Dangers of Repeated Concussions

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Acute consequence of concussion is a cascade of molecular changes in the brain that affect performance and increase vulnerability for repeat injury. Multiple repeat injuries can be long lasting and potentially debilitating. Prevention of single and repeat concussions should be the goal. Following a concussion, adequate time for physiological recovery must be allowed to prevent cumulative impairments.
Wild bootstrap analysis detected significant changes in the white matter of concussed athlete. Other athletes with sub-concussive head blows had changes in a percentage of their white matter that was over 3 times higher than controls. If validated in larger cohorts, the relationship between these changes in white matter and concussions need to be further investigated.
Currently, MRI (T1-weighted) scans and CT scans are inadequate way to manage sports related concussion patients because of inability to detect subtle structural changes in the white matter of the brain. These changes can only be detected through DTI scans, thus serving as biomarker for concussion and may provide an objective diagnostic tool to help determine severity of injury, management and help make return to play decisions.
Concussion is a series of metabolic events within the brain with distinct phases of injury and recovery. Human and animal studies have shown that following a traumatic brain injury; a vulnerable period to repeat injury exists. Recent clinical data have shown long-term effects of prior concussion on cognitive and motor function. The pathophysiology of concussion is different in children and adolescent compared to adults because of unique cerebral development in the prior group.
Results provide preliminary evidence that young athletes with repetitiv...

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... prevention of TBI in sports must really be the primary focus.
Results showed that severity of post-concussive symptom was significantly correlated with a reduction in white matter integrity as manifested by increases in diffusivity and reduced anisotropic diffusion. Moreover, the findings suggest microstructural injury as a neuropathological substrate of post concussion syndrome.
Mild TBI may have persistent effect on brain function and structure. This review describes the impact on mild TBI and its potential effect upon brain regions and connectivity. The child and adolescent brain provides a challenge in this type of injury and highlights the need for specific management of the developing CNS. New neuroimaging modalities may identify markers of severity and long-term disability and aid in delineating more precise treatments for the neurologic sequelae of mild TBI.

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