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CDC Brain Injury Guidelines For Physicians: When To Scan A Concussion

By Richard C. Hunt, MD, FACEP

Centers for Disease Control and Prevention

A 17 year-old athlete arrives on the sideline, at your office, or in the emergency department after hitting her head during a collision on the sports field and is complaining that she has a headache and “just doesn’t feel right.”

Can she return to play? If not, when can she safely return to school, sports, and to her normal daily activities? Does she need immediate care, a Head CT or MRI, or just some time to rest?

Do those questions sound familiar?

Each year thousands of young athletes present at emergency departments and in the primary care setting with a suspected sports- and recreation-related concussion. And every day, health care professionals, like us, are challenged with identifying and appropriately managing patients who may be at risk for short- or long-term problems.

As you know, concussion symptoms may appear mild, but this injury can lead to significant, life-long impairment affecting an individual’s ability to function physically, cognitively, and psychologically. Thus, appropriate diagnosis, referral, and education are critical for helping young athletes with concussion achieve optimal recovery and to reduce or avoid significant sequelae.

And that’s where you come in. Health care professionals play a key role in helping to prevent concussion and in appropriately identifying, diagnosing, and managing it when it does occur. Health care professionals can also improve patient outcomes by implementing early management and appropriate referral.

As part of my work at CDC, and as a health care professional, I am committed to informing others about CDC’s resources to help with diagnosing and managing concussion. CDC collaborated with several organizations and leading experts to develop a clinical guideline and tools for the diagnosis and management of patients with concussion, including:

For more information about the diagnosis and management of concussion, please visit

Also, learn more about CDC’s TBI activities and join the conversation at:

Combating Concussions: Impact Sensors For NFL Players’ Helmets

Anyone who’s ever watched football, the American variety, knows how rough of a sport it can be. With 22 fast-moving players (some weighing as much as 350 pounds) scrambling and tackling for possession of the pigskin, injuries are inevitable.

One of the scariest injuries a football player can get is a concussion. With its commonly insidious onset, concussions of the brain are often difficult to diagnose, or immediately treat to avoid long-term consequences.

The National Football League (NFL) has announced that they will be launching a pilot program next season in which accelerometers will be placed in players’ mouthpieces, earpieces, and helmets to analyze how blows to the head relate to the effects and severity of concussions and other traumatic brain injuries. The data could potentially help team doctors diagnose the severity of a concussion within a few minutes. Collected long-term from groups of players, the impact data could help coaches and doctors determine how players get injured and the possible effects of such injuries. Such data could also help engineers design a better football helmet.

As long as the game of football continues to be played, concussions will be pretty much impossible to avoid. However, changing technology and increasing knowledge of traumatic brain injury will hopefully only make football a safer, more enjoyable sport.

Wired article: Impact Sensors Slated for NFL Helmets Next Season…

Medgadget archive: Football helmet technology…

*This blog post was originally published at Medgadget*

Simple Blood Test To Detect Mild Brain Injury?


FREDERICK, Md. — The Army says it has discovered a simple blood test that can diagnose mild traumatic brain damage [TBI] or concussion, a hard-to-detect injury that can affect young athletes, infants with “shaken baby syndrome” and combat troops.

“This is huge,” said Gen. Peter Chiarelli, the Army vice chief of staff.

Yes, it is, if it pans out. There’s so little actual information in this that it’s hard to get excited about it, but let’s say they’ve isolated a “brain injury” protein.

First, it would have uses outside traumatic brain injury (TBI), though that in and of itself might be useful. I don’t want to poo-pooh this test for TBI, but there are already rules for returning to contact sports (and combat has to be the ultimate in contact activities), so what’s the purpose here? (I forsee more Purple Hearts, which is fine.)

Stroke? TIA? Seizure? Pseudotumor cerebri, as a strain indicator? What if this is the test that allows us to diagnose meningitis without doing lumbar punctures? I’m all in on that front. Let’s hope this pans out, for all our sakes.

*This blog post was originally published at GruntDoc*

Apple’s Steve Jobs On The iPad’s Use By Kids With Special Needs

In a Wall Street Journal profile on how iPad apps are being used by special needs children, such as those who have speech impediments and as a communication tool — Steve Jobs commented on how even he did not have the foresight to see that the iPad could be used in such a fashion.

“We take no credit for this, and that’s not our intention,” Mr. Jobs said, adding that the emails he gets from parents resonate with him. “Our intention is to say something is going on here,” and researchers should “take a look at this.”

Last year we reported on how how much cheaper Apple’s portabile devices were compared to the traditional speech software/hardware products, and how insurance companies were hesitant to reimburse for a significantly cheaper Apple products verse industry products. At the time of our report, insurance companies were willing to reimburse up to $8,000 for a product that could be replaced by an iPod Touch with speech therapy apps would cost approximately $600. Since our report on the topic last year, not much has changed. Read more »

*This blog post was originally published at iMedicalApps*

PTSD “Breakthrough?” Real Science Doesn’t Need Endorsement

The PTSD BreakthroughIt infuriates me when someone misappropriates the word “science” to promote treatments that are not actually based on science. I have just read a book entitled The PTSD Breakthrough: The Revolutionary Science-Based Compass RESET Program by Dr. Frank Lawlis, a psychologist who is the chief content advisor for Dr Phil and The Doctors. There is very little science in the book and references are not provided. It amounts to an indiscriminate catalog of everything Dr. Lawlis can imagine that might help post-traumatic stress disorder (PTSD) patients. 

He describes recent brain imaging studies suggesting that signs of traumatic brain injury are associated with PTSD.  He thinks PTSD can no longer be considered a psychological condition, but must be approached as a complex biological, physical, psychological, and spiritual condition. He says many of these patients have brain damage. Read more »

*This blog post was originally published at Science-Based Medicine*

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