Category Archives: Football

Concussed Football Player Sues School District After Coach Tells Him to ‘Man Up’ Among Stories in Latest Concussion Litigation Reporter

Concussion Litigation Reporter, November 2019, Vol. 8, No. 5

Timely reporting on developments and legal strategies at the intersection of sports and concussions—articles that benefit practicing attorneys who may be pursuing a claim or defending a client.

Table of Contents

Concussed High School Football Player Sues School District After Coach Allegedly Tells Him to ‘Man Up’ and ‘Get Back Out There’

Brain Injury from Concussion May Linger Longer than One Year After Return to Play

NFHS Sparks Controversy With Position Paper Claiming No Linkage Between CTE and Playing High School Football

Mets Fan Sues Team After Getting Hit in the Head by a T-shirt Fired from a T-shirt and Suffering Concussion

Doctor and Co-Founder of Tulane’s Center of Sport Talks Concussions

WWE Challenges Lawsuit Brought by Former Wrestlers

Chronic Traumatic Encephalopathy: Basic Issues to Consider in Traumatic Brain Injury Litigation

Study Finds No Link Between Youth Contact Sports and Cognitive, Mental Health Problems

Federal Trade Commission Sues Dallas-Based Maker of Brain Health Supplements, Citing Deceptive Claims

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New Brain Research Could Change How Concussions Are Treated

Traumatic brain injuries (TBI), including concussions, can be caused by anything from sports injuries to battlefield trauma. And they can have fatal or lasting effects. The results of a severe concussion–problems with thinking, memory, movement, emotions–are clear. The causes, or underlying pathological mechanisms, were not.

A new study questions the ongoing hypothesis that the blunt force behind a traumatic brain injury causes nerve damage, or axonal injury. A team of researchers, including Cold Spring Harbor Laboratory professor Partha Mitra, found greater signs of blood vessel damage than nerve damage after performing post mortem scans on an injured brain. The findings could influence the treatment of and development of new drugs for TBI.

“Nerve damage following traumatic brain injuries has been a majority point of view, and therapy as well as drug development has been targeted towards that,” Mitra said. “The idea is that if the mechanism is actually different, therapeutic intervention may also be different.”

Mitra’s lab worked on the research with colleagues at the National Institutes of Health, National Institute of Neurological Disease and Stroke, University of Maryland, Center for Neuroscience and Regenerative Medicine, and Uniformed Services University of the Health Sciences who had been studying human brains of deceased patients using MRI. The CSHL team performed closer analysis on the postmortem brain tissue using a high-throughput neurohistological pipeline (an assemblage of techniques for labeling and visualizing brain slices) Mitra developed to study the wiring of mouse brains.

With MRI, the resolution is limited to several hundred microns, which makes it hard to discern whether nerve fiber (axonal) or blood vessel (vascular) injuries had occurred, Mitra said. Digitally analyzing the postmortem tissue at micron resolution, correlated with the MRI scan, allowed the team to see the vascular injury more clearly.

Mitra focused on areas surrounding lesions, or where the trauma left a physical imprint on the brain. They appeared on MRI scans as “black blobs.” The team used an iron stain (which shows up in blue) for presence of blood and a myelin stain for presence of nerve fiber fragments on the brain samples. They saw a significant amount of iron-marked blood cells across the area where the lesion was located in the brain sample, indicating traumatic microbleeds caused by ruptures along the blood vessels across the brain. The researchers did not observe any significant nerve damage from the myelin stains.

While the researchers could not completely rule out that patients with TMBs also suffered axonal injury, they concluded that traumatic vascular injury is a distinct characteristic of traumatic microbleeds and could be a target for new therapies.

The team also found that traumatic microbleeds often predict future health problems and disabilities for people with TBI, but could not determine the direction of the relationship between TMBs and acute injuries. TMBs could simply be a signature of more severe injury, or they could cause a worse outcome.

