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Sports-Related Traumatic Brain Injury

Nearly 300,000 sports-related traumatic brain injuries (TBIs) occur each year in the United States.1 Athletes involved in sports such as football, hockey and boxing are at significant risk of TBI due to the high level of contact inherent in these sports. Head injuries are also extremely common in sports such as cycling, baseball, basketball and skateboarding. Sadly, many sports head injuries lead to permanent brain damage or worse. Traumatic brain injury, or TBI, is the leading cause of death in sports-related accidents.

Players who have sustained a traumatic brain injury require immediate medical attention and, if permanent damage results, often need ongoing care, which can be very expensive. Many traumatic brain injury patients and their families suffer financial hardship due to injury-related expenses.

If you or someone you know suffered sports-related brain damage as a result of someone else's negligence, you may be entitled to compensation for medical expenses and other damages. A traumatic brain injury lawyer can review your case and help you earn the compensation you deserve.

High School Sports and Traumatic Brain Injury

While moderate to severe traumatic brain injuries are usually obvious, seemingly mild head injuries often go undetected. Because they usually fall under the category of closed head injury, as opposed to open head injury (in which the skull has been penetrated), damage caused by these injuries is not visibly apparent — nor is it visible in computed tomography or magnetic resonance imaging scans. As a result, doctors are often forced to rely solely on reported symptoms. Unfortunately, many players hide their symptoms or pain in order to continue playing, despite being injured. For this reason, some players do not reach full recovery and experience devastating brain damage.

The failure to detect and treat a TBI is particularly harmful to younger athletes. Because teenagers do not have fully developed brain tissue, head injuries sustained among high school athletes often lead to detrimental damage. Injuries suffered at this stage of development can cause longer-lived symptoms and create vulnerability to further damage if another injury occurs.

Approximately 21 percent of all traumatic brain injuries in people under 18 years old are a result of sports-related accidents, according to the American Association of Neurological Surgeons. Unfortunately, many high school players fail to recognize the signs of a traumatic brain injury, or downplay their symptoms in order to continue playing. The American Journal of Sports Medicine estimates three to four concussions occur each year in an average 50-player high school football team.

Traumatic Brain Injury in College and Professional Sports

Unlike the brains of high school athletes, college and professional sports players' brains are fully developed. However, the blows they endure are much more powerful than those endured in high school sports. According to one study, the force to the head sustained by National Football League (NFL) football players is 98 times more powerful than the force of gravity.2

In addition, college and professional players are frequently encouraged to return to playing as quickly as possible, jeopardizing their full recovery. In other instances, players are not properly evaluated after sustaining a head injury.

Neurologists at the University of Pittsburgh Medical Center have found evidence that many professional football players have brain damage similar to the damage seen in severe cases of dementia. Players are especially vulnerable to Alzheimer's disease, a terminal form of dementia.

Almost 61 percent of NFL players have sustained a concussion, and 16 percent believe they suffer from long-term damage as a result of head injury, according to a study by the University of North Carolina.

In response to this alarming trend, many college and professional sports teams have created awareness programs and committees to prevent further traumatic brain injuries. Many players are subject to thorough neurological evaluations before the start of every season and after any head injury. Other organizations have created committees to further investigate the phenomenon and learn more about ways to prevent and treat sports-related traumatic brain injuries.

Sports-Related Concussions

Most sports-related traumatic brain injuries come in the form of a concussion. The American Journal of Clinical Medicine defines concussion as "a trauma induced transient loss of normal mental function that lasts less than 24 hours." Patients with concussions sometimes, but not always, lose consciousness.

The classification of concussions is an inexact science. However, for the sake of simplification, concussions are sometimes divided into three "grades."3

Grade 1 concussion: A concussion in which alteration in mental status lasts less than 15 minutes. Patients experiencing a grade 1 concussion should cease participation in sporting activity immediately and be monitored for 15 minutes. Grade 1 patients should then see a physician and refrain from participating in sports until symptoms are absent for more than a week.

Grade 2 concussion: A concussion in which alteration in mental status lasts more than 15 minutes, not accompanied by loss of consciousness. Like grade 1 patients, grade 2 patients should cease participation in the sporting activity and see a doctor immediately. In addition, they should avoid returning to the activity until symptoms are absent for more than a month.

Grade 3 concussion: A concussion in which the patient loses consciousness for any period of time. Patients who lose consciousness should be immediately transported to an emergency facility. Some grade 3 patients will need to undergo a CT scan.

Athletes who experience multiple concussions will need to take extra measures to prevent undue brain injury. The measures taken depend on the severity of the concussions as well as individual circumstances.

Second Impact Syndrome

Following a concussion, the neurovascular system can struggle to respond to the body's increased demands for energy. When a second injury occurs, the situation is compounded. One of the most dangerous potential aftereffects of TBI is second impact syndrome, or brain swelling that occurs after an athlete has suffered a second concussion before the first concussion has fully healed. This can result in the death of brain cells, in turn leading to severe and/or permanent brain damage. Second impact syndrome is often a fatal condition.

Patients who have sustained one concussion are four times more likely to sustain a second one.4 Some well-known football players have suffered several concussions over the course of their careers, including NFL quarterback Troy Aikman, who racked up more than 10 concussions.

Once an athlete has sustained a head injury, each subsequent traumatic brain injury needs more time for recovery. Subsequent injuries also cause more severe damage, often leading to devastating results. Brain damage caused by multiple concussions is called chronic traumatic encephalopathy.

Preventing Sports-Related Traumatic Brain Injury

Coaches and sports officials have recently taken several steps to encourage traumatic brain injury prevention. The National Athletic Trainers' Association and the American Football Coaches Association have edited some of the regulations regarding head contact, including those aimed at regulating head-down and helmet contact more strictly.

Players are encouraged to purchase helmets that are approved by the American Society for Testing and Materials (ASTM). Players should also promptly replace any athletic equipment that is damaged, and rest if they have been injured or ill.

Coaches who fail to take the necessary safety precautions or allow for proper recovery after a head injury may be found negligent. To learn more about traumatic brain injury and TBI legal implications, continue reading All About Traumatic Brain Injury.

1Centers for Disease Control and Prevention (CDC)
2The Denver Post
3American Journal of Clinical Medicine
4Centers for Disease Control and Prevention (CDC)

[Last revision: July 2009]

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