Brain Injury Lawyer - New York

Concussion Insurance Benefits for Student Athlethes

Here is some hopefully, refreshing news from an insurance company for a change.  It has been reported that Wells Fargo’s Student Insurance Division (SID) and the Sports Concussion Institute (SCI) has launched Play It Safe Concussion Care (PSC). According to the insurance carrier, it’s a new concussion management treatment and services solution for athletes nationwide.

PSC includes insurance underwritten by National Union Fire Insurance of Pittsburgh, and provides concussion medical expense benefits for athletes who sustain a covered head injury.

The company stated that the process begins with a baseline assessment by SCI, or its affiliated medical providers, which includes a neurocognitive evaluation administered to athletes pre-season. Athlete suffering a covered head injury would receive a post-injury assessment to compare to their baseline results, helping to evaluate the extent of the injury and inform treatment. 

Let’s hope that the “covered” head injuries is not so restrictive as to make the coverage meaningless. I am hopeful that any concussion or even suspected concussion should be covered for post-injury assessment and any player who is diagnosed with a concussion should receive rehabilitation benefits under the plan.  If not, then the coverage is not very beneficial.

Comparing Brain Damage in Brains of Wounded Vets to Brain Damage in Football Players

The Sports Legacy Institute and the Boston University Center for the Study of Traumatic Encephalopathy have announced that they will be now examining the brain tissue of service members who have passed away after suffering from blast injuries.  They will be comparing the pathological findings in the brain tissue of victims of blast injury to the findings in tissue examined in football players who have sustained multiple concussions. The full story is reported in the New York Times article, "A Chance for Clues to Brain Injury in Combat Blasts".

The researchers hope to determine whether single, non-impact blasts in battle can cause the same type of brain damage found in the brains of football players who have been subject to years of repetitive head injury.

They researchers also are interested in determining whether their are physical changes to the brain in service members who have been diagnosed with post traumatic stress disorder (PTSD) since many of the symptoms associated with this condition, such as depression, erratic behavior , diminished ability to concentrate are all similar to the post concussion symptoms faced by professional athletes and other concussion victims.

Brain Injury Resource Lecture at The George Washington University

I am thrilled to be in Washington DC today to again lecture at the Master's Degree Program in the Center for Education and Human Services Acquired Brain Injury Masters program at The George Washington University.

This semester’s lecture is focused on examining the various sources of information that is available on the internet in the area of traumatic brain injury. We will be exploring government web sites such as the Center For Disease Control and the National Institute of Health, great brain injury resource sites such as BrainLine, web sites that emphasize management of sports concussions, web sites that provide useful information on special education, various neuropsychological accrediting groups, brain injury association pages, brain injury professional societies and of course the brain injury news and information blog and brain law and the brain injury legal guide web site.

The Master's Degree Program in Special Education: Emphasis in Acquired Brain Injury is focused in addressing the national shortage of special education and related service personnel qualified to meet the needs of students with traumatic brain injuries (TBI) and their families. Graduates are uniquely prepared to be educators and systemic improvement specialists in schools, hospitals, rehabilitation programs, advocacy programs, and related organizations. Scholarship support for qualified students is available. You can obtain more information on the GW Acquired Brain Injury Program by clicking here.

New Concussion Guidelines for Children and Teens: Keep Them Off the Field!

An international panel of neurologists, updating their recommendations on concussion care in the May issue of The British Journal of Sports Medicine, said that any athlete 18 or younger who was believed to have sustained a concussion during a game or practice should never be allowed to return to the playing field the same day.

The group had previously said that such athletes could return if cleared by a doctor or certified athletic trainer, An international panel of neurologists, updating their recommendations on concussion care in the May issue of The British Journal of Sports Medicine, said that any athlete 18 or younger who was believed to have sustained a concussion during a game or practice should never be allowed to return to the playing field the same day. 

The new consensus is from the International Conference on Concussion in Sports.

The group had previously said that such athletes could return if cleared by a doctor or certified athletic trainer, but now contend that such determinations are too difficult and dangerous for same-day return to be considered safe.

When it comes to concussions, children and teens require different treatment, according to  the international experts who recently published their consensus recommendations. The British Journal of Sports Medicine's new guidelines say children and teens must be strictly monitored and activities restricted until fully healed. These restrictions include no return to the field of play, no return to school, and no cognitive activity.

