A concussion is brain trauma brought on by a biomechanical force. It consists of a group of neurological symptoms that impair the patient for a variable amount of time. The symptoms are often not immediately obvious to the patient or an observer, making the diagnosis of a concussion challenging.
The recent announcement of an FDA-approved blood test that can help resolve this diagnostic dilemma has been met with great interest both by the public and the scientific community.
A biomarker is a measurable substance in an organism that may indicate the presence of a disease, infection or environmental exposure. The Banyan Brain Trauma Indicator is based on identifying proteins that are released from the brain into the bloodstream after impact.
The specific proteins detected by this test (UCH-L1 and GFAP) can be identified up to 12 hours after injury. The blood sample takes approximately three hours to process. The principal studies were conducted by the Department of Defense in soldiers who experienced brain trauma.
Brain trauma has become a significant health problem in the United States. There were approximately 2.8 million visits to the emergency room in 2013. Currently, there are approximately 3.8 million sports-related concussions each year in the United States. This discrepancy is based on the fact that brain trauma is a range of injury that includes brain trauma from severe motor vehicle accidents and penetrating trauma from blasts and gunshots. Concussion is the mildest type of brain trauma on this range and often does not require brain imaging such as CT scanning.
Currently this new blood test has very limited application in sports, where decisions need to be made quickly and away from a laboratory. It is also not useful in identifying sub-concussive blows to the brain that result in cumulative injury. It is not approved for use in children at this time.
This blood test will be helpful in an emergency room setting after serious brain injury.
Despite its limitations, the Banyan biomarker is a significant advance in the diagnosis of brain trauma and will hopefully lead to better testing.
Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu
The danger of sexual predators in sports
The recent conviction and sentencing of Larry Nassar should be a reminder to all that vigilance is necessary to protect children from predators.
More importantly, Nassar violated an established trust between a patient and physician. This and other recent episodes of abuse have also shattered the faith placed in organizations and universities entrusted to protect young athletes.
Sexual predators often methodically build relationships with victims over a period of years. The underlying premise in many abusive situations is the exertion of power over a victim. Early recognition of typical behaviors can avoid a potential crisis.
Grooming is one technique used by predators. It is a process by which an offender draws a victim into a sexual relationship and maintains that relationship in secrecy. Typical targets are young, unsuspecting athletes who have low self-esteem and little parental oversight. Athletes with intellectual impairments can be particularly vulnerable.
Establishing a bond with the athlete and parents allows a sexual predator a lot of opportunity.
Private coaching or physical treatments specific for that athlete can be warning signs.
Isolation is also a crucial element in an abusive relationship. Participation on travel teams and competitions that require overnight accommodations can present occasions for abuse.
Excessive physical contact that appears inappropriate can also be a sign of abuse. If physical contact is necessary in the course of a medical examination, a parent or other adult should be present. The practitioner should welcome inquiries regarding the nature of the examination. Unfortunately, many young athletes actually report incidents of abuse but are not taken seriously.
There are many dedicated coaches, medical personnel and parents involved in youth sports. Vigilance on the part of all adults involved in youth sports is crucial to stopping what has become a disheartening trend.
Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu.
More importantly, Nassar violated an established trust between a patient and physician. This and other recent episodes of abuse have also shattered the faith placed in organizations and universities entrusted to protect young athletes.
Sexual predators often methodically build relationships with victims over a period of years. The underlying premise in many abusive situations is the exertion of power over a victim. Early recognition of typical behaviors can avoid a potential crisis.
Grooming is one technique used by predators. It is a process by which an offender draws a victim into a sexual relationship and maintains that relationship in secrecy. Typical targets are young, unsuspecting athletes who have low self-esteem and little parental oversight. Athletes with intellectual impairments can be particularly vulnerable.
Establishing a bond with the athlete and parents allows a sexual predator a lot of opportunity.
Private coaching or physical treatments specific for that athlete can be warning signs.
Isolation is also a crucial element in an abusive relationship. Participation on travel teams and competitions that require overnight accommodations can present occasions for abuse.
Excessive physical contact that appears inappropriate can also be a sign of abuse. If physical contact is necessary in the course of a medical examination, a parent or other adult should be present. The practitioner should welcome inquiries regarding the nature of the examination. Unfortunately, many young athletes actually report incidents of abuse but are not taken seriously.
There are many dedicated coaches, medical personnel and parents involved in youth sports. Vigilance on the part of all adults involved in youth sports is crucial to stopping what has become a disheartening trend.
Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu.
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