Concussions. Defined and explained.

[lets_go_bills]

Concussion of the brain: A traumatic injury to the brain as a result of a violent blow, shaking, or spinning. A brain concussion can cause immediate and usually temporary impairment of brain function such as of thinking, vision, equilibrium and consciousness.

 

Recovery from concussion: It takes considerable time and energy for the brain to correct this chemical imbalance. Changes in the brain start to resolve immediately, but the recovery time seems to vary. The time depends not only on the severity of the blow, but also on how many previous concussions a person has had.

 

After a concussion, the arteries in the brain constrict. This reduces blood flow to the brain and lowers the rate at which oxygen is delivered to the brain. At the same time the demand rises for the sugar glucose which provides energy to the brain for healing. But the need for more glucose cannot be met by the narrowed arteries and this discrepancy ("mismatch") creates a metabolic crisis. Eventually the damaged brain cells (that survive) do slowly repair themselves, the demand for glucose eases, the arteries to the brain open wider, and blood flow to the brain returns to normal. However, the brain stays in a lowered metabolic state, a quiescent condition, for a considerable length of time before it can return to normal.

 

Return to normal activities: The American Academy of Neurology has established guidelines for athletes with concussion returning to play. The guidelines divide concussions into three grades of severity, with a prolonged knockout being the worst. The Academy recommends that athletes whose symptoms -- headaches, nausea, amnesia, blurred vision -- do not clear up within 15 minutes, or who lose consciousness even briefly, be kept out of competition until their symptoms have disappeared completely for at least a week.

 

Susceptibility to future concussions: Once a person has had a concussion, he or she is as much as four times more likely to sustain a second one. Moreover, after several concussions, it takes less of a blow to cause the injury and requires more time to recover.

 

Source:

 

http://www.medterms.com/script/main/art.asp?articlekey=13166

[lets_go_bills]

My point?

 

Even if Trent recovers in time for SD, he'll still be at risk for more concussions.

 

4 times more likely to be exact. This is not good. Especially for a young QB. Recovery time also goes up. So do the severity/damage of them.

 

Concussions killed Eric Lindros' once promising career.

 

We'll have to keep him super-protected from now on. Any more big hits will ruin us. Obviously this is worst-case-scenario, but it is scary.

 

I'm not gonna hit the panic button yet.

[The Big Cat]

Even if Trent recovers in time for SD, he'll still be at risk for more concussions.

 

4 times more likely to be exact. This is not good. Especially for a young QB. Recovery time also goes up. So do the severity/damage of them.

 

Concussions killed Eric Lindros' once promising career.

 

 

I'm not gonna hit the panic button yet.

 

Hit it? No. Press it with modest conviction? Yes.

[ofiba]

My point?

 

Even if Trent recovers in time for SD, he'll still be at risk for more concussions.

 

4 times more likely to be exact .This is not good. Especially for a young QB. Recovery time also goes up. So do the severity/damage of them.

 

Concussions killed Eric Lindros' once promising career.

We'll have to keep him super-protected from now on. Any more big hits will ruin us. Obviously this is worst-case-scenario, but it is scary.

I'm not gonna hit the panic button yet.

 

You sure?

 

Let's just get him a Kelso head and be done with it.

[MarkyMannn]

My point?

 

Concussions killed Eric Lindros' once promising career.

 

Didn't help the Sabres' Tim Connolly either

[DDD]

Concussion of the brain: A traumatic injury to the brain as a result of a violent blow, shaking, or spinning. A brain concussion can cause immediate and usually temporary impairment of brain function such as of thinking, vision, equilibrium and consciousness.

 

Recovery from concussion: It takes considerable time and energy for the brain to correct this chemical imbalance. Changes in the brain start to resolve immediately, but the recovery time seems to vary. The time depends not only on the severity of the blow, but also on how many previous concussions a person has had.

 

After a concussion, the arteries in the brain constrict. This reduces blood flow to the brain and lowers the rate at which oxygen is delivered to the brain. At the same time the demand rises for the sugar glucose which provides energy to the brain for healing. But the need for more glucose cannot be met by the narrowed arteries and this discrepancy ("mismatch") creates a metabolic crisis. Eventually the damaged brain cells (that survive) do slowly repair themselves, the demand for glucose eases, the arteries to the brain open wider, and blood flow to the brain returns to normal. However, the brain stays in a lowered metabolic state, a quiescent condition, for a considerable length of time before it can return to normal.

