It has been two months since Damon Janes, a 16-year-old with his whole life ahead of him, tragically died after suffering a head injury in a high school football game in Western New York.
Damon died after playing a game that millions of Americans watch religiously every weekend, but until recently, were unaware of the high cost to participants. The question we find ourselves asking as neurosurgeons is: How many athletes will have brain injuries before adequate changes are made to the sports we love most?
The era of players getting their “bell rung” and returning to action after sitting out for a play must come to an end. A phenomenon known as “second impact syndrome,” a second head blow after a more recent head injury leading to potential fatal brain swelling, is all it takes to end the life of a young athlete. We must ask if we are cultivating a future cohort of athletes with cognitive and behavioral impairment due to multiple concussive injuries, simply for the love of these games on which we place so much value. If the professional and collegial leagues have mandated sufficiently trained personnel at every game to identify concussion and brain injuries, then we need the same protection for younger athletes, too.
Society’s love of competition and sporting events has been well-documented throughout history, but surely our modern society has evolved beyond the gladiatorship of ancient Rome, where opponents fought to the death. With the recent deaths of former NFL players Junior Seau and Ray Easterling, and the more recent $765 million settlement made between the National Football League and former players who have suffered concussion-related injuries, more attention is now paid to concussion and head injuries than ever before.
If the NFL’s implementation of “unaffiliated neuro-trauma consultants,” a group of specialists trained to protect players by identifying the symptoms of concussion and head injury, is any indication of the gravity of head trauma, then why aren’t the thousands of youth players in various sports provided the same level of protection?
Sports serve as an outlet for our youth to learn teamwork, discipline and the importance of physical fitness as part of a healthy lifestyle. The benefits of participating in sports are undeniable, but no sport comes without risk. As sports science advances and players become stronger, faster and more athletic, the collisions between players are more violent. Therefore, it is incumbent upon the organizers and administrators of sporting events to protect the young participants involved. A concussion may not be entirely preventable, but recognizing and removing a player with a concussion from the field could be life-saving.
The University of Pittsburgh Brain Trauma Research Center estimates that more than 300,000 sports-related concussions occur annually in the United States, and the likelihood of suffering a concussion while playing a contact sport is estimated to be as high as 19 percent per year of play. Additionally, the Centers for Disease Control and Prevention reports that in the past decade, there has been a 60 percent increase in emergency department visits by children and adolescents for sports- and recreation-related traumatic brain injuries. The data accrued by various institutions and organizations, however, only accounts for documented and treated concussions, leaving one to wonder how many concussions are left undiagnosed each year.
Concussion is defined as a clinical syndrome characterized by immediate and transient alteration in brain function, including alteration of mental status and level of consciousness, resulting from mechanical force or trauma. Contrary to popular belief, loss of consciousness is not required for one to have experienced concussion. In fact, according to the CDC, most concussions do not involve loss of consciousness. Despite the increase in attention and statistical information regarding concussion, the long-term effects of concussions experienced by amateur and professional athletes are debilitating and may cause issues with problem solving, behavior, planning and memory, to name just a few.
Barring parents preventing their children from participating in contact sports, such as hockey, football and soccer, concussions will remain an unavoidable occurrence. However, the need for trained personnel who recognize the danger and protect children from further injury is imperative. Even more awareness and education is required as we watch a generation of professional athletes come to the forefront with neurologic ramifications from careers rife with multiple head blows.
The athletic community as a whole should take a page from the NCAA, which, through its Sports Medicine Handbook, has bylaws requiring participating institutions to have concussion management plans. The system is by no means perfect, because some incidents are unavoidable, however, ensuring young athletes come off the field safely with their lives still ahead of them should be the top priority.
Dr. Hakeem Shakir is in his third year of residency in the University at Buffalo’s Department of Neurosurgery. Dr. Elad Levy is chairman and professor of neurosurgery in UB’s Department of Neurosurgery, and an unaffiliated neuro-trauma consultant for the NFL.