The guidelines also point to the important role parents, coaches, and teachers play in assessing and treating young athletes."

For children and adolescents, the guidance strongly reiterates several key points for coaches, parents, and physicians:

• Injury to the developing brain, especially repeat concussions, may increase the risk of long term effects in children, so no return-to-play until completely symptom free.
• No child or adolescent athlete should ever return to play on the same day of an injury -- regardless of level of athletic performance. Children and adolescents may need a longer period of full rest and then gradual return to normal activities than adults.
• For children, "cognitive rest" is a key to recovery. While restrictions on physical activity restrictions are also important, cognitive rest must be carefully adhered to, including limits on cognitive stressors such as academic activities and at-home/social activities including text messaging, video games, and television watching.

The group's recommendations for children and adolescents were based on the fact that though 80 to 90 percent of adult concussions resolve in seven to 10 days, for children and adolescents, the recovery time is often longer. In all cases, the decision to "return-to-play" should be made based on the individual's progress, not a standard time period. Careful post-injury evaluation of the injured student-athlete is essential.

Concussion Management Bill Introduced in Congress

Urge House Members to Cosponsor HR 1347, The Concussion Treatment and Care Tools Act of 2009 
 
Members of the House of Representatives have introduced the Concussion Treatment and Care Tools Act of 2009 (HR 1347), a bill designed to ensure adoption, dissemination, and implementation by elementary and secondary schools of concussion management guidelines for the purpose of better treatment and awareness of the injuries of the estimated 3.8 million young people that suffer sports and recreational concussions each year.

The sponsors of this Act, Representatives Bill Pascrell, Jr. and Todd R. Platts, have called upon Congress to provide grants to states for the purpose of ensuring that elementary and secondary schools implement these guidelines by funding computerized pre-season baseline and post-injury neuropsychological testing for student athletes.

Because the support of this initiative is vital to the protection of school aged children engaging in sports and recreational activities, it is important for us to urge as many Congressional Members as possible to sign on as cosponsors!
 
 

More evidence that children need to be assessed following a concussion before being allowed to go back to sports or play time activities

Children hospitalized with concussions should wait until they are seen by a clinician in a follow-up exam before returning to regular sports or playtime activities, according to researchers at The Children's Hospital of Philadelphia.

Rather than only consulting a doctor when there are obvious trouble signs after the initial treatment, the Children's Hospital researchers recommend that a qualified healthcare provider perform a formal assessment after hospital discharge but before child resumes exertional activities. The study team used a computer-based testing program created to assess athletes with concussions and determine when it was safe to return to play. The authors found that nearly all the children admitted to the hospital with a concussion had some abnormal brain function during initial testing.

The  article appears in the May issue of the journal Annals of Surgery.

Prior research has demonstrated that children are more likely to sustain another concussion if they return to play or exertional activities prematurely. In addition, high school athletes recover more slowly than college or professional athletes. Presumably the same is true for children with concussion from non-sports related causes.

The study, which looked at 116 children ages 11 through 17 at an urban Level 1 trauma center over two years, set out to determine if measurable impairments existed in children admitted to the hospital with a concussion and if the computer-based testing program could be easily used in the hospital setting. The computer assessment is administered bedside and takes about 25 minutes.

The test results revealed an alarmingly high rate of cognitive deficits in nearly all patients. It tests specific abilities, such as attention span, memory, nonverbal problem solving and reaction time. Almost all patients tested below the 25 percentile in at least one area; the majority demonstrated significant impairment for all four subtests.

The test also assesses the degree of concussion symptoms, and the majority of children with concussions demonstrated an abnormal symptom score. The follow-up group demonstrated significant improvement in neurocognitive performance on all four subtests as well as an improvement in their symptom scores.

New national guideline proposed for sports concussions

A national guideline that young athletes suspected of sustaining a concussion or head injury in practice or games be removed from competition until examined or cleared by a medical professional is at the heart of a multi-organizational call-to-action announced today at the American College of Sports Medicine (ACSM) 56th Annual Meeting in Seattle. ACSM is collaborating with the Brain Injury Association of Washington (BIAWA) and the U.S. Centers for Disease Control and Prevention (CDC) to build national momentum on a new Washington state law protecting young athletes from death or disability caused by premature return to play following a concussion.

