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Old 08-25-2004, 03:16 PM
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Default Head Injuries And Secondary Impact Syndrome

High School Head Injury Project Gears Up for Expansion
By Monique H. Olesniewicz, CRC / Project Coordinator
High School Head Injury Project

Nearly 100 years after President Theodore Roosevelt threatened to ban the sport of football because of the large number of serious injuries and deaths among players, the High School Head Injury Project begins a new phase of operations. Begun in 1997 as a San Diego-based consortium of health care professionals and research institutions, the Project’s mission was to educate parents, coaches, school administrators and medical personnel about how to identify and evaluate concussions.
Working with local football players, the Project conducted baseline neurological test, post-trauma test among head-injured athletes and post-season tests of all athletes. Analysis of the data enabled researchers to learn more about risk factors for concussion, the recovery process and to begin to develop a standardized assessment tool for non-medical professionals. In what amounts to a new phase of operations scheduled to stretch through 2004, the Project will broaden its operations geographically by expanding from one to four research centers, with new centers begin located in Washington, Florida and New Jersey. In addition, the Project will broaden its activities from testing and research to actively developing a standardized testing regimen for nonmedical professionals, communicating its availability and training on-thefield personnel in its use.
The need for expanding the Project’s mission was made clear as evidence was gathered suggesting that, while awareness of concussion and its attendant dangers was widespread, there existed significant and potentially dangerous discrepancies in the recognition and evaluation among the various parties working with athletes with head injuries. Several instances were reported of differing evaluations of the same injury between emergency responders on the field and the followup evaluation by a physician. Discrepancies such as this create the possibility of further, potentially deadly head trauma.
The need to ensure continuity and consistency stems from the serious dangers posed by a allowing a player with an undiagnosed or under-diagnosed brain injury to return to activity before he or she is completely free of the effects of that injury. It has been determined that an athlete with a single concussion has a fourfold risk of incurring a second. A repeat concussion occurring while the athlete is still suffering the effects of the first, the socalled “second impact syndrome,” can lead to dangerous, often fatal, consequences. In a dramatic finding, the testing of football players mentioned above revealed 81% of the players tested had symptoms of concussion sometime during the season yet did not report them.
Currently, there are as many as 16 neurological assessments in use around the country to evaluate concussion. While most of these tests use common criteria for concussion, notably loss of consciousness and post-traumatic amnesia, all are based upon the opinion of experts rather than upon measurable and objective facts.
Further, each of these tests has a set of guidelines to help non-medical personnel
“grade” a concussion and to help determine when an athlete may safely return competition. While nearly all the tests classify concussion as “Grade 1,” “ Grade 2” and “Grade 3” (mild, moderate and severe), it is possible to reach different conclusions as to the grade, from the same set of symptoms. Since return to play is shorter for milder concussions, tests which look at the same set of symptoms and yield a more moderate grade 1 or 2 diagnosis provide less safety margin than tests which yield a grade 2 or 3 diagnosis. Over the course of the next phase of the High School Head Injury Project, researchers will attempt to evaluate the strength and weaknesses of the various assessment methods and select one (or, perhaps, develop a hybrid of several). This selection will then be the focus of the Project’s efforts to promulgate a common assessment tool among constituencies involved in preventing or treating athletic head injury.

From: http://www.cramersportsmed.com/pdfs/fa_winter_2000.pdf
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Old 08-25-2004, 03:16 PM
RickI's Avatar
RickI RickI is offline
Administrator
Site Admin
 
Join Date: Jul 2004
Location: Florida
Posts: 8,679
Default Head Injuries And Secondary Impact Syndrome

High School Head Injury Project Gears Up for Expansion
By Monique H. Olesniewicz, CRC / Project Coordinator
High School Head Injury Project

Nearly 100 years after President Theodore Roosevelt threatened to ban the sport of football because of the large number of serious injuries and deaths among players, the High School Head Injury Project begins a new phase of operations. Begun in 1997 as a San Diego-based consortium of health care professionals and research institutions, the Project’s mission was to educate parents, coaches, school administrators and medical personnel about how to identify and evaluate concussions.
Working with local football players, the Project conducted baseline neurological test, post-trauma test among head-injured athletes and post-season tests of all athletes. Analysis of the data enabled researchers to learn more about risk factors for concussion, the recovery process and to begin to develop a standardized assessment tool for non-medical professionals. In what amounts to a new phase of operations scheduled to stretch through 2004, the Project will broaden its operations geographically by expanding from one to four research centers, with new centers begin located in Washington, Florida and New Jersey. In addition, the Project will broaden its activities from testing and research to actively developing a standardized testing regimen for nonmedical professionals, communicating its availability and training on-thefield personnel in its use.
The need for expanding the Project’s mission was made clear as evidence was gathered suggesting that, while awareness of concussion and its attendant dangers was widespread, there existed significant and potentially dangerous discrepancies in the recognition and evaluation among the various parties working with athletes with head injuries. Several instances were reported of differing evaluations of the same injury between emergency responders on the field and the followup evaluation by a physician. Discrepancies such as this create the possibility of further, potentially deadly head trauma.
The need to ensure continuity and consistency stems from the serious dangers posed by a allowing a player with an undiagnosed or under-diagnosed brain injury to return to activity before he or she is completely free of the effects of that injury. It has been determined that an athlete with a single concussion has a fourfold risk of incurring a second. A repeat concussion occurring while the athlete is still suffering the effects of the first, the socalled “second impact syndrome,” can lead to dangerous, often fatal, consequences. In a dramatic finding, the testing of football players mentioned above revealed 81% of the players tested had symptoms of concussion sometime during the season yet did not report them.
Currently, there are as many as 16 neurological assessments in use around the country to evaluate concussion. While most of these tests use common criteria for concussion, notably loss of consciousness and post-traumatic amnesia, all are based upon the opinion of experts rather than upon measurable and objective facts.
Further, each of these tests has a set of guidelines to help non-medical personnel
“grade” a concussion and to help determine when an athlete may safely return competition. While nearly all the tests classify concussion as “Grade 1,” “ Grade 2” and “Grade 3” (mild, moderate and severe), it is possible to reach different conclusions as to the grade, from the same set of symptoms. Since return to play is shorter for milder concussions, tests which look at the same set of symptoms and yield a more moderate grade 1 or 2 diagnosis provide less safety margin than tests which yield a grade 2 or 3 diagnosis. Over the course of the next phase of the High School Head Injury Project, researchers will attempt to evaluate the strength and weaknesses of the various assessment methods and select one (or, perhaps, develop a hybrid of several). This selection will then be the focus of the Project’s efforts to promulgate a common assessment tool among constituencies involved in preventing or treating athletic head injury.

From: http://www.cramersportsmed.com/pdfs/fa_winter_2000.pdf
__________________
FKA, Inc.

transcribed by:
Rick Iossi
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