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Experts: Do more on head injuries

Wesley Venteicher

About three dozen concussion experts who met in Pittsburgh this week are aiming to overturn the prevailing view that rest is the only treatment for the injury.

“Concussion is treatable, and we’re going to find out how,” Javier Cardenas, director of the Barrow Concussion and Brain Injury Center at Barrow Neurological Institute in Phoenix, said at a news conference Friday.

Thirty-seven clinicians representing a range of organizations — from hospitals and universities to the NFL, NCAA, FIFA, the Department of Defense and the National Institutes of Health — agreed unanimously after meetings Thursday and Friday that concussions are treatable.

“We now realize that a more active approach to treating a concussion is indicated — active rehab, active physical therapies and active approaches,” said Dr. Michael “Micky” Collins, clinical and executive director of UPMC’s Sports Medicine Concussion Program, which sponsored the gathering.

While clinicians disagree about the best treatments, the group encourages coaches, parents and athletes around the country to stop recommending rest after every concussion and to seek treatment from clinics that specialize in the injury.

A concussion is a generally mild type of traumatic brain injury from a bump, blow or jolt to the head, the Centers for Disease Control and Prevention says. The injuries are a growing focus in adult and children’s athletics as more becomes known about their long-term effects on the brain.

The meeting participants did not focus on treatment of the injury’s long-term effects, Collins said, but clinicians hope that active treatment will reduce long-term effects.

The participants reached unanimous consent on the statement that concussions are treatable, and the majority agreed on 19 other statements related to concussion treatment, Collins said. The statement will be published sometime in the next couple of months in the journal Neurosurgery, he said.

UPMC’s concussion program has identified six subtypes of concussion, based on which parts of the brain are damaged: cognitive/fatigue; vestibular, which affects balance; ocular, which involves vision; post-traumatic migraine; cervical, affecting the neck and spinal cord; and anxiety/mood. People may experience combinations of symptoms, but they can usually be organized and ranked using the subtypes, Collins said.

Treatment at UPMC focuses on rehabilitating the damaged systems, ranging from vision exercises to physical exercise for people with concussion-related anxiety. The health system recommends targeted, active therapy for more than 17,000 patients each year, Collins said.

What will come of the consensus remains to be seen, Collins said, including whether the emerging science on concussions will affect how sports organizations respond to the injuries.

“We’ve put out the information, and we’re going to have to see how they respond to that,” he said.

Wes Venteicher is a staff writer for Trib Total Media. He can be reached at 412-380-5676 or [email protected].


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