The Burden Of Concussion And Traumatic Brain Injury

The vast majority of traumatic brain injuries are concussions. Researchers talk about the problem of these head injuries in sports.
Jason Socrates Bardi, Editor

(Inside Science) -- In simple terms, a concussion is some form of neurological deficit that happens because of a bump, blow or jolt to the head. In broad terms, concussions fall on a much larger spectrum of what are called traumatic brain injuries, a major cause of death and disability.

"There are about 250,000 people who are hospitalized as a result of a traumatic brain injury each year and about 50,000 deaths. On the concussion side, which again represents the vast majority, there's about 1.8 million people who present to an emergency room every year following a concussion. There are another estimated 2 million people who sustain a concussion and then either don't seek treatment or seek treatment through an outpatient mechanism,” said David Okonkwo, clinical director at the UPMC Brain Trauma Research Center.

In recent years, much attention has been paid to the problem of head injuries in sports, particularly concussions sustained in sporting events.

"I’m the director of our brain injury center, where we have a large team that deals with concussions. We'll see 400 or 500 folks each month, and most of them come through the sports medicine because most of the concussions are sports-related,” said Mark Proctor, neurosurgeon-in-chief at the Boston Children's Hospital.

This attention has led to greater awareness of the problem -- among doctors, fans, coaches and the players themselves.

“The Pittsburgh Steelers in particular have had a very long history of commitment to the reality of concussion in football. They were the first franchise to have a neurosurgeon, Joe Maroon, on the medical staff. Many of the tools and technologies that we use to evaluate concussions that are used on a national basis trace their roots to work that was related to this issue with the Pittsburgh Steelers,” said Okonkwo.

But the impacts of concussions and traumatic brain injuries are felt far beyond competitive sports. Whether by accident or ill intent, head injuries are seen all too often in other walks of life -- the military, where soldiers serving in war zones are exposed to explosions; car crashes, where head injuries are common; everyday life, where people can take bad falls -- and, tragically, even small children are vulnerable.

"So, you look where the head injuries occur outside of sports, and you can almost break it into age range, right? So, for young children, the biggest risk is probably what we call non-accidental trauma, or another word would be child abuse, where we know that that happens, and that's a leading cause of brain injury under two years of age. As you start to get older, then it's things like falls and bicycle accidents. So, whether or not bicycles are considered sports is -- most of these are just recreational accidents. So that's an area. Then clearly motor vehicle accidents is a big area,” said Proctor. Understanding these problems can lead to change.

“I mean we do know that driving slower makes a difference. I don't know that we'll see a giant impact there. I do have to say car companies have led the way in safety, right? So, we've actually seen reductions in traffic fatalities for a number of years in a row just because cars are safer in between the airbags and the anti-lock brakes and the traction control. Traction control is probably one of the bigger things that's really helped prevent injury,” said Proctor.

Researchers say that some improvements are also being seen in professional sports.

"The quality of the concussion evaluation and concussion protocol at the professional sports level has had a trickle-down effect that has broadly impacted recreational sports across our country in a very positive way,” concluded Okonkwo.

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Jason Socrates Bardi is the former News Director of the American Institute of Physics and a longtime science writer.