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Concussion recovery much longer than previously thought – study

Different mechanics in head impacts caused by translational vs. rotational acceleration. Rotational acceleration (when impact comes from side, as from a hook in boxing) causes more axonal shearing and tension on brain tissue and vessel than translational acceleration.

Different mechanics in head impacts caused by translational vs. rotational acceleration.
Rotational acceleration (when impact comes from side, as from a hook in boxing) causes
more axonal shearing and tension on brain tissue and vessel than translational acceleration.
© Sanna Neselius

A scientist in Sweden using a new analysis method has showed that recovery from concussion is much slower than previously thought, and that the brains of children and adolescents are more sensitive and require longer time to heal.

Sanna Neselius, a scientist at the University of Gothenburg’s Sahlgrenska Academy and a member of the medical commission of the Swedish Boxing Federation, has shown that analysis of the cerebrospinal fluid after concussion can be used to determine the magnitude of brain injury.

Her previous studies have shown that amateur boxing causes damage to nerve cells, that can take more than two weeks to heal. This discovery led to her being offered a place in the International Olympic Committee’s expert group for boxing-related head injuries.

Sanna Neselius, specialist doctor and research student, former boxer, University of Gothenburg.

Sanna Neselius, specialist doctor and research student, former boxer, University of Gothenburg.

Neselius defended her doctoral thesis at the Sahlgrenska Academy, in which she shows that sports-related concussion heals much slower than previously known.

“Our studies show that a concussion, such as may be experienced after being knocked out, can take more than four months to heal,” said Neselius, who is a former boxer.

Further, the results show that repetitive head trauma in the sport damages nerve cells in the brain, even though the boxer may not show any concussion symptoms.

Concussion is one of the most common sports-related injuries, and more athletes experience it every year. In recent years, focus has been directed on the effects of repeated concussions, in which athletes may suffer from long-term effects.

The cerebrospinal fluid samples analysed by Sanna Neselius and her colleagues can be followed until normalization and thereby be a valuable tool to prevent athletes resuming sport too early.

“The assessment today is often based on physical symptoms, neuropsychological tests, and the neurological examination of the athlete. Our studies show that these tests are not sensitive enough, nor can we rely on the athletes self-reported lack of symptoms. Concussion symptoms usually pass after a few days, but the neurological damage may still be present,” Neselius said.

“The first sample is recommended to be taken 10 to 4 days after the concussion. This allows us to see the magnitude of the injury, and gives an idea of how long the healing process will be. I hope that brain injury markers in the cerebrospinal fluid, and hopefully also later in blood, can be used at all levels in all sports. By this we can use individual measurements to plan and guarantee safe rehabilitation.”

The full study is available here.

The FEI says after 2004, the rate of eventing falls began to decrease and is now flattening out.

© Mike Bain

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