Because of this, the team thinks that follow-up experiments are needed to identify the underlying causes and effects of TBI for better diagnosis, prognosis, identifying therapeutic targets and improving patient outcomes.

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NFHS Sparks Controversy With Position Paper Claiming No Linkage Between CTE and Playing High School Football

Editor’s Note: Dr. Karissa L. Niehoff is in her second year as executive director of the National Federation of State High School Associations (NFHS) in Indianapolis, Indiana. She is the first female to head the national leadership organization for high school athletics and performing arts activities and the sixth full-time executive director of the NFHS. Clearly, Dr. Niehoff, who was previously executive director of the Connecticut Association of Schools-Connecticut Interscholastic Athletic Conference for seven years, is not afraid to take a position as evidenced by the following paper she released through the NFHS last week.

When it comes to the long-term effects of concussions in sports, there is a wide range of information published – almost on a daily basis. Unfortunately, much of the media coverage as it relates to high school sports – and particularly the sport of football – is misleading.
Last week, the Concussion Legacy Foundation introduced its new public-service announcement that compared youth football dangers to smoking. As the pre-teen football players puff on cigarettes, the voiceover says, “Tackle football is like smoking, the younger I start, the longer I’m exposed to danger.”
The “Tackle Can Wait” campaign by the foundation is an attempt to steer children under the age of 14 into flag football. Although establishing a finite age may be difficult, reducing contact at youth levels is certainly a positive. USA Football is doing just that nationally through its Football Development Model. Likewise, the 51-member state associations of the National Federation of State High School Associations (NFHS) have enacted limitations on contact during preseason and practice sessions.
Our concern is the term “exposed to danger.” These types of messages continue to spread unwarranted fear to parents of high school student-athletes. The “danger” refers to reports that players who incur repeated concussions can develop chronic traumatic encephalopathy (CTE).
A 2017 study from the Journal of American Medical Association (JAMA) linked CTE in the brains of deceased National Football League players. Even if this report is accurate, these are individuals who endured repeated blows to the head for 20 to 25 years BEFORE any concussion protocols were in place.
Less publicized is a study by Dr. Munro Cullum and his colleagues at the Peter O’Donnell Jr. Brain Institute, which is a part of the University of Texas Southwestern Medical Center in Dallas. Cullum’s group studied 35 former NFL players age 50 and older who had sustained multiple concussions throughout their careers. The findings showed no significant association between the length of the individuals’ careers, the number of concussions and their cognitive function later in life.
Two studies, two different conclusions. Regardless of the outcome, however, they are not applicable to kids playing football before and during high school. There is absolutely no linkage to CTE at these levels, and the word “danger” should not be a part of the discussion.
A more applicable and significant study was also published in JAMA in 2017. In a study of about 4,000 men who graduated from Wisconsin high schools in 1957, there was no difference in cognitive function or decline between those who played football and those who did not as they reached 65 years of age. We would assume the majority of these individuals discontinued football after high school.
With more than one million boys – and girls – playing the contact sport of football each year, severe injuries do occur from time to time, but parents should know that efforts to lessen the risk of a catastrophic injury, including head injuries, have never been stronger than they are today.
In fact, new data from the National High School Sports-Related Injury Surveillance Study indicates some positive trends in concussion rates. The study, which was released in the American Academy of Pediatrics online issue of Pediatrics this week, indicated that concussion rates during football practices dropped from 5.47 to 4.44 concussions per 10,000 athletic exposures between the 2013-14 and 2017-18 seasons.
In addition, repeat concussion rates across all sports declined from 0.47 to 0.28 per 10,000 exposures during the same time period.
Concussion laws are in place in every state. All NFHS sports rules books have concussion management protocols. Helmet-to-helmet hits are not allowed in football. Limits on contact in preseason and practice in football are in place in every state.
After considering all the available research, we encourage parents to let their kids play their sport of choice in high school, but we would discourage moving away from football – or any contact sport – solely based on the fear of developing CTE later in life.
 
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