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Do helmets prevent concussions? Do genetics play a role?

In the 10 Things You Didn't Know About Concussions, UHNews asked people on the streets of Toronto these questions and more. Then we had TSN analyst and CFL Hall of Famer Matt Dunigan, whose career was ended by concussions, answer those questions with renowned concussion expert Dr. Charles Tator.

Watch the player above to test yourself – and see how others did – in a video highlighting 10 facts about concussions, taken from a recently published article by Tator. You can also read the answers below for more details.

Video: 10 Things You Didn't Know About Concussions

(Watch the full video or scroll to a question of choice)

  1. How many symptoms are needed to diagnose a concussion? (00:32)
  2. Who is more susceptible to concussions, men or women? (1:18)
  3. Do helmets prevent a concussion? (2:12)
  4. Have experts identified the part of the brain where a concussion occurs? (2:50)​
  5. Do genetics play a role in how concussions affect the brain? (3:15)
  6. Who is more susceptible to concussions – children, adolescents or adults? (4:02)
  7. Can an x-ray or CT scan diagnose a concussion? (4:35)
  8. Does an athlete need to receive direct impact to the head to sustain a concussion? (5:15)​
  9. What is the only treatment proven to be successful to initially treat a concussion? (5:52)
  10. True or false, you can only get a concussion by playing a sport/physical activity? (6:25)

     

On July 22, the Canadian Medical Association Journal published an article written by Tator, founder of the Canadian Sport Concussion Project at UHN's Krembil Neuroscience Centre.

Tator's article, "Current Diagnosis, Management, and Prevention of Concussions and Their Consequences," summarizes what medical experts in the field agree has been learned about concussions and their effects over the last decade, and how to properly manage them.

"Over the last 10–15 years, the knowledge and information concerning concussions has changed quite a bit. It's lead to a lot of uncertainty among practitioners on how to deal with them," said Tator.

The article will help bring medical practitioners up to speed on how to better recognize, diagnose and treat concussed athletes to improve management of this injury. Not only does it tell us what experts have learned about concussions since 2000, it also gives an indication of the questions about this brain injury that experts still need to answer with more research.

Watch the video player above to hear Tator and Dunigan discuss the 10 Things You Didn't Know About Concussions – and read their answers in more detail below.

1. UHNews: How many symptoms are needed to diagnose a concussion?​​

Answer: A concussion has 22 symptoms but only 1 is required to diagnose a concussion.

Currently, medical professionals use a standardized tool for evaluating injured athletes for concussion known as the Sport Concussion Assessment Tool, Version 3 (SCAT3). The SCAT3 contains a combination of clinical tests and a list of symptoms that medical experts can refer to in order to diagnose a concussion. Experts agree that there are at least 22 possible and different symptoms of a concussion, but only one symptom needs to be present – for example, dizziness – in order to diagnose a concussion.

These types of resources help health professionals recognize concussions early and in a timely manner which is important so that the student or athlete not only receives the proper treatment and management for his or her concussion, but is also temporarily removed from sport to prevent further injury to the brain.​​

2. UHNews: Who is more susceptible to concussions, men or women?

Answer: Women appear to be more susceptible to concussions than men.

Experts agree that women appear to be more susceptible to concussions than men. One theory that might explain this difference is the unequal neck strength between males and females. Where men's necks are stronger and perhaps better able to resist the whiplash effect from a direct blow, women's necks are not as strong and may be more prone to snap back as a result of impact and cause more jiggling of the brain. More research is needed to better understand this difference.

3. UHNews: Do helmets prevent a concussion?

Answer: Helmets do not prevent a concussion.

Helmets are an important piece of protective equipment and can protect individuals from catastrophic brain injuries such as cerebral lacerations (the cutting or tearing of brain tissue) and intracranial hematomas (bleeding in the brain or around the brain as a result of ruptured blood vessels). Helmets do not, however, protect the brain from concussions because they do not eliminate rotational acceleration (or jiggling) of the brain.

