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Winnipeg Free Press - PRINT EDITION

New book makes case it's no longer possible to laugh off concussions

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LOOKING dazed and seeing stars after a knock on the head are well-worn comic clichés.

But when a gifted $9-million-per-year athlete like Sidney Crosby sits out half a hockey season due to ongoing post-concussion symptoms, it's no longer possible to laugh them off, Don Cherry notwithstanding.

Besides being fodder for comedy, fighting through the pain, nausea and disorientation of being concussed has often been seen as macho.

This American book makes a convincing case for a radical shift away from both of those attitudes, towards an understanding of concussion as a mild traumatic brain injury (TBI) with potential for long-term, permanent changes in brain functioning and behaviour.

It captures the enormity of the price many athletes have paid for their involvement in sport. And it calls into question the very way sports, especially football, hockey and boxing, are played in North American culture.

Linda Carroll is a health and science writer and David Rosner has been a sportswriter and editor of the magazine Neurology Now. They live in New Jersey.

They begin by telling the life stories of intelligent, talented individuals with drive and all the promise in the world, whose lives unravel because of the brain injury they've suffered.

(It's obvious that had Crosby lived in another time, he might still have been playing, opening himself up to the possibility of future depression and dementia.)

Though they lack that spark that makes characters really lift off the page, the anecdotes do make chilling statistics -- such as the high number of unreported concussions -- less mathematical and more human.

Carroll and Rosner define concussion (less than 10 per cent of them involve loss of consciousness), and explain how objective neuropsychological testing is done as a way to determine the degree of brain malfunction (correctly identifying how many fingers the coach holds up does not count). They offer practical, hands-on advice for those faced with a suspected mild TBI.

Adept at using plain language, they break down complex processes for interested lay people. For example, they compare the buildup of amyloid plaques in the brains of patients who had died, the same ones found in Alzheimer's patients, to a "trash heap" growing more quickly than the "street-sweeper enzyme could clean it up" when in the presence of a particular form of gene.

Accounts of the pathologists, physicians and researchers who became advocates for players with mild traumatic brain injury, often against the most stubborn opposition, make for entertaining reading.

At U.S. congressional hearings only two years ago, the National Football League continued to deny any findings of long-term damage due to recurrent concussions. It took the threat of losing their multibillion-dollar anti-trust exemption for them to finally sit up and pay attention.

Anyone involved in contact sports, and many who aren't, will find The Concussion Crisis accessible and educational. It could help prevent a lot of needless and preventable suffering.

Ursula Fuchs is a Winnipeg nurse.

Republished from the Winnipeg Free Press print edition October 8, 2011 J9

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