Scientific research and subsequent breakthroughs continue to
change the way doctors approach the treatment of their patients,
and those advances are especially helping medical professionals
understand brain injuries.
The wars in Iraq and Afghanistan have inadvertently shed more
light on the issue of brain trauma and the long term effects.
Roughly one-quarter of all soldiers who have returned home have
suffered cognitive impairments and mental health problems. The
concussive blasts from improvised explosive devices and other
high-powered weaponry has left many with learning deficiencies or
disorientation on seemingly simple tasks.
The seriousness of concussions, especially when related to prep,
college or professional sports, has been spotlighted as former
players with permanent brain injuries tell their horror stories.
There are even local stories, including the one about Jake
Snakenberg, the Grandview High School student who took a second
blow to the head and died on the football field in 2004.
Sub-concussive blows, or second impact syndrome, has been blamed
in the deaths of several athletes, and the discovery of major brain
damage stemming from repeated blows has led school districts across
the country to change their procedures when dealing with head
injuries. The Centers for Disease Control and Prevention even
drafted a letter to Congress underscoring the importance of
learning more about traumatic brain injuries.
The issue has taken on special importance in youth sports as
more symptoms are being recognized in the classroom setting.
Injured kids are unable to grasp basic formulas and information or
cannot retain details that have been regurgitated multiple
times.
Dr. Peter Thompson, co-leader of the Douglas County School
District’s Traumatic Brain Injury Team, said he has even seen young
elementary school students suffer from concussion symptoms from
injuries that occurred years earlier. One student fell from a
second-story window as a toddler but the parents did not realize he
suffered brain damage until learning issues manifested themselves
in the classroom eight years later. Many brain injuries go
undetected for years.
Thompson, also a school psychologist at Rocky Heights Middle
School in Highlands Ranch, said the school district has identified
more than 80 students who have suffered from sports-related
concussions this school year. The majority of those students have
had their school schedules modified. Some have been pulled from
class for weeks and excused from tests. It is not an overreaction,
Thompson says, but rather the district exercising caution.
Research has shown that forcing students who have suffered
concussions to think critically can lead to long-lasting damage.
The old adage that one week of rest will cure everything is not
true.
“What we knew 10 years ago doesn’t even hold water anymore,”
Thompson said.
It takes an average of 19.1 days for symptoms to subside, and
until then, it is recommended that concussion victims not be
exposed to critical-thinking tasks. Students in the Douglas County
School District are slowly re-introduced back into the classroom
setting, starting out with half-days, because being in a social
setting can have positive effects. Administrators and teachers are
made aware of the issue and make special arrangements for those
students.
The latest protocols were put to use when Mountain Vista High
School student Cameron Cannon suffered a concussion after being
knocked out in a club-level hockey game Nov. 6. The 15-year-old was
checked into the boards and later taken to a hospital in Aspen. He
was subjected to an impact test to assess memory and brain
function. Those who suffer a concussion sit out the remainder of
the game and take an impact test three days later. Post-injury
results are typically compared with baseline tests administered
when the student took their sports physical.
“They are kept out [of sports] until they are back to that
baseline,” Thompson said.
The trained neuropsychologist has been surprised by the reaction
of some parents who insist that their child continue to participate
in their sport, particularly the gifted athletes who might have
college scholarships on the line. Thompson said the “walk it off”
mentality can no longer be tolerated now that brain injuries have
been proven to cause lasting damage.
Cannon, a sophomore at Mountain Vista, was slammed into the
boards directly in front of his mother, Cindy, who called the
incident her “worst fear.” He was initially disoriented and Cindy
Cannon immediately rushed him to the emergency room after an
on-scene paramedic diagnosed the injury as a concussion.
Her son was not allowed to immediately return to school. He had
previously been knocked unconscious, so the care team was extra
cautious when monitoring his condition after the latest incident.
Cameron Cannon says he was unaware that the school districts’s
traumatic brain injury team existed, but is glad for the treatment
he received.
“They handled it really well,” he said, adding he is now more
aware of dangerous situations on the ice. Cannon was able to take
his school finals this month.
Thompson credits the collaborative effort of the district’s
nursing staff, top administrators and teachers for the success of
the 6-year-old traumatic brain injury team. Athletic trainers are
of critical importance because they are the “frontline soldiers” in
the battle against permanent brain damage, he said.
A sophisticated surveillance system that serves all interested
parties, including parents, is in place for county students who
suffer a head injury. The system will be refined as science yields
evidence that requires more precautions. Dr. Paulette Joswick, the
Douglas County School District’s head of student wellness, helped
Thompson craft the documents that dictate the procedures for head
injuries.
Cindy Cannon, who said she was “thrilled” to learn there are
brain injury resources within the district, plans on becoming an
advocate for brain injury awareness and will use her son’s story to
reflect the importance of proper treatment. She will try to make it
mandatory for baseline tests to be administered to athletes
participating in non-school sanctioned sports.
Cameron Cannon is now wearing a helmet that better protects his
head.
With permission from the patient, the Douglas County School
District has access to medical tests and scans from Sky Ridge
Medical Center, but because of stringent student privacy rules, the
flow of information does not yet go the other way.
The Colorado Department of Education has taken an interest in
the brain injury teams popping up all over the state. The REAP
(Reduce, Educate, Accommodate and Pace) project, created by the
former athletic director at Grandview High School, also has gained
traction with state and school officials.
The CDC labels concussions as the “silent epidemic” and has
spent the last few years urging athletes and medical providers to
look at the latest facts. The Douglas County School District hopes
its response team can act as a model for other schools interested
in implementing stringent rules for post-concussion care.
“We try to go as far as we can to help the student because we
recognize it’s a serious issue,” Thompson said.