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IRA FLATOW, HOST:
This is SCIENCE FRIDAY. I’m Ira Flatow. We know that concussions can have unequivocally critical consequences, utterly if you’ve suffered some-more than one conduct injury. But new investigate is observant that even a singular concussion might means durability mind damage. The new investigate compared mind scans from a organisation of healthy people and a organisation of concussion patients and found that after a year, those who suffered a concussion showed signs of constructional mind repairs in regions of a mind related to mood disorders and depression.
So what are some of a long-term effects of concussions? Why are these forms of injuries still so formidable to diagnose? Joining me now is Steven Flanagan. He is Howard A. Rusk highbrow of reconstruction medicine and co-director of a Concussion Center during NYU Langone Medical Center here in New York. Welcome to SCIENCE FRIDAY.
STEVEN FLANAGAN: Thanks for carrying me.
FLATOW: Does that meant that everybody who has a concussion is going to have durability mind damage?
FLANAGAN: Absolutely not. So, many people who have a concussion – that is a amiable dire mind repairs – do sincerely good and indeed turn asymptomatic within a sincerely brief duration of time. But there is a, what we would call a poignant minority – that can operation anywhere between 10 and 20 percent, depending on what novel we review – that might go on to rise ongoing problems.
And that might embody problems with mood, being vexed or anxious, or maybe problems with headaches or balance, or maybe usually problem with their thinking, carrying problems profitable courtesy or concentrating. So it’s a tiny percentage, though a poignant minority.
FLATOW: So what forms of changes in a mind were celebrated with concussion patients? You were not partial of this study, though we investigate concussions all a time.
FLANAGAN: Absolutely. So, this was an engaging study, since they took folks who indeed came into a puncture department. So we’re unequivocally assured that these folks had a concussion. And they imaged them. They did these imagination MRI technologies, and a year later, they did a unequivocally same ones. And what they found in this sold investigate was that there was some mind atrophy or mind shrinkage, if we will – not in everybody, though as a whole.
There was – if we looked during all of a patients that they studied, there was decline of a brain. And they compared them to other people who did not have concussions, and a decline in a mind was many some-more poignant in a folks who had concussion.
FLATOW: So was this thing about usually one concussion, durability mind damage, unequivocally startling to we and to people who investigate concussions?
FLANAGAN: So it’s not startling to me in that people can rise these long-lasting problems. we cruise what is distinguished about a investigate is that there’s justification of constructional changes. There’s indeed a earthy change in a mind that potentially might comment for some of these problems that people have over a prolonged term.
FLATOW: Problems such as?
FLANAGAN: Such as being concerned or depressed, maybe carrying problems with their ability to compensate attention, concentrate, devise and organize, solve problems. And these are some of a common symptoms that people who have what we know as post-concussion syndrome mostly protest about.
FLATOW: 1-800-989-8255 is a number. So they were indeed means to see a tools of a mind that were affected. And what tools were they, and what kinds of effects did they have?
FLANAGAN: Well, what they beheld was that there was a decline sum – not a dramatic, though positively poignant adequate to accommodate a investigate criteria. But there were certain areas in a front partial of a mind in particular, famous as a cingulate, and a small bit in a back, as well, that seemed to many susceptible.
Not terribly startling in some ways, since we know that these areas of a mind are receptive to some-more critical forms of dire mind injury. So it would make clarity that we might also see that in amiable TBI, as well.
FLATOW: Is there a way, when a studious comes in, for we to diagnose a concussion?
FLANAGAN: Well, it all depends on when they come in. So we will start off by observant that concussion, or amiable dire mind injury, is a condition that’s done shaped on what a studious is revelation we in their symptoms, and to some degree, their earthy examination. But there’s no justification test. So standard, out-of-date CT scans and MRI scans are typically ideally normal after a concussion.
FLATOW: Yet they still do them, don’t they?
FLANAGAN: There’s some denote to do them in some cases, though in many cases, substantially not necessary. But there’s no blood exam for this. There’s no other justification test. There’s a lot of investigate going on right now perplexing to find that biomarker or justification test, if we will. Right now, we don’t have it.
FLATOW: Is there something that we would like? You contend we don’t have it. What marker, what something could we demeanour for? we mean, what would there be? You know, what would there be?
FLANAGAN: That’s a good question. So we’re not certain yet. You know, scholarship is looking during a series of intensity markers or justification tests that we could do on a blood. We’re not there yet, since some of a tests that have been talked about uncover justification of repairs usually within a initial day or two. And if you’re observant someone after a concussion some-more than that, not utterly helpful.
There might be, as in this study, some justification on, or an imaging exam that might assistance us make a diagnosis some-more definitively – that is, not usually relying on clinical signs and symptoms.
FLATOW: We have on – we put out a twitter progressing in this week seeking – it’s a doubt of a week, that is: Would we concede – if you’re a parent, would we concede your kids to play sports if we cruise they’re going to get a concussion? Would we – what is your answer to relatives whose kids are football, hockey, whatever sport, soccer? What should they be wakeful of?
FLANAGAN: That is a good question. So let me usually initial start off by observant is there is extensive advantage to children participating in group sports. You know, there’s a whole amicable development, training how to work as a group and a collegiality, and that there’s so many to be gained from that that we would be retiring to contend let’s do divided with strike sports.
That said, we cruise we have to make these sports as protected as we can, and relatives and educators and coaches and jaunty trainers should be entirely wakeful of concussion, know when – or know when to cruise when a child has had a concussion, make certain we mislay them play, don’t let them lapse to play, and they are totally asymptomatic, and make certain that their lapse to play is graduated shaped on their symptoms and augmenting levels of activity.
And those are a discipline that we’re using, though we cruise it’s ridiculous – from my viewpoint – to contend we should be doing divided with strike sports.