4. UHNews: Have experts identified the part of the brain where a concussion occurs?

Answer: Experts do not know where a concussion actually occurs in the brain.

Medical experts believe that concussions result from what is called "rotational acceleration" of the brain – a jiggling of the brain inside the skull as result of sustained impact. This trauma to the brain can affect some of its chemical functions and many experts believe that concussion is a "biochemical injury." However, it is still unknown in what part of the brain a concussion occurs, or where in the brain the acute symptoms of a concussion originate from.

VIDEO – Watch how a concussion occurs: http://thinkfirst.ca/programs/hockey.aspx

5. UHNews: Do genetics play a role in how concussions affect the brain?

Answer: There may be a genetic factor to concussion susceptibility.

​Researchers have noticed some families have more than one member who get concussions. They are therefore studying whether presence of certain genes can make some individuals more prone to concussions than others or may experience more difficulty recovering from them. Research is still ongoing, but if a genetic factor to concussions is uncovered, it would help individuals make informed decisions about whether to participate in high collision sports.
 

6. UHNews: Who is more susceptible to concussions – children, adolescents or adults?

Answer: Younger brains, specifically in adolescents, are more susceptible to concussions and take longer to recover from them.

Recent research indicates that a younger brain, particularly the adolescent brain, may be more vulnerable to concussions and more affected by them, than at other stages of development. A study at the Université de Montréal showed that adolescents are more sensitive to the effects of concussions than are children or adults, and that cognitive deficits sometimes persisted 6 months for this age group after sustaining a concussion.
 

7. UHNews: Can an x-ray or CT scan diagnose a concussion?

Answer: There is no existing imaging or blood test to diagnose a concussion.

A concussion diagnosis can only be made by a physician trained to recognize its symptoms because there is currently no medical imaging technology or blood test that can diagnose and confirm that an individual has sustained a concussion.

Although researchers are investigating different concussion biomarkers – a measurable characteristic that indicates the severity or presence of a particular disease – conventional computed tomography (CT) and magnetic resonance imaging (MRI) almost always show normal results even if someone has sustained multiple concussions. Conventional X-rays have also been ruled out as a tool to confirm a concussion diagnosis.

8. UHNews: Does an athlete need to receive direct impact to the head to sustain a concussion?

Answer: An individual does not need to lose consciousness or receive a direct impact to the head to sustain a concussion.

Although a concussion can result from a direct hit to the head, you don't necessarily need to be hit in the head or be knocked out to get a concussion. For example, a concussion can also occur from a blow to the chest that causes a whiplash effect on the brain. All that is needed is impact with enough force to cause the brain to "jiggle" inside the skull, the action that experts believe most likely to be the cause of a concussion.

9. UHNews: What is the only treatment proven to be successful to initially treat a concussion?

Answer: Mental and physical rest are the only treatments proven to be successful for the initial  treatment of  a concussion.

Inclusion of mental rest as part of treating a concussion is a major change that has occurred in concussion management in the last decade. Removal from athletic play, work or school and mental as well as physical rest are the most important aspects of treatment to implement immediately after a concussion has been diagnosed.  To date, no other treatment has been proven successful in the initial stages of brain recovery from a concussion.

 

10.UHNews: True or false, you can only get a concussion by playing a sport/physical activity?

Answer: You don't have to play sports to sustain a concussion.

Concussions are frequent in all age groups and occur in all kinds of settings such as an individual's work environment, as a result of a car accident or from a fall in one's home. Military personnel can also suffer from symptoms that resemble concussions as a result of a bomb blast.​​


​​Related:
Snowboarder funds concussion research

​​For media interviews, please contact:
Alexa Giorgi
Senior Public Affairs Advisor
Krembil Neuroscience Centre, Toronto Western Hospital
416-603-5800 x6776
alexa.giorgi@uhn.ca​

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