Concussion

NEW YORK TIMES BESTSELLER • NOW A MAJOR MOTION PICTURE • Dr. Bennet Omalu discovered something he could not ignore. The NFL tried to silence him. His courage would change everything. “A gripping medical mystery and a dazzling portrait of the young scientist no one wanted to listen to . . . a fabulous, essential read.”—Rebecca Skloot, author of The Immortal Life of Henrietta Lacks Jeanne Marie Laskas first met the young forensic pathologist Dr. Bennet Omalu in 2009, while reporting a story for GQ that would go on to inspire the movie Concussion. Omalu told her about a day in September 2002, when, in a dingy morgue in downtown Pittsburgh, he picked up a scalpel and made a discovery that would rattle America in ways he’d never intended. Omalu was new to America, chasing the dream, a deeply spiritual man escaping the wounds of civil war in Nigeria. The body on the slab in front of him belonged to a fifty-year-old named Mike Webster, aka “Iron Mike,” a Hall of Fame center for the Pittsburgh Steelers, one of the greatest ever to play the game. After retiring in 1990, Webster had suffered a dizzyingly steep decline. Toward the end of his life, he was living out of his van, tasering himself to relieve his chronic pain, and fixing his rotting teeth with Super Glue. How did this happen?, Omalu asked himself. How did a young man like Mike Webster end up like this? The search for answers would change Omalu’s life forever and put him in the crosshairs of one of the most powerful corporations in America: the National Football League. What Omalu discovered in Webster’s brain—proof that Iron Mike’s mental deterioration was no accident but a disease caused by blows to the head that could affect everyone playing the game—was the one truth the NFL wanted to ignore. Taut, gripping, and gorgeously told, Concussion is the stirring story of one unlikely man’s decision to stand up to a multibillion-dollar colossus, and to tell the world the truth.

In the past decade, few subjects at the intersection of medicine and sports have generated as much public interest as sports-related concussions - especially among youth. Despite growing awareness of sports-related concussions and campaigns to educate athletes, coaches, physicians, and parents of young athletes about concussion recognition and management, confusion and controversy persist in many areas. Currently, diagnosis is based primarily on the symptoms reported by the individual rather than on objective diagnostic markers, and there is little empirical evidence for the optimal degree and duration of physical rest needed to promote recovery or the best timing and approach for returning to full physical activity. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture reviews the science of sports-related concussions in youth from elementary school through young adulthood, as well as in military personnel and their dependents. This report recommends actions that can be taken by a range of audiences - including research funding agencies, legislatures, state and school superintendents and athletic directors, military organizations, and equipment manufacturers, as well as youth who participate in sports and their parents - to improve what is known about concussions and to reduce their occurrence. Sports-Related Concussions in Youth finds that while some studies provide useful information, much remains unknown about the extent of concussions in youth; how to diagnose, manage, and prevent concussions; and the short- and long-term consequences of concussions as well as repetitive head impacts that do not result in concussion symptoms. The culture of sports negatively influences athletes' self-reporting of concussion symptoms and their adherence to return-to-play guidance. Athletes, their teammates, and, in some cases, coaches and parents may not fully appreciate the health threats posed by concussions. Similarly, military recruits are immersed in a culture that includes devotion to duty and service before self, and the critical nature of concussions may often go unheeded. According to Sports-Related Concussions in Youth, if the youth sports community can adopt the belief that concussions are serious injuries and emphasize care for players with concussions until they are fully recovered, then the culture in which these athletes perform and compete will become much safer. Improving understanding of the extent, causes, effects, and prevention of sports-related concussions is vitally important for the health and well-being of youth athletes. The findings and recommendations in this report set a direction for research to reach this goal.

