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Mild Concussion Isn't So Mild After All

Posted Nov 26 2012 3:00am
I'll be the first to admit that I don't follow football nearly as closely as many friends do but as I read about Peyton Manning getting tested for a concussion in yesterday's USAToday , I couldn't help but think about a case control study published online prior to print in next month's Radiology in which the authors concluded that even mild traumatic brain injury (TBI), commonly referred to as a concussion, led to notable changes on functional magnetic resonance imaging correlating with post-traumatic symptoms such as depression, anxiety, fatigue & post-concussion syndrome as well as neurocognitive dysfunction.

The authors arrived at their conclusions by comparing 23 patients who had suffered mild TBI resulting in symptoms for 2 months after their injury to 18 age-matched healthy control subjects.  What's scary, in my opinion, is that conventional imaging using CT or MRI typically shows a normal picture w/o any evidence of anatomic injury.  Yet this study shows that physiologically, there is tremendous impact (no pun intended) from even mild TBI.  

This builds upon a research letter published earlier this month in JAMA in which the authors noted that soccer players who regularly head the ball but without having sustained a history of a concussion had alteration to their white matter compared to matched swimmers who are at very low risk for repetitive subconcussive head trauma.  While I'm not ready to change the rules for playing a global sport, I do believe we need to start paying more attention to what we label as a "mild" concussion.

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