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Concussion summit focuses on science behind brain injury

The Stanford Sports Concussion Summit was held on campus recently to discuss advances in the diagnosis and treatment for mild traumatic brain injury.

I'm 5'3" with roughly the arm strength of a bumblebee, so the first and only time I have "played" football was last Saturday at the first Stanford Sports Concussion Summit. Courtesy of virtual reality goggles designed to provide concussion education, I got hyped in the locker room, ran out onto the field with the team, and was almost immediately sacked. At least, I think I was; just before impact, I yanked the goggles aside. It was that real.

Concussion, a mild traumatic brain injury, affects more than 3 million adults and children every year in the United States, and the average recovery time is two to four weeks. While not all concussions occur due to sports, athletes are at particular risk; one in five high school athletes will get a concussion, Angela Lumba-Brown, MD, event chair and co-director of the Stanford Brain Performance Center, told me.

Stanford's one-day summit explored advances in the diagnosis and management of mild traumatic brain injury. "This was the first real opportunity to engage the public in showcasing advances in concussion research and clinical care originating at Stanford," Lumba-Brown said.

The summit's 160-plus attendees explored a variety of assessments and treatments at hands-on demonstration stations set up throughout Stanford Athletics Home of Champions. After my stint on the virtual football field, I had the "gaze positions" of my eyes tested with a system that has been used on the sidelines of Stanford football games for several years. The goggles assess functional impairment following injury.

The summit included lectures addressing gender disparity in the study of concussion; military adaptations for concussion; sleep disturbance and exercise management following injury; and advances in diagnostic technologies and treatments. The event became personal when NFL Hall of Fame inductee Steve Young spoke of his experience with concussion during a panel discussion.

"I say I had a vanilla concussion," Young told the assembled clinicians, coaches and community attendees. "My symptoms did not last more than a few days... but now when I forget something, my wife will joke, 'Here we go -- the beginning of the end.' And I don't laugh."

Young continued, "I did so many things playing that I wouldn't do today. Now I want to live to be 100, but I didn't make that plan until I was 38 years old. Up until the time I was 38, I just had a plan to live until 20."

Young was joined on the panel by William Maloney, MD, Stanford professor of orthopedic surgery and team physician for the 49ers and the Golden State Warriors­­­; Gary Steinberg, MD, PhD, chair of neurosurgery at Stanford and former 49ers' team neurosurgeon; and Jamshid Ghajar, MD, director of the Stanford Brain Performance Center.

"Today, Steve would have been taken off the field," Maloney said. "Now we have an eye in the sky, an athletic trainer connected to a sideline judge, a neurosurgeon unaffiliated with the team assessing the situation... but it is a stressful thing. 95 percent of players want to go back onto the field... you need an objective test to say this doesn't look good and the NFL has to say everyone must use it so there is no competitive disadvantage."

For players, the goal is to stay on the field, Young admitted.

"You can play with a brain that's injured. You can't play with an injured knee," Young said. "Why do people try to game the system? Because right now you can... In the end, what Stanford has been doing for years is objective testing and I think that's an important piece of the puzzle."

Going forward, Lumba-Brown said she plans to work with the Pac-12 Brain Trauma Task Force to characterize and compare types of concussions and to assess recovery progress and the prediction of outcomes.

Photo of William Maloney and Steve Young by Susan Coppa

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