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New York needs a strong concussion management program

I am honored to reproduce today’s editorial in the Buffalo News concurring in my views and recommendations for a strong concussion management program in New York Sate.

Protect young athletes

Epidemic of head injuries shows need for stronger regulations on concussions

Dr. Elad Levy calls it an epidemic that has rendered some young people unable to complete their high school or college studies.

Levy, a local neurosurgeon and president of the Program for Understanding Childhood Concussion & Stroke, is referring to the problem of head injuries among young athletes.

Evidence of the seriousness of the epidemic is all around:

* The Centers for Disease Control and Prevention, for example, reported in October that annual visits to emergency departments across the country for traumatic brain injuries among young people ages 18 and under grew by 62 percent between 2001 and 2009, when nearly a quarter million such hospital visits occurred.

* Also in October, a 16-year-old defensive tackle died after getting dinged on a routine play and suffering a brain bleed during a high school game in Cortland County, and in August a college football player in Maryland collapsed during a practice and died less than a week later due to a traumatic brain injury caused by helmet-to-helmet contact.

* Closer to home, teenager Philip Kane of South Buffalo suffers from splitting headaches and struggles to read, due to at least six concussions stemming from contact sports such as football and hockey, according to a story Sunday by News reporter Charlie Specht.

New York recently took a step in the right direction when Gov. Andrew M. Cuomo signed into law the Concussion Management and Awareness Act, which will require the state's nearly 700 school districts to take better precautions in handling suspected concussions on the field or in the gym.

The new law, set to take effect on July 1, 2012, will standardize a hodgepodge of school protocols that ran the gamut in looking out for student safety regarding head injuries.

But there is more that must be done to confront the concussion crisis.

Unfortunately, some athletes and coaches -- and even some parents -- still adhere to the old "bell rung" canard, which suggests it's OK for players to shake off a hit to the head and stay in the game.

The new law will go a good distance toward eliminating that line of thinking. The law requires the immediate removal from all athletic activities of any student suspected of suffering a concussion, and it bars his return until he has been free of concussion symptoms for at least 24 hours and receives clearance from a doctor.

It also mandates special training about concussions for coaches, physical education teachers, nurses and athletic trainers.

But some critics say the law comes up short on several fronts, most notably for not requiring that all athletes take a baseline neuropsychological test before being allowed to participate in a sport.

Such a test would give doctors a point of reference in determining whether an athlete who suffered a concussion has recovered fully from his injuries and is able to play again, according to Michael V. Kaplen, a lawyer and chairman of the New York State Traumatic Brain Injury Coordinating Council.

The council has recommended that the state's commissioners of health and education include mandated baseline testing as they write the regulations implementing the new state law.

The testing would be considered preventive medicine, covered under most health insurance plans for children, and thus won't add to any school district's financial burden, said Kaplen.

Kaplen also points out that most professional and intercollegiate teams in all sports use such baseline testing as a key tool in managing concussions.

It's hard, then, to argue against its use among high schoolers, whose still-developing brains are even more susceptible to long-term damage from repeat concussions.

The Traumatic Brain Injury Coordinating Council has put forth other worthwhile recommendations that the state commissioners should strongly consider, as well.

"In the year 2011, there's not a topic more relevant in high school sports than concussion management and traumatic brain injury," said Kaplen. "We need some uniformity throughout the state. This is the brain we're talking about."

Area school districts would be wise to begin implementing as much of the state law as they can, as soon as possible, instead of waiting until next summer.

In addition, some districts and independent sports programs stand out as leaders in trying to prevent head injuries and should be emulated.

Athletic trainers at Starpoint and Lewiston-Porter high schools, for example, already use baseline testing to identify concussions and keep brain-injured athletes out of the lineup until they're healthy again.

At Orchard Park High School, football coach Gene Tundo bans full-contact hitting during practices to avoid unnecessary shots to the head.

The precautions don't have to come at the expense of winning, either. Orchard Park finished a perfect 13-0 season on Sunday by capturing the state championship title in Syracuse.



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Arnold Sadwin, MD

What about Chiari malformation and concussion.

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