AndoverMagazineFrontWinter2013

sPoRts tALk
TBI @ PA:
20 Andover | Winter 2013
A Comprehensive New Approach to Brain Injury
by Amy Patel, MD
Medical Director
John Hurley
Falling off a bike and hitting your head
on the ground, participating in a football
game without noticeable injury,
head butting another soccer player—which
one is more likely to cause a concussion
versus a traumatic brain injury? The truth is
that any of those activities may cause a concussion,
and that a concussion is a traumatic
brain injury (TBI). TBIs occur when the brain is injured either by a
direct blow to the head or by a hit to the body that causes the head to
be forcefully jarred. The result is a complex neurometabolic response
within the brain.
Contrary to what many people think, TBIs often do not involve a loss
of consciousness. Resulting symptoms can range in intensity, and the
force of the injury does not necessarily correlate with the severity or
duration of the TBI. Symptoms may include fatigue, headache, mood
changes, dizziness or feeling dazed, and memory impairment. And the
diagnosis is easily confounded by the concomitant stress and sleep deprivation
often seen within the adolescent population.
The CDC estimates that approximately 1.7 million TBIs occur
annually, with the highest numbers reported in very young children
(ages 0–4 years), older adults (65 years and older), and older adolescents
(15–19 years). Approximately six percent of Phillips Academy’s
students sustain concussions each year, half of which occur during
interscholastic athletic games and practices. The other half occur
during daily activities common to adolescence, such as bike riding
or playing with friends. Our statistics mirror the national average regarding
recovery—approximately two-thirds will resolve within two
weeks, and almost all will recover within one month.
The TBI Working Group, an offspring of PA’s Community
Health Team, has been developing an interdisciplinary TBI management
protocol to ensure appropriate evidence-based treatment.
The group consists of the medical director, athletics director, coordinator
of student disability resources, registrar/associate dean of
studies, and director of psychological services—encompassing all
facets of concussion management.
Increasingly, Academy administrators and clinicians are recognizing
the need for prompt TBI diagnosis and appropriate management. The
most important treatment? Brain rest. The first 24–48 hours are crucial.
Victims must unplug from all sources of brain activity—reading,
texting, browsing the Internet, and watching TV, as well as any kind of
physical, emotional, or mental exertion. At PA, students remain in Isham
Health Center, closely monitored by the medical team during the
first 24–48 hours, both to watch for any signs of a more severe head
Gil Talbot