Brain injury team heeds research advice

Posted 12/21/10

Scientific research and subsequent breakthroughs continue to change the way doctors approach the treatment of their patients, and those advances are …

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Brain injury team heeds research advice


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.


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