On an early spring day not too many years ago, a friend was playing outfield in a corporate softball game. The ball was hit, and my friend scrambled backwards to snag it. He caught the ball, but lost his footing and fell backwards, hitting his head against the hard-packed earth.
When he came to after a few seconds of blackout, he saw double and had to be helped off the field. The team congratulated him on the catch (which, remarkably, stayed in the mitt), and then took him to the only place that made sense to them—the bar.
He did go to the hospital later that night (dragged there by his wife), where the doctor diagnosed concussion…and then jokingly asked if he could get a videotape of the catch. No special instructions…no actual diagnostic tests…no follow-up. After all, it was “just” a concussion.
A Gray Area in Gray Matter
In a recent online publication of the medical journal Pediatrics, researcher Carol A. DeMatteo and colleagues examined diagnosis and treatment of 434 children with head injury admitted to a children’s hospital. Their results suggest something astonishing: Children who have the same symptoms will receive different levels of treatment depending on whether they are diagnosed as having a concussion or mild traumatic brain injury (MTBI).
A child diagnosed with concussion will be discharged from the hospital earlier and will return to school sooner than a child with the same symptoms who is diagnosed with MTBI.
This study raises two main issues. First, the medical community needs a more consistent way to diagnose head injuries. With something as serious as head injury, it seems that there must be a way to have clearer guidelines.
Second, labeling any brain injury as “concussion” is potentially dangerous. “Concussion” is not taken seriously by just about anybody, including some doctors, parents, and the patients themselves.
Not to be Ignored
A single concussion can cause significant and lasting damage in the brain. Multiple concussions can sometimes cause a disorder call chronic traumatic encephalopathy (CTE), which leads to memory impairment, emotional instability, dementia, brain degeneration, and death. At autopsy by specialists at the Boston University School of Medicine, CTE was found in the brain of former Tampa Bay Buccaneer Tom McHale—the sixth former NFL player found to have suffered from this disorder.
In the Pediatrics article, DeMatteo and colleagues conclude that “perhaps we should use the term ‘MTBI,’” instead of concussion. Maybe then, everyone will take it more seriously—doctors, athletes, coaches, parents, patients, and …yes, softball players.
HensonFuerst will be following up with more information about concussions and MTBI in future blogs. Stay tuned, and stay safe!