Monthly Archives: March 2011

Concussion Discussion: Sideline Screening

After his own brain injury, a South Florida student works to get sideline concussion screening for all of Miami-Dade County.

David Goldstein Op Ed -Sports-related brain injuries can be avoided – Miami Herald

March is National Brain Injury Awareness Month, and I am among the 140,000 high school athletes who suffer a sports-related concussion each year, according to the National Federation of State High School Associations.

Last year, I had a head-to-head collision with another soccer player. Although it was my third concussion playing soccer in four years, I didn’t realize the risks of playing on. This time, my head really hurt, even though I did not fall or lose consciousness. As badly as I felt, it was an important game, so I played on for my team.

For more than three months, I had constant headaches so painful that every day I had to sleep a couple of periods at the school nurse’s office. My doctors told me to never play soccer again, which was crushing.

I was depressed and unable to participate in regular social activities. Luckily, I eventually found help at the University of Miami’s and Miami Project to Cure Paralysis’ Sports Medicine Concussion Clinic.

My symptoms finally went away, and gradually I returned to the sport I love. Today, I am a smarter player and wear a rugby helmet. I know the signs of concussion, and what to do. But I learned the hard way, and it didn’t have to be that way.

Last month I visited our state Capitol to talk about my experience in hopes of helping other student athletes avoid concussions and the problems I faced. Sen. Anitere Flores of Miami and Rep. Ronald Renuart of Ponte Vedra Beach are sponsoring bills to protect young athletes (HB301, SB730).

The Florida High School Athletic Association (FHSAA) would be required to adopt policies informing youth athletes and parents of the nature and risk of head injuries. Athletes also would need a parental consent form before practicing or competing. Players sustaining a suspected head injury would be immediately suspended from play until receiving clearance from a qualified medical professional.

The bill is supported by the Brain Injury Association of Florida, National Football League, FHSAA, and a statewide Sports Concussion Task Force of medical experts, athletic officials and health care providers. Florida would be the tenth state to pass this needed legislation.

Schools, coaches, parents and players must be educated on head injuries. More than 40 percent of high school athletes return to play before they are fully recovered.

Brain injury has been called the “silent epidemic” because so few people know what a serious health problem it is in this country.

Locally, public awareness is growing. Recently, all of the Miami-Dade public school athletic directors, trainers and PE teachers were trained on concussions. I am grateful to Cheryl Golden, Instructional Supervisor, and the Miami-Dade School Board for addressing the needs of our student athletes.

My schoolmates at Ransom Everglades raised donations so that the Kidz Neuroscience Center of the Miami Project to Cure Paralysis can provide education and concussion support through ImPACT testing at the Miami-Dade County Public High Schools.

Please join me in contacting legislators to support the concussion legislation. It is part of the Brain Injury Association of Florida’s statewide Mind Your Brain Campaign . . . Because It Matters to raise public awareness about traumatic brain injury and sports concussion. The Association recently launched a comprehensive Resource & Support Center at www.byyourside.org with information on community-based services. If the center had been in place when I got hurt, my family and I might have found the expert help I needed a lot sooner.

I know first-hand that concussion education, prevention and treatment really do matter. It can mean the difference between staying out for just a game or being out of play forever with problems that affect your overall quality of life.

Let’s make sure that every youth athlete in Florida plays it safe — so we all will be winners.

David Goldstein, 16, is a sophomore at Ransom Everglades High School in Miami.

Better serve, document victims of brain injuries – Orlando Sun Sentinel

March 25, 2011|By Patrick Gorman | Guest columnist

March is National Brain Injury Awareness Month, so it was welcome news recently when doctors reported the remarkable progress Arizona Congresswoman Gabrielle Giffords continues to make after being shot in the head during a public event barely two months ago.

“Gabby,” as the world now knows her, can talk in short sentences and walk with assistance. She is upbeat and focused on getting better, doctors said this month.

Even as well-wishers rejoiced at this hopeful outlook, news headlines somberly noted the passing of Dave Duerson, 50, a former NFL star defensive back who had retired to Florida. Duerson took his life last month, leaving a request to examine his brain tissue for evidence of a degenerative disease that has been linked to ex-football players who repeatedly suffered head injuries during their pro careers.

