Articles Posted in Brain Injuries

Ridge Barden, a 16 year old Phoenix, New York high school football player, died on October 14, 2011 after suffering a concussion and traumatic brain injury (TBI) during a game for Homer High School. Barden was a defensive tackle for the team, and died a few hours after falling to the turf in the 3rd quarter of the game following a blow to the head. The coroner determined the cause of death to be subdural hematoma, and massive swelling of the brain.

A subdural hematoma occurs when blood vessels rupture between the brain and the outermost of three membranes that cover the brain, (the dura) resulting in a collection of blood. Subdural hematomas can occur acutely, from a severe blow to the head, subacutely, in which the signs and symptoms can occur days or weeks later, or chronically, in which the precipitating cause might not even be known or remembered by the person suffering the condition. (Additionally, the elderly, people taking aspirin daily, or alcohol abusers can also suffer a subdural hematoma).

Coaches and school administrators watched a video of the game to determine if they noted a particularly violent collision which caused the fatal injury to Barden. Also under scrutiny was the helmet that Ridge was wearing, known as a Riddell “Revolution”. There are lawsuits pending by former NFL players against the league and Riddell Sports, Inc., the manufacturer of football helmets, alleging that former players now suffer from severe injuries from repeated collisions and concussions, including dementia, and CTE, meaning chronic traumatic encephalopathy. Chronic traumatic encephalopathy is a progressive debilitating disease suffered by people who have had multiple concussions or other head injuries. The brain tissue deteriorates from the blows and a protein called “tau” accumulates on the brain. CTE is also known as “dementia pugilistica”, since until recently the huge majority of these cases were diagnosed in boxers.
Teenagers are considered to be more at risk for concussions and traumatic brain injuries as the brain tissue is not completely developed. The National Center for Catastrophic Sports Injury Research notes that Ridge Barden was the 13th high school football player to die from a brain injury since 2005 and the third in 2011. An additional 5 college football players have suffered fatal brain injuries during a game in that same 6 year span. In Ridge Barden’s case, there was apparently no prior history of head trauma or concussion, and the autopsy did not reveal any previous brain injury.
During a recent Senate Commerce Committee Hearing, the topic being addressed was whether manufacturers of sports equipment made misleading statements and claims about their products. Several neurosurgeons and sports concussion experts testified who specialize in traumatic brain injury and sports concussions. Dr. Kevin Guskiewicz, the chairman of the department of Exercise and Sports Science at the University of North Carolina testified that Ridge Barden’s life could only have been saved if he had undergone an immediate operation to relieve the pressure on his brain as a result of the subdural hematoma. However, the problem is that in order to diagnose the issue, a CAT Scan must be ordered, and Barden’s condition deteriorated to quickly allow him to undergo a CAT Scan.

Dr. Robert Cantu, a neurosurgeon at Boston University and well known expert in the field of sports related head trauma and injuries, explained that when a person is conscious immediately after a trauma, and then deteriorates quickly as in Ridge Barden’s case, the cause of death is not the subdural hematoma, but massive brain swelling. Frequently, the fatal injury is due to a previous trauma to the brain compounded by a second impact in close proximity in time to the first. Dr. Cantu calls this “second impact syndrome” in association with subdural hematoma.

After a House Judiciary Committee hearing in October of 2009 in which NFL Commissioner Roger Goodell was pounded with questions about the NFL’s concussion policies, the NFL changed its rules to require that a player diagnosed with a concussion would not be permitted to return to that same game even if he was not experiencing any symptoms.

In the wake of the truly tragic death of Ridge Barden, numerous other high school and college football players like him, and the continuing litigation by former NFL players against the league and Riddell, changes must be contemplated and hopefully implemented. One possibility would be to terminate the three point stance for linemen, (with one hand on the ground as well as two feet), and go to a two point stance, in the expectation that this would limit helmet to helmet contact and result in more blocking with arms and hands. Another possibility would be to eliminate the purposeful helmet hit whereby running backs lower their heads into a defender to garner some additional yardage, and defenders respond by lowering their heads as well. Something else to consider would be fewer full contact drills, which undoubtedly contribute to the long term problem—after all, there are no referees blowing a whistle for helmet on helmet contact, and it is certainly unlikely that a head coach or assistant coach at any level would lecture a player for being too aggressive with an opposing teammate in practice.

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