Every year, an estimated 1.7 million Americans sustain brain injury. Long-term disabilities impact nearly half of moderate brain injury survivors and nearly 50,000 of these cases result in death. Brain Neurotrauma: Molecular, Neuropsychological, and Rehabilitation Aspects provides a comprehensive and up-to-date account on the latest developments in the area of neurotrauma, including brain injury pathophysiology, biomarker research, experimental models of CNS injury, diagnostic methods, and neurotherapeutic interventions as well as neurorehabilitation strategies in the field of neurotraum research. The book includes several sections on neurotrauma mechanisms, biomarker discovery, neurocognitive/neurobehavioral deficits, and neurorehabilitation and treatment approaches. It also contains a section devoted to models of mild CNS injury, including blast and sport-related injuries. Over the last decade, the field of neurotrauma has witnessed significant advances, especially at the molecular, cellular, and behavioral levels. This progress is largely due to the introduction of novel techniques, as well as the development of new animal models of central nervous system (CNS) injury. This book, with its diverse coherent content, gives you insight into the diverse and heterogeneous aspects of CNS pathology and/or rehabilitation needs.

Now in a fully revised and expanded second edition, this comprehensive text remains a timely and major contribution to the literature that addresses the neuromechanisms, predispositions, and latest developments in the evaluation and management of concussive injuries. Concussion, also known as mild traumatic brain injury, continues to be a significant public health concern with increased attention focusing on treatment and management of this puzzling epidemic as well as controversies within the field. The book is comprised of five thematic sections: current developments in evaluation; biomechanical mechanisms; neural substrates, biomarkers, genetics and brain imaging; pediatric considerations; and clinical management and rehabilitation. Since the publication of the original edition in 2014, much has changed regarding the current understanding of mild traumatic brain injury including development of more precise imaging modalities, development and classification of new biomarkers, and updates to clinical treatment and management of athletic concussion. This new edition will include new chapters targeting the influence of genetics on concussive injury, as well as an expansion on the knowledge of pediatric response to concussion and the influence of repetitive subconcussive impacts on athlete health. An invaluable contribution to the literature, Concussions in Athletics: From Brain to Behavior reestablishes itself as a state-of-the-art reference that will be of significant interest to a wide range of clinicians, researchers, administrators, and policy makers, and this updated version aims to narrow the gap between research findings and clinical management of sports-related concussion and other mild traumatic brain injury. The second edition also attempts to broaden the scope of the knowledge to apply to more professionals and pre-professionals in the fields of neuroscience, neuropsychology, and other allied health professionals that closely work with athletes and sports medicine professionals.

In Impact, 21 women writers consider the effects of concussion on their personal and professional lives. The anthology bears witness to the painstaking work that goes into redefining identity and regaining creative practice after a traumatic event. By sharing their complex and sometimes incomplete healing journeys, these women convey the magnitude of a disability which is often doubted, overlooked, and trivialized, in part because of its invisibility. Impact offers compassion and empathy to all readers and families healing from concussion and other types of trauma. Contributors: Adèle Barclay, Jane Cawthorne, Tracy Wai de Boer, Stephanie Everett, Mary-Jo Fetterly, Rayanne Haines, Jane Harris, Kyla Jamieson, Alexis Kienlen, Claire Lacey, E. D. Morin, Julia Nunes, Shelley Pacholok, Chiedza Pasipanodya, Judy Rebick, Julie Sedivy, Dianah Smith, Carrie Snyder, Kinnie Starr, Amy Stuart, Anna Swanson