FLATOW: There was a apart investigate that came out this week that pronounced there’s no good justification that helmets unequivocally strengthen athletes from concussions. It pronounced that helmets strengthen a skull, though not indispensably a brain. Explain how that works.
FLANAGAN: So if we cruise a mind as, in a healthy state, has a coherence of shaped Jell-O – it’s indeed utterly soothing – and it’s floating in liquid called a intelligent spinal fluid, and it’s all encased in a unequivocally tough skull, and a middle aspect of a skull infrequently is not unequivocally smooth.
So if we are in a conditions where we fall, or we strike your head, and a mind gets jerked behind and forth…
FLATOW: Rings like a bell.
FLANAGAN: That’s right. The soothing mind will strike itself on a middle apportionment of a skull and potentially be damaged. And also since a mind is so soft, as your conduct gets jerked brazen and backwards, as in a tumble or in a sporting event, a mind can roughly smash on itself and afterwards widen as your conduct goes behind and forth, and that stretching can indeed widen all of a haughtiness cells and can describe them nonfunctional, possibly temporarily or potentially permanently, and that can means durability problems.
FLATOW: So are we removing a fake clarity of security, then, when we put a helmet on?
FLANAGAN: To some degree, yes. And we would positively not disciple not wearing a helmet, positively during this point, though we don’t trust that there will ever be a helmet that positively prevents a mind repairs or a concussion. I’m tough pulpy to trust that they’ll ever rise that.
FLATOW: Well, since there’s going to be that impact. As prolonged as we have a aroused impact, you’re going to have a mind toll around inside a skull.
FLANAGAN: That’s right.
FLATOW: And there’s no approach to forestall that with any kind of helmet.
FLANAGAN: we don’t see that. Perhaps somebody will come adult with something that’ll be spectacular. we have problem envisioning it.
FLATOW: So what kind of – what kind of diagnosis does – let me – though we usually have a few mins left. Let me get as many information out as we can. When should we see a alloy if we have a conduct banged?
FLANAGAN: Well, for children, we should substantially see one, since you’re going to need one to get behind into play, so if we have a sporting concussion. But if you’re – we know, if – certainly, if your symptoms don’t go divided within a duration of time, within a few days, or positively a week, though if your symptoms are removing worse…
FLATOW: Symptoms such as?
FLANAGAN: Headache, becloud vision, fatigue, problem staying awake, slurring speech. If those symptoms are removing worse, boy, we unequivocally improved go see a medicine or health caring provider right away.
FLATOW: They always contend you’re going to get exhausted after a concussion. Is that true?
FLANAGAN: You certain – we can.
FLATOW: You can.
FLANAGAN: But we cruise if your sleepiness is removing worse and worse, don’t put it off. Always be safe.
FLATOW: Now if your child is personification in that game, one of a round games or whatever game, and a manager wants – a child gets strike in a head, what should a manager do?
FLANAGAN: Take them out.
FLATOW: Immediately. You should insist yourself if you’re during a diversion and a manager wants to put a child behind in?
FLANAGAN: If we have any guess during all that someone has had a concussion, adult or a child, mislay them from play. It’s a protected thing to do, utterly for children. There’s a thing called intensity second-impact syndrome, and children who are still symptomatic who go behind to play can get into critical problem if they get another concussion.
FLATOW: Is there any customary diagnosis for a concussion?
FLANAGAN: we won’t contend there’s customary treatment, though we cruise it’s substantially best to have a group of professionals, like a concussion center, if we will, where we have reconstruction specialists and neurologists, pediatricians, full services of a radiology dialect – like we have during NYU, for instance – that we can unequivocally make certain that everybody is being treated a approach they need to.
FLATOW: It’s amazing, since there are some athletes – I’m meditative of Jason Bay of a Mets, people who have had unequivocally bad concussions, and they’re going on for years. Is that not unusual?
FLANAGAN: Well, we cruise that a lot of people have not unequivocally famous what concussion is, what a symptoms are, and they simply go back. And we cruise there’s substantially also, we know, some clarity in veteran sports, we know, that this is their bread and butter. They need to get back. But we have to be discreet and comprehend that, we know, repeated concussions – utterly if we have not entirely recovered from a initial one – are usually going to means some-more problems down a road.
FLATOW: So there’s no advice, usually go home, take an aspirin or Ibuprofen, and it’ll go divided on a possess if something bad has happened.
FLANAGAN: Rest is a buttress of treatment, though if a symptoms are removing worse or they don’t get better, it’s time to see a concussion specialist.
FLATOW: And where would we find one of those?
FLANAGAN: So not everybody specializes in concussion. A lot of comforts have concussion centers. We have one during NYU that brings in all sorts of professionals together. It’s not usually rehab medicine. It’s usually not neurology, though we have neurosurgery, orthopedics. We have a ED that’s involved, pediatrics. we cruise if we have a lot of folks entrance together that can residence this in a multidisciplinary way, your outcomes are usually going to be better.
FLATOW: Find one nearby you.
FLANAGAN: Absolutely.
FLATOW: Thank you, Dr. Flanagan. Steven Flanagan is Howard A. Rusk highbrow of reconstruction medicine and co-director of a Concussion Center during NYU Langone Medical Center here in New York. Thanks for entrance in today.
FLANAGAN: Thank you.
FLATOW: We’re going to take a time out, and when we come back, we’re going to speak about an engaging thing about mind tumors. Maybe you’re a cyberchondriac. Yeah. We’re going to speak about what that’s like – we know, sitting during a list during night, and we cruise you’ve got a mind growth since you’ve Googled it, but, we know, it’s usually a small headache. Maybe you’re a cyberchondriac. We’ll speak about that after this break. Stay with us.
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