The Dangerous Consequences of Repetitive Head Trauma

The link between football and traumatic brain injury continues to strengthen. Now, one of the largest studies on the subject to date finds that 110 out of 111 deceased NFL players had chronic traumatic encephalopathy (CTE), a degenerative brain disorder associated with repetitive head trauma.

Several studies have linked CTE to suicidal behavior, dementia and declines in memory, executive function and mood. Professional athletes may be at higher risk for CTE because of their high likelihood for concussions and other traumatic brain injuries; up to 3.8 million sports-related concussions occur in the United States each year. In 2016, a health official with the NFL acknowledged the link between football and CTE for the first time.

In the new study, published in the Journal of the American Medical Association researchers looked at the brains of 202 deceased people who had played football, including those who played for the NFL and diagnosed CTE in 87% of the players. Among the 111 NFL players, 99% had CTE. The CTE symptoms worsened as the person had played more football. Those players with severe CTE, 85% showed signs of dementia, while 89% manifested behavioral symptoms.

Of course, many people suffer brain injuries from various modes of trauma, including automobile collisions; motorcycle and bicycle accidents; blunt force trauma; slip, trip and falls as well as from industrial injuries.  The recovery can be long and arduous, depending on the nature of the brain injury, extent of the cause and symptoms.

Head injury survivors may experience a range of neuro­psychological problems following a traumatic brain injury (TBI).  Depending on the part of the brain affected, personality changes, memory and judgment deficits, lack of impulse control, and poor concentration are common symptoms. In some cases, extended cognitive and behavioral rehabilitation in a residential or outpatient setting will be necessary to regain certain skills.

Those who are believed to have made a good recovery may still demonstrate some personality changes. Brain injury survivors often experience short-term amnesia related problems. Generally, new learning presents the greatest challenge to memory or remembering. The ability to focus and concentrate are keys to addressing some short-term memory problems.  The Family Caregivers Alliance offers some helpful tips:

• Have the individual repeat the name of a person or object, after you, if memory impairment is severe.
• Whenever possible, have the person write down key information (e.g., appointments, phone messages, list of chores).
• Keep to routines. Keep household objects in the same place. Use the same route to walk to the mailbox or bus stop.
• A written routine schedule of activities and repetition make it easier to remember what’s expected and what to do next.

In 1998, the National Institute of Health  held a Consensus Development Conference on Rehabilitation of Persons with Traumatic Brain Injury. The Consensus Development Panel recommended that TBI patients receive an individualized rehabilitation program based upon the patient’s strengths and capacities and that rehabilitation services should be modified over time to adapt to the patient’s changing needs. The rehabilitation therapy often involves individually tailored treatment programs in the areas of physical therapy, occupational therapy, speech/language therapy), psychology/psychiatry, and social support. The overall goal of rehabilitation is to improve the patient’s ability to function at home and in society.

Remember, it is important for TBI patients and their families to select the most appropriate setting for rehabilitation. A number of options include home-based rehabilitation, hospital outpatient rehabilitation, inpatient rehabilitation centers, comprehensive day programs at rehabilitation centers, independent living centers, school-based programs for children, and many others. The traumatic brain injury patient, their family, and the rehabilitation team members should work together to find the best place for the patient to recover.