This book arises from the challenges and difficulties involved in the evaluation and management of concussions in wheelchair athletes. Concussions are most readily identified in the ambulatory population via identifying gross motor instability or when athletes lose their balance and stumble after a blow to the head or neck region. Because wheelchair athletes participate in sport while sitting down and using a wheelchair, clinicians must be extra attentive to identify a potential concussion. Once a potential concussion is identified, there are many challenges in evaluation of the wheelchair athlete population due to their comorbidities. At baseline, they may have signs and symptoms that mimic a concussion, and their impairments can also alter their cognitive and balance assessments. Therefore, it is critical to make a distinction between these athletes’ baseline comorbid impairments and potential new exam findings in a concussion. Filling in a critical gap in the literature, this is a concise pocket guide for any clinician, trainer, or rehabilitation specialist who is involved in wheelchair sports. It focuses on the unique challenges in evaluating a concussion in the wheelchair athlete, including baseline testing, the process of evaluating the signs and symptoms of a concussion, cognitive and vestibular examination, new clinical techniques specific to wheelchair athletes, and the return to play process. A Concussion Management Program (CMP) for use on the sideline as well as in the office is included. Practical and timely, Concussion Management for Wheelchair Athletes is a valuable resource to increase awareness, provide guidance on the unique challenges within this population, and generate interest in future research and investigation.

Daniel Amen and The Amen Clinics have become widely known and respected across America and internationally via television, print, and the online world reaching millions of viewers and consumers each year. We now have the wonderful opportunity to publish a line of health care books under the Amen Clinics imprimatur. #1 New York Times bestselling author, Daniel Amen, will write a foreword for each book and promote the book through all of his channels (mailing list, newsletter, social media). The first book we will be publishing is Concussion Rescue, which will give readers the natural and effective protocols for healing from traumatic brain injury. In Concussion Rescue, Dr. Kabran Chapek shares the programs and protocols that he uses at the Amen Clinics to put patients on the pathway to healing from traumatic brain injury. From general assessment using sophisticated tools (SPECT imaging, MRIs and CAT scans) to very specific blood tests (out-of-balance lab values in blood can point to symptoms of brain injury and may explain why the brain is not healing), Dr. Chapek guides readers to getting the proper medical care. He shares the cutting edge and most effective treatments for acute traumatic brain injury, as well as chronic traumatic brain injury, and provides the most powerful natural treatments including diet and supplements. Concussion Rescue will be an invaluable and potentially lifesaving resource for athletes, parents of student athletes, coaches, and anyone who suffers a mild or severe brain injury.

NEW YORK TIMES BESTSELLER • The story of how the NFL, over a period of nearly two decades, denied and sought to cover up mounting evidence of the connection between football and brain damage “League of Denial may turn out to be the most influential sports-related book of our time.”—The Boston Globe “Professional football players do not sustain frequent repetitive blows to the brain on a regular basis.” So concluded the National Football League in a December 2005 scientific paper on concussions in America’s most popular sport. That judgment, implausible even to a casual fan, also contradicted the opinion of a growing cadre of neuroscientists who worked in vain to convince the NFL that it was facing a deadly new scourge: a chronic brain disease that was driving an alarming number of players—including some of the all-time greats—to madness. In League of Denial, award-winning ESPN investigative reporters Mark Fainaru-Wada and Steve Fainaru tell the story of a public health crisis that emerged from the playing fields of our twenty-first-century pastime. Everyone knows that football is violent and dangerous. But what the players who built the NFL into a $10 billion industry didn’t know—and what the league sought to shield from them—is that no amount of padding could protect the human brain from the force generated by modern football, that the very essence of the game could be exposing these players to brain damage. In a fast-paced narrative that moves between the NFL trenches, America’s research labs, and the boardrooms where the NFL went to war against science, League of Denial examines how the league used its power and resources to attack independent scientists and elevate its own flawed research—a campaign with echoes of Big Tobacco’s fight to deny the connection between smoking and lung cancer. It chronicles the tragic fates of players like Hall of Fame Pittsburgh Steelers center Mike Webster, who was so disturbed at the time of his death he fantasized about shooting NFL executives, and former San Diego Chargers great Junior Seau, whose diseased brain became the target of an unseemly scientific battle between researchers and the NFL. Based on exclusive interviews, previously undisclosed documents, and private emails, this is the story of what the NFL knew and when it knew it—questions at the heart of a crisis that threatens football, from the highest levels all the way down to Pop Warner.