 

Return to normal activities: The American Academy of Neurology has established guidelines for athletes with concussion returning to play. The guidelines divide concussions into three grades of severity, with a prolonged knockout being the worst. The Academy recommends that athletes whose symptoms -- headaches, nausea, amnesia, blurred vision -- do not clear up within 15 minutes, or who lose consciousness even briefly, be kept out of competition until their symptoms have disappeared completely for at least a week.

 

Susceptibility to future concussions: Once a person has had a concussion, he or she is as much as four times more likely to sustain a second one. Moreover, after several concussions, it takes less of a blow to cause the injury and requires more time to recover.

 

Source:

 

http://www.medterms.com/script/main/art.asp?articlekey=13166

 

This is scary stuff. I take solace in the fact that Trent is pretty bright guy and should be fine. Now if that happened to JP on the other hand...

[Saint Doug]

The team will keep Trent out of practice until he has zero symptoms. They will not even have him using his brain by watching film either. If an athlete sustains even a mild hit to the head while still have symptoms of a concusion, they will likely develop Second Impact Syndrome (SIS). SIS is extremely deadly; a 50% mortality rate and a very high incidence of permanent neurologic handicap. So, we are not just talking about Trent risking his career by going back too early.

 

Now, if he is symptom free by this Sunday, there is a small chance he may be able to play again SD. If not, it will not be too bad if he misses the SD game - probably best in the long run.

 

At least we will able to see a fully prepared JP within Schonert's offense. Then after he fails, we can stop hearing about him.

[TDRupp]

From what I have read and seen, Trent Edwards probably suffered a Grade 2 Concussion and presumably it was his first. So I would expect that Trent will not be practicing until late next week (1 week after all symptoms disappear) at the earliest, assuming the Protocol the Bills follow is something similar to what is contain in the following link:

 

http://www.geocities.com/wadeinblack/concussion.html

 

 

 

GRADES OF CONCUSSION

Grade 1:

 

Transient confusion (blank stare, inability to carry out goal-directed movement or maintain coherent stream of thought)

No loss of consciousness

Commonly referred to as having had their "BELL RUNG" or been "DINGED".

Concussion symptoms or mental status abnormalities on examination resolve in less than 15 minutes.

Grade 2:

 

Transient confusion

No loss of consciousness

Concussion symptoms or mental status abnormalities (including amnesia) on mental examination last more than 15 minutes.

Grade 3:

 

Any loss of consciousness

Brief (seconds)

Prolonged (minutes)

 

MANAGEMENT RECOMMENDATIONS

Grade 1:

Remove from contest

Examine immediately and every 5 minutes for development of mental status abnormalities or post concussive symptoms at rest and with exertion.

May return to contest if mental status abnormalities or post-concussive symptoms clear within 15 minutes.

Grade 2:

 

Remove from contest and disallow return to play that day.

Examine on-site frequently for signs of evolving intracranial pathology.

A trained person should re-examine the athlete the following day.

a physician should perform a neurologic examination to clear the athlete for return to play after 1 full asymptomatic week at rest and with exertion.

Grade 3:

 

Transport the athlete from the field to the nearest emergency department by ambulance if still unconscious or if worrisome signs are detected (with cervical spine immobilization, if indicated).

A thourough neurologic evaluation should be performed emergently, including appropriate neuroimaging procedures when indicated.

Hospital admission is indicated if any signs of pathology are detected, or if the mental status of the athlete remains abnormal.

 

WHEN TO RETURN TO PLAY

An athlete may return to play only after all post-concussive symptoms have resolved both at rest and with exercise.

 

*Grade 1 Concussion

May return to play after 15 minutes if no headache or other post-concussive symptoms are present.

 

*Multiple Grade 1 Concussions

Return to play after 1 week without symptoms.

 

*Grade 2 Concussion

Return to play after 1 week without symptoms.

 

*Multiple Grade 2 Concussions

Return to play after 2 weeks without symptoms.

 

*Grade 3 Concussion(brief)

Return to play after 1 week without symptoms.

 

*Grade 3 Concussion (prolonged)

Return to play after 2 weeks without symptoms. May need to consider terminating season if symptoms persist.

 

*Multiple Grade 3 Concussions

Hold out at least one month. Base on decision of evaluating physician.

 

 

 

Here is hoping Trent is feeling back to normal by now or very soon, but my guess is he sit for the SD game. It is a hige game since it is in the AFC and against a team we hopefully will be competing with for the Playoffs.