While these recent cases grabbed headlines because of the public figures involved, traumatic brain injury (TBI) can happen to anyone, anytime, anywhere. Senior citizens who slip and fall, youth athletes bumping heads, returning soldiers injured in battle, car accident victims — millions of ordinary Americans have suffered from TBI. TBI has been called the silent epidemic because few Americans know its serious health risks or enormous treatment costs totaling billions of dollars annually.

In Florida, public awareness is growing on several fronts. The Brain Injury Association of Florida recently unveiled a statewide campaign highlighting the 100,000 Floridians who sustain brain injuries each year. As part of the campaign, the association launched Florida’s first Traumatic Brain Injury Resource & Support Center, providing one-stop access to a vast network of information, services, education and advocacy through a Web-based portal (byyourside.org) and a toll-free helpline (800-992-3442).

The nonprofit association, founded in 1985 by the mother of a TBI survivor, also has joined with the NFL and a statewide Sports Concussion Task Force to support bills in the Florida Legislature protecting youth athletes who sustain a concussion from returning to play prematurely.

More can be done. Florida could expand services to TBI survivors and families, lower costs and improve patient self-sufficiency by adopting a nationally recognized privatization model. It combines Web-based and telephone assistance for mild TBI cases with more intensive family support services for serious injuries.

States like Minnesota and Indiana report impressive results, returning more than half of TBI survivors to work or school within one year of their injuries. Vocational rehabilitation referrals grew by nearly one-third, and work-force productivity of TBI survivors increased by more than $31 million a year.

Under the state of Florida’s program structure, TBI survivors aren’t being adequately served or documented. For example, in 2009, only a fifth of the 19,000 TBI hospital admissions were tracked by the state’s central registry with just more than 1,000 served. That includes 330 Medicaid cases costing taxpayers more than $30,000 per patient.

Brain Injury Association contracts with the state to provide education, support and referral assistance to TBI survivors and their families. However, the state prevents access to its central registry and provides only a monthly list of closed cases of TBI survivors, many still needing assistance.

If Florida were to adopt a TBI privatization model, potential benefits include: expansion of services to TBI survivors and families; lower costs to the state and improvement in patient self-sufficiency; reduced state office costs by locating privatized workers in hospital trauma centers, giving TBI patients a direct pipeline to services; and increased probability of getting TBI survivors back to work sooner and off government assistance by focusing on symptom management.

At a minimum, Florida’s families would be better served if Florida maintained one registry for all TBI injuries and immediately provided case information to qualified TBI service providers. Early intervention prevents complications that could result in mild brain injuries getting worse. Let’s ensure that every TBI survivor gets prompt, professional assistance because it really does matter for all of us.

Patrick Gorman is a licensed psychologist in Winter Park and is chairman of the board for the Brain Injury Association of Florida.

Student campaigns for concussion awareness – WSVN

MIAMI (WSVN) — A South Florida student athlete is getting to work to prevent and treat concussions in Miami-Dade County high schools.

Sixteen-year-old David Goldstein knows how devastating a concussion can be. Goldstein is a Ransom Everglades High School sophomore and has spent months living a nightmare after suffering a serious concussion while playing soccer.

After months of research and work, about 120 athletic directors from across the Miami-Dade school district gathered at the Lois Pope Life Center in Miami Thursday to learn the proper ways to treat concussions. “It’s really important to get the word out to the families so they understand,” said Marc Buoniconti of the Miami Life Project to Cure Paralysis, “and being involved today with all these athletic directors, it really helps a great deal because know we can understand the short term and long term impacts of concussions.”

Goldstein got to work after suffering his concussion and has helped raise over $8,000 at Ransom Everglades to help fund testing for student athletes all over Miami-Dade County. “You have this super vision of concussions in the NFL and in pro sports, in collage sports. You don’t see that at the high school level where most of the concussions in this country occur, so it seems logical to me to do what I can to help the kids,” said Goldstein.

Daniel Cuadra is the Athletic Director at Ronald Reagan Senior High in Doral. He said he has seen the consequences a concussion can have on a student athlete. “I have definitely seen, especially during kick off, some athletes get hit pretty hard, and I’m looking at them and, wow, they can’t even return to play, and I send them to a neurologist,” said Cuadra.

Goldstein’s work is far from over. “I’ve been working on the concussion legislation that will be going through Florida congress later this year. People in Tallahassee are supporting me, my friends, my school. It’s all good,” he said.

