illustration: Sean McCabe