[Saint Doug]

After a concussion, the arteries in the brain constrict. This reduces blood flow to the brain and lowers the rate at which oxygen is delivered to the brain. At the same time the demand rises for the sugar glucose which provides energy to the brain for healing. But the need for more glucose cannot be met by the narrowed arteries and this discrepancy ("mismatch") creates a metabolic crisis. Eventually the damaged brain cells (that survive) do slowly repair themselves, the demand for glucose eases, the arteries to the brain open wider, and blood flow to the brain returns to normal. However, the brain stays in a lowered metabolic state, a quiescent condition, for a considerable length of time before it can return to normal.

 

And this is why they keep sending him home instead of having him stand on the sidelines or watch film. Due to the glucose metabolism mismatch, they don't even want him thinking. By thinking, your brain uses a higher amount of glucose than if you were just staring at a blank wall. If the brain has a higher metabolic need for glucose and can't actually get it, healing will be retarded.

[eball]

And this is why they keep sending him home instead of having him stand on the sidelines or watch film. Due to the glucose metabolism mismatch, they don't even want him thinking. By thinking, your brain uses a higher amount of glucose than if you were just staring at a blank wall. If the brain has a higher metabolic need for glucose and can't actually get it, healing will be retarded.

It's not nice of you to insult healing like that.

[Saint Doug]

It's not nice of you to insult healing like that.

 

[BillsNYC]

I just hope Edwards isn't walking around OBD in a dress....

[stevewin]

My fear is not that he won't come back from this OK - but as others have mentioned how susceptible he may be to injury from subsequent (not even as severe) hits. Nothing you can do about that though I guess but hope for the best.

 

 

Now - is this the thread we post our personal concussion stories?

 

I received what based on the info in this thread was a Grade 3 concussion (actually it was thought to be a double concussion) when I was a junior in High School at basketball practice on a Sat. morning. At one point in the practice we were scrimmaging and I went full out barrelling after a loose ball. My progress was abruptly stopped when my face stopped the progress of the forehead of one of my teammates also barrelling after the ball. The people who were there said after a sickening crack sound, I kind of froze in position for a second - out cold on my feet - then slowly fell backward and the back of my skull cracked on the floor. I was definitely out cold then, and everyone gathered around. One of my friends soon noticed I was choking on something, so he carefully turned my head sideways, and a river of blood started to flow onto the floor (it's likely he could have actually saved my life by doing this). Later my coach, who coached both football and basketball at that point for over 20 years, said it was the worst sports injury he had ever witnessed.

 

I'll never forget the sensation when I came to in the gym and then in the ambulance - I knew I was awake and I felt awake - but I couldn't remember the simplest things - a very weird feeling. It turns out my Mom was Christmas shopping, and my Dad was deer hunting (this was before cell phones) - so I went to the hospital and literally laid on a gurney in a hallway for hours. At some point my parents finally showed up, I got admitted to a room, and I'll never forget the surreal image of a doctor rushing into my room wearing a tuxedo (apparently coming from some Christmas party/function). He gave me a quick examination, looked at my eyes and turned to my parents and said "One of his pupils is larger than the other - that could mean he has pressure on his brain, and we may need to drill to relieve the pressure". At that point I saw my Mom's face grow white - and I swear I thought she was going to have a heart attack and be admitted to the bed next to me (it turns out after more tests they determined there was nothing seriously wrong - and it was discovered that actually one of my pupils is normally larger than the other). At some point that night, I remembering trying to open my mouth and my jaw was locked - never really sure what happened - if the force of the collision had done something to relocate/dislocate part of my jaw, but I just forced it open and heard a loud *crack* - then that hurt like hell, but I never told anyone b/c I was so sick of doctors at that point. To this day the left side of my jaw is loose. My nose was completely shattered - so the next day I had reconstructive surgery. Everything was kind of a haze for those few days - but the thing I remember most was coming back to my room from some test or procedure and the other guy in my room said "They shot John Lennon, man!"

 

I had bad headaches for a while afterwards - but don't feel like I had any long term affects in life (although my wife may say there may be some delayed affects now - when she says I didn't listen to her or remember what she told me - that could be my excuse ). As far as subsequent blows to the head - the only other time I really cracked my skull open was in college on a sidewalk (resulting in 12 stitches above my eye) - but that was more an alcohol related injury, not a sports one - and is another story altogether

[lets_go_bills]

My god. That is awful.

[Orton's Arm]

My point?

 

Even if Trent recovers in time for SD, he'll still be at risk for more concussions.

 

4 times more likely to be exact. This is not good. Especially for a young QB. Recovery time also goes up. So do the severity/damage of them.

 

Concussions killed Eric Lindros' once promising career.