The Lystedt Law is named in honor of Zackery Lystedt, a Seattle-area young athlete who suffered a concussion in 2006 during a middle school football game. After returning to the same game, he later collapsed on the field.  The legislation, according to ACSM and its partners, is the standard for a no-cost, highly protective model for national duplication.

In order to replicate the characteristics of the Lystedt Law that will protect young athletes in sports, ACSM says state legislation can work to require:

- School districts to work with their state athletic associations to develop guidelines and informational forms to educate coaches, youth athletes and their parents of the nature and risk of concussion and head injury.

- Information handouts to parents and players on the signs and symptoms of concussion; returned and signed by parents and youth athletes acknowledging the risk of concussion and head injuries prior to practice or competition.

- Removal of a youth athlete who is suspected of or sustains a concussion or head injury from play. "When in doubt, sit them out"

- Written clearance prior to returning to play from a licensed health care provider for a youth athlete who has been removed from play.

- Compliance from private, nonprofit youth sports associations with the policies adopted in that state.

ACSM has a long history of advocating for concussion management, as well as establishing resources and partnerships to support treatment and prevention updates that help coaches and athletes avoid head injuries during play or competition.

In 2006, ACSM published Concussion (Mild Traumatic Brain Injury) and the Team Physician: A Consensus Statement, a guide to help team physicians diagnose and treat athletes with a concussion. The primer outlines best practices in identifying a mild traumatic brain injury; factors that should be considered in making return-to-play (RTP) decisions; the need for a game-day medical plan specific to concussions; the need for documentation, and more.

For more information on the Lystedt Law in Washington state, visit the brain injury association of washington web site. 

Concussion: Compliance with Return to Play Advice and Follow-up Status

While we are all concerned with the incidence of concussions in sporting activities and return to play decisions, we need to have equal concern for the rate of compliance among individuals who have sustained concussions.

The Canadian Journal of Neurological Sciences, (Volume 36, Number 2 / March 2009) reports the results of a study designed to  determine the compliance rate among hockey players with concussion or other head injuries who were advised by a physician about return to play. To assess compliance of hockey players with return to play advice and to assess the incidence of long-term post-concussion symptoms.

The results were are quite distressing.  Five (33%) of 15 hockey players advised to never return to play were non-compliant and returned to play, and four continued to suffer from post concussion symptoms two or more years later. After repeated concussions, 65% of hockey players had long-term sequelae that prevented return to play and produced long-term post-concussion symptoms.

More effort needs to be placed on educating athletes and their families about the long term dangers associated with concussions.  Just as important, however is the need for teams, coaches and those responsible for the health and safety of athletes to say, “No-you cannot return to play”.  It is ill advised to leave this ultimate decision in the hands of the individual suffering with brain damage.

Sports Concussions To Be Discussed At Next Meeting New York State Traumatic Brain Injury Services Coordinating Council

The next meeting of the New York State Traumatic Brain Injury Services Coordinating Council will be held this Wednesday, April 22, 2009 in Delmar, New York in the Main Conference Room of the Health Department offices located at 161 Delaware Avenue, Delmar. The meeting is scheduled to begin at 10:30 AM

We are scheduled to discuss the sports concussions and recommendations to the Commissioner of Health.

We have scheduled two nationally recognized experts to assist the council.  They are:

Mark Lovell, Ph.D., Director, University of Pittsburgh Medical Center, Sports Medicine Concussion Program

Brian Reiger, Ph.D., Director, Concussion Management Program & CNY Sports Concussion Center
SUNY Upstate Medical Center

As the chair of the New York State Brain Injury Services Council, I would encourage all those with an interest in this important topic to attend.  The meeting is open to all members of the public.

Retired Hockey Player Donates Brain For Medical Research

Former, NHL player, Keith Primeau, a victim of repeated concussions has decided to bequeath his brain to the Sports Legacy Institute, an organization dedicated to studying the effects of concussions and other sports-related brain injuries. Upon his death, it will be examined by the Center for Traumatic Encephalopathy at the Boston University Schooll of Medicine. 

The Institute has been on the cutting edge of scientific research on the issue of chronic traumatic encephalopathy, brain damage caused by repeated concussions. 

Primeau, who played for the Philadelphia Flyers was forced to retire as a result of the many concussions he received while playing hockey.  He believes that he sustained permanent brain damage as a result of his repeated injuries and wants to advance the science of brain injury.  He has agreed to be examined on an annual basis to document any brain damage that appears throughout his life.

You can read the full story by clicking here.