Concussions Q&A

By DAVE SCHEIBER, Times Staff Writer
Published August 5, 2007

Is there a misconception that concussions result in a player being knocked out?

Dr. Mickey Collins of the University of Pittsburgh Medical Center, ImPACT coordinator for baseball: "Absolutely. Only 10 percent of concussions will include a loss of consciousness. Certainly some of the most severe injuries we see occur when the athlete doesn't lose consciousness. We found that memory loss around the time of the incident may be up to 10 times more predictive of outcome than people who briefly lose consciousness."

Any other common misconceptions?

Collins: "CT scan/MRIs are always going to be normal with the injury. Those tests are very important to rule out more serious problems, like a skull fracture or a bleed. But the injury is a functional, neurochemical blood flow, metabolic injury. It's not a structural brain injury. So we can't see it when we look at the structure of the brain. It's when we put the brain to work that you see it. That's why we developed ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing). It's a tool that allows us to give the brain a physical. It puts the brain to work and doing that allows us to see its functional deficits. And we can track and monitor recovery by accessing that data over time."

How did the NHL approach the issue?

Lightning head trainer Tom Mulligan: "What the league adopted in the late '90s was a leaguewide concussion protocol and they were pretty proactive on that. They knew it was a major problem in the league and that was the first year they started with the baseline testing. So at that time, every player signed to an NHL contract had to go get a neuropsychological baseline test. They were in a large data base and if they suffered a concussion in the future, they were retested to compare the results and see if there any deficits. Then the following season they'd get rebaselined to see where they were at."

What innovations would you like to see?

Dr. Johnny Benjamin, director of Medical Specialty Procedures Surgery Center, Vero Beach, has worked with light heavyweight champion Antonio Tarver and many other boxers: "If you look at Peyton Manning's helmet, it comes down lower than jaw line. Part of the problem is taking a punch to chin. As we've seen with boxers, a guy who takes a punch to the chin goes down. It's the same with a football player. A key brain stem lives behind the jaw, and controls many functions of the body. So helmets should protect below the chin."