(Copyright 2011 by Sunbeam Television Corp. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.)

In the News — The Miami Project

The First Miami-Dade Countywide Concussion Care Workshop presented by the KiDZ Neuroscience Center at The Miami Project to Cure Paralysis and UHealth Sports Medicine Center

March 2, 2011 – The KiDZ Neuroscience Center at The Miami Project to Cure Paralysis and the UHealth Sports Medicine Center will host the first Concussion Care Workshop March 3rd for more than 100 Miami-Dade County Public High Schools (M-DCPS) athletic trainers and athletic directors.  The event is intended to educate and implement in the M-DCPS Senior High Schools concussion management programs and ImPACT Testing.  The program will take the unprecedented step of implementing the performance of baseline neurocognitive testing this year for each student athlete in the contact sports of football, girls volleyball, boys and girls soccer, baseball and softball.

Presentations during the morning long conference will include experts in field and stakeholders in the fight against concussions including; Dr. Lee Kaplan, Director UHealth Sports Medicine Center, Vinny Scavo, UHealth Sports Medicine Director of Sports Medicine Services & Head Athletic Trainer, Cheryl Golden, Instructional Supervisor, Greater Miami Athletic Conference, Division of Athletic/Activities, Miami-Dade County Public Schools, David Goldstein, a student at Ransom Everglades who has suffered from concussions,  Dr. Kester Nedd, Director Neurorehabilitation UM/JMH and Co-Director Concussion Program at UHealth Sports Medicine, Dr. Gillian Hotz, Director KiDZ Neuroscience Center and Concussion Program at UHealth Sports Medicine, and  ImPACT Training via webinar from Doug Tauchen.  Marc Buoniconti, President of The Miami Project to Cure Paralysis will offer the closing remarks.

“This Countywide Concussion Care Program will allow each High School Football Player and eventually every Junior Varsity and Varsity player in high risk sports baseline ImPACT testing.  This will allow us to have an objective cognitive assessment to assist in the management of their concussion and to returning them back to the game safely,” said Dr. Hotz.

“The M-DCPS are excited to help develop and implement Concussion Management Programs in the senior high schools athletic programs. The ability to implement ImPACT testing to our athletes is a huge tool to add to the education of our patents, student athletes, coaches, faculty and administrators help in the understanding of  the concussion diagnoses, treatment and safe return to play for all of our student athletes,” said Cheryl Golden.

The KiDZ Neuroscience Center (KNC) is under the auspices of The Miami Project.  The KiDZ Injury Prevention & Research Program will focus specifically on injury prevention in childhood.  The program will be dedicated to tracking the types, causes, and consequences of childhood injuries by using epidemiological tools to identify risk factors for injury.  This program will encompass the WalkSafe™, BikeSafe™, and Car Seat programs.  Dr. Hotz is the Director of the WalkSafe Program, which considered one of the best pediatric pedestrian injury prevention programs in the country.  Its primary goal is to reduce the number of injuries and fatalities of children (ages 5-13).  WalkSafe pioneered the injury prevention model which was adopted by the National Center for Safe Routes to School Initiative. Currently, a feasibility study is taking place for BikeSafe.   Dr. Hotz also directs the Concussion Program which serves the public and private high school and college sports teams (football, soccer, wrestling, etc.) and athletes from the community.  This program offers comprehensive evaluations and recommendations for returning to play safely.

ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is the first, most-widely used, and most scientifically validated computerized concussion evaluation system.

Developed in the early 1990’s by Drs. Mark Lovell and Joseph Maroon, ImPACT is a 20-minute test that has become a standard tool used in comprehensive clinical management of concussions for athletes of all ages. ImPACT Applications, Inc. was co-founded by Mark Lovell, PhD, Joseph Maroon, MD, and Michael (Micky) Collins, PhD.

Given the inherent difficulties in concussion management, it is important to manage concussions on an individualized basis and to implement baseline testing and/or post-injury neurocognitive testing. This type of concussion assessment can help to objectively evaluate the concussed athlete’s post-injury condition and track recovery for safe return to play, thus preventing the cumulative effects of concussion. In fact, neurocognitive testing has recently been called the “cornerstone” of proper concussion management by an international panel of sports medicine experts.