The Physician and Sportsmedicine
Menubar Home Journal Personal Health Resource Center CME Advertiser Services About Us

[EDITOR'S NOTES]

You Can't Ice Your Brain

THE PHYSICIAN AND SPORTSMEDICINE - VOL 25 - NO. 5- MAY 97


In the early years of sports medicine, the standard of care for brain injury was simple: If the patient was unconscious, he was taken by ambulance to the ER. If alert, he could be back in the football game unless he could not remember the plays or ran the wrong way with the ball.

But in the past few years, sports physicians have become more concerned with sequelae of concussion. At issue are the effects on long-term brain function—for example, the ability to concentrate on classwork. Athletes' vulnerability to reinjury, particularly the deadly second-impact syndrome, is also under study. In March, the American Academy of Neurology (AAN) announced new guidelines for return to play after concussion. Last month, the American Medical Society for Sports Medicine (AMSSM) devoted a morning of its annual meeting in Colorado Springs to an update on concussion pathophysiology and the use of neuropsychological testing. Indicative of the questions remaining in the field, the AMSSM is not supporting the AAN guidelines. Nevertheless, the general trend is clear: Better protection of brain function for the sports participant.

Neuropsychological testing is now being used by some teams to assess brain function after concussion. The Pittsburgh Steelers, for example, have implemented baseline testing to have a comparison in case a player gets a head injury. Someday, neuropsychological assessment—now costly and time-consuming—may be readily administered through microcomputers.

The competitive years are few—for most participants, high school only—and life is increasingly long. You can't ice your brain like your quads and hope that it works next week.

Cordially,
Richard H. Strauss, MD
Editor-in-Chief

P.S. For a few practical pointers, check our special selection of "Activity Pearls" (page 29), in which physicians share tips for motivating patients to exercise. Also this month we inaugurate our new department, "Continuing Sports Medicine Education", which previews each article's learning objectives. Reading the objectives will help prepare you for each month's CME Self Test, sponsored by the American College of Sports Medicine.

I am indebted to the four AMSSM presenters whose thoughts and words I have drawn on here: Julian Bailes, MD, of Allegheny General Hospital in Pittsburgh, whose apt words supplied the title; Jeffrey Barth, PhD, of the University of Virginia Medical Center, Charlottesville; David Hovda, PhD, of the University of California, Los Angeles; and Mark R. Lovell, PhD, of the Henry Ford Health System, Detroit.


RETURN TO MAY 1997 TABLE OF CONTENTS

HOME  |   JOURNAL  |   PERSONAL HEALTH  |   RESOURCE CENTER  |   CME  |   ADVERTISER SERVICES  |   ABOUT US  |   SEARCH