 

We'll have to keep him super-protected from now on. Any more big hits will ruin us. Obviously this is worst-case-scenario, but it is scary.

 

I'm not gonna hit the panic button yet.

I agree with what you've written. Thus far this season, the Bills have been extremely cavalier about protecting Trent from getting hit. Now they're paying the price. Let's hope that when the 2009 draft rolls around, protecting the QB and blocking for Lynch is considered more important than drafting yet another defensive back.

[WildBills]

trent is fine. he had a mild concussion. people saw him filling up his propane tank at home depot today. he was driving himself. if his concussion was so bad he would not be driving himself. it was also said that he was at the sabres game tonight. must not be that bad if he can tolerate the loud noise of the opening game.

[lets_go_bills]

Yeah, but I'd be willing to bet nobody at Home Depot tackled him. I think there's a difference between doing daily things and suiting up in pads and playing the violent game of football. That said, if what you say is true, then I'm happy. That's good news and definately positive for us.

[Thurman#1]

trent is fine. he had a mild concussion. people saw him filling up his propane tank at home depot today. he was driving himself. if his concussion was so bad he would not be driving himself. it was also said that he was at the sabres game tonight. must not be that bad if he can tolerate the loud noise of the opening game.

 

 

 

People with concussions somewhat resemble drunks in that their decision-making abilities can be impaired. In the same way that seeing a person driving does not prove that he is not to drunk to drive, seeing Trent driving does not prove that he is not injured.

 

We just have to wait and see.

[Thurman#1]

This also should be a wake-up call for not just Trent but every single Buffalo Bill to start wearing the two helmets that are specifically and successfully designed to prevent concussions, the Riddell Revolution and the Schutt DNA. The helmets look slightly less cool than normal helmets, and that is the only reason they're not in wide use. They have been proved to successfully prevent a large percentage of concussions. They aren't even that much more expensive than normal helmets.

 

C'mon TBD, let's make them mandatory on this team.

[Pyrite Gal]

My concussion story was one of the weirder experiences I ever had (and this comes from a full selection of usually self-selected weird experiences.

 

I remember watching coverage of the Clarence Thomas questioning on Nightline and going to the can. Apparently over an hour later one of the guys I roomed with said he was awakened by me standing over his bed saying that I was in trouble and think I hurt my head.

 

He woke up the other roomie (an EMT actually) and a visual exam revealed no blood but a likely lump on my noggin. They called 911 which had them ask me questions to determine my condition while an ambulance came out. They could tell from my answers that I was not with the planet (even more than normal). The ambulance came and I seemed to be more with the program and they suggested they take me to the emergency room for observation.

 

I was in VA and offered that I used to go to GW hospital back in the day and that they likely had my records. The ambulance guys said they could not drive me across the river, but if I stood up without falling over then likely my buds could drive me to GW. I stood up and stayed up so off we went to GW hospital. We were in the waiting room for a little while after checking in and apparently I kept trying to stand up saying I wanted to go to the phone and call my honey back in Buffalo to say I was OK. My buds convinced for a few minutes that this was unnecessary as no one if Buffalo knew I was at the hospital.

 

Finally, I went into the ER where the doctor asked me what day it was and I correctly answered it was Thursday, but that I really did not know for sure whether it was February or October.

 

This is the only thing I remember about the episode since going to the can after Nightline. I was walking and talking and occaisionally coherent remembering things from years before. However, I have no memory of any of this.

 

The kept me in the hospital overnight. The next day I talked to one of my roomies and asked him to bring my wallet down. He replied that I had insisted on bringing it with me the night before and it was in the pocket of the sweats I was wearing that night. Lo and behold he was correct but I have no memory of this.

 

It was likely a grade 3 concussion as I lost conciousness. The likely cause was something called micturation syncope which means when you micturate (piss) your fluid balances change in your body and it is supposed to compensate for this because one fluid that may change is blood and if it rushes from the brain you can collapse. I apparently did this and clocked my head on a towel rack.

 

It did take a bit over a week until I felt normal though i was back to work in a couple of days. The abnormal thing which did not stop me from working but felt weird was that I realized that the way I remembered things was to riffle back through my memory incredibly quickly. Immediately after my concussion I found that often I would begin rifling back and I hit the missing slot and trying to remember just stopped. I would remember things way back by mentally leaping to a time and the checking to see if I went back too far or too little and triangulate my way in (all of this happened incredibly quickly normally (dozens of years accurately with miliseconds) but I noticed because it did not work well for a good week,

 

In the end I built up enough new memories so there was no problem but it gave me a new respect for an athlete who could still perform after getting his bell rung.