Head injuries still at forefront of discussion, research

When Philadelphia Flyers center Jeremy Roenick lost a defensive zone faceoff during the third period of a game against the New York Rangers Feb. 12, 2004, Roenick found himself collapsing on the ice, lying in a puddle of blood. Roenick, who was hit in the face by a slap shot off the stick of Rangers defenseman Boris Mironov, suffered a fractured jaw and his ninth concussion.

“I lost the draw in my defensive zone,” Roenick said in a telephone interview. “Mironov came at me with a massive shot and destroyed my face.”

Roenick’s jaw was fractured in 19 places and had to be wired shut. He told ESPN that his concussion was his “biggest challenge of his career.” Despite this, he returned to game action ahead of schedule to help the Flyers reach the Eastern Conference Finals, scoring 13 points along the way.

Then Roenick suffered another concussion during the postseason run, he said.

“It was not a good summer. It was a long recovery stage.” Roenick said.

Roenick is one of many professional athletes such as Eric Lindros and Keith Primeau who have suffered multiple concussions during their playing days.

Concussions and post-concussion syndrome has been a subject of research by many medical institutions among collegian and professional athletes.

The Centers for Disease Control and Prevention (CDCP) defines a concussion as a type of a traumatic brain injury caused by a bump, blow or jolt to the head that can change the way your brain normally works.

According to the CDCP, concussions affect a wide range of functional short or long term changes which affect a person’s thinking, sensation, language or emotions. Repeated injuries to the brain can cause permanent damage to the brain, experts said.

“To me, it would be a reason to stop playing sports,” Dr. Steven Galetta, a neurologist at the Hospital of University of Pennsylvania (HUP), said. “If somebody had these persistent concussive effects, they probably shouldn’t get hit in the head again.”

The University of Washington Medical Center said that post-concussion syndrome happens when symptoms of a concussion continue for months. These symptoms include headaches, neck pain, sleep pattern changes, dizziness, memory problems, noise sensitivity, personality changes, fatigue, and nausea and vomiting.

But doctors have not been able to explain why post-concussion syndrome occurs and why it affects some more than others.

“Yeah, we don’t really know that,” Galetta said. “We don’t have any particular biomarker to understand why somebody is more vulnerable.”

According to the Department of Neurological Surgery at the University of Pittsburgh, child and teenage athletes might be expected to have a slower recovery than college-aged athletes or older athletes. The recovery from concussions requires a lot of rest, both mentally and physically.

According to the Journal of Clinical Neuroscience, most concussions are resolved in seven to 10 days, although it may be longer in children and adolescents.

“Because you have a developing brain, their necks aren’t as strong so they might get whipped,” Galetta said. “Their total body weights are lower so they could get launched by a much bigger kid. If some young kid who doesn’t have high body weight or neck strength gets launched by a much bigger kid, [they] might have a lot more whiplash.”

The Agency for Healthcare Research and Quality collected statistics from the Healthcare Cost and Utilization Project on emergency department visits for sports-related concussions in 2008. According to this statistical brief, 58 percent of ED visits were for youths ages 14 to 18 years old while less than one-tenth were 24 and older.

“To me, that’s where we really have to make a big effort,” Galetta said. “Listen, it’s important for everyone to know what they are doing to their brain, but the youth in particular because they don’t have the education or knowledge.”

Galetta and his colleagues at HUP have been working on a new sideline test called the King-Devick, a “rapid number-naming test that helps figure out if a player suffered a concussion,” he explained.

The King-Devick test is performed in less than a minute and is conducted by giving a player three cards, then asking them to count 40 numbers as fast as they can. There are other protocols to determine concussions, but Galetta said this KD test is “practical” for sideline testing.

“We’re trying to do this to validate tests to help the coach or trainers predict concussions,” Galetta said. “We need something easy like this that’s objective and can be measured to help because you don’t want to put a kid back in, right?”

This year, the neurologists at HUP tested the KD test on the Flyers in addition to other tests the NHL requires. Galetta said HUP wants to educate parents about the effects of a concussion on the brain by passing on research found in professional sports.

“We need to take these highly publicized media cases and educate people,” Galetta said. “And get that down to the level of the parents so they can make informed decisions about their kid. The kids are the group I’m most worried about.”

His ninth concussion didn’t stop Roenick from playing hockey. He returned later that year, and played five more years before hanging up his skates. Today, Roenick is a TV analyst for NBC Sports Network and is doing fine, he said.

Roenick played in the Flyers-Rangers alumni game Dec. 31 at Citizens Bank Park.

“[I have] no side effects.” Roenick added. “I’ve been able to recover very well [from my concussions], if anything, I have short-term memory [problems].”