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The Dangers of Concussions and Chronic Traumatic Encephalopathy (CTE)

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The Dangers of Repetitive Concussions and Chronic Traumatic Encephalopathy (CTE)

Information for Research Papers, Reports, Essays, and Speeches

The information provided on this web page is intended to help students write an informative research paper / report / essay on the topic of concussions and chronic traumatic encephalopathy, also known as CTE.  Although the health risks of repeated concussions and traumatic brain injuries have been mentioned for decades, it is only until recently that a lot of media attention has concentrated on the topic of chronic traumatic encephalopathy (CTE). This web page provides a possible introductory paragraph with thesis statement, outline, and a list of resources such as books, journal articles, magazine articles, newspaper articles, and websites. When possible, we try to explain each source and cite the source in MLA format. We try to provide enough information to help you write a paper as easy as possible without actually writing the paper for you.

We know how important it is for students to find credible online resources so that they can do a lot of their work at home. We feel that the list of resources that are presented will provide enough information about concussions, traumatic brain injury (TBI),  and chronic traumatic encephalopathy so that you can write a significant portion of your research paper / report / essay  OR speech, from home. There are some EXCELLENT, credible peer-reviewed journal articles that can be accessed online, FOR FREE.

The intended audience for the information on this web page is the college student. Many of the peer-review journal articles are very scholarly. HOWEVER, many students in middle and high school may find the information helpful, too.


The following information will provide information on a variety of topics related to concussions and CTE such as: statistics; symptoms; tests; signs of concussions and signs of traumatic brain injury (TBI); and more concussion-related material.

 

The following paragraph includes a possible title and introductory paragraph with thesis statement.

Concussions and Chronic Traumatic Encephalopathy are Serious Health Dangers

     Concussions have received increased attention in the world of sports.  Concussion is an injury that can happen in just about any sport. Indeed, it has been happening to a countless number of athletes for centuries. However, concussions can happen to just about anyone. For example, it is easy to just trip when walking and hit your head on the ground. Throughout history, there has been a tendency for people to ignore a concussion as a serious injury. There will continue to be dangers for athletes in just about any sport. However, concussions can lead to serious health issues such as chronic traumatic encephalopathy (CTE). Concussions and chronic traumatic encephalopathy are serious conditions that have to be taken seriously in order to help prevent serious health disorders later in life for millions of people.

The thesis statement is “Concussions and chronic traumatic encephalopathy are serious conditions that have to be taken seriously in order to help prevent serious health disorders later in life for millions of people. You are going to prove, or report, on how serious the health risks are for concussions and chronic traumatic encephalopathy.

Here is a possible outline that you may want to consider:

I. DEFINITION
II. HISTORY
III. STATISTICS
IV. RISK FACTORS
  A. Athletes
  B. Age
  C. General public
  D. Military
  E. Genetics
V. SYMPTOMS
VI. CASE STUDIES
VII. DIAGNOSIS
VIII. TREATMENT
IX. PREVENTION
  A. Tests
  B. Rules and enforcement
  C. Changes to techniques
X. CONCLUSION

 

OVERVIEW of Concussion and Chronic Traumatic Encephalopathy (CTE). The resources that provide most of the information for the following overview, or summary, are listed much farther down this web page.

Definition

A concussion is an injury to the brain when something hits the head OR the body to make the brain move within the skull and hit the side of the skull. The brain has the consistency of gelatin and floats, to a degree, in cerebrospinal fluid.  A sudden blow to the head or harsh movement of the body can cause the brain to move within the head to bang against the side of the skull causing some type of injury.


Symptoms

The symptoms can vary due to a number of factors, especially due to the severity of the movement of the brain within the skull. Contrary to popular belief, a person may OR may NOT lose consciousness. Common symptoms include headache, dizziness, fainting, nausea, blurred vision, sensitivity to light, sensitivity to noise, memory loss, confusion, drowsiness, anxiety, irritability, and slurred speech. However, the more severe the concussion, the more severe the symptoms can be.


Who is at Risk?

For many people, when they hear the word concussion they think about the sport of football.  However, just about anyone is at risk of obtaining a concussion. Easily, a concussion can occur to a countless number of people who are walking along and then fall hitting their head on the ground. Many people do this a day and do not realize that they may have just suffered a very mild form of concussion. They do not think about visiting a physician. The same is true for anyone who enjoys, skiing, sledding, tobogganing, ice skating, and riding a bicycle. Research studies indicate that military personnel are at risk of obtaining concussions from a variety of events that they face. With a little imagination, you can think of  SO MANY things that any human person does that might result in a concussion. Contact-sports, such as football, are not the only activities that are the causes of concussions, mild traumatic brain injury, or chronic traumatic encephalopathy.

Some research indicates that genes can play a role in the relationship between trauma, neuropathological changes, and disordered cognition and behavior. The Apolioprotein E gene (ApoE4 allele) has been described in its association with Alzheimer’s disease where individuals with homozygous ApoE4/E4 genotype have a 19-fold increased risk of developing Alzheimer’s disease. This same gene is now thought to possibly have a role in the development of chronic traumatic encephalopathy. A research study by Teasdale et al. reported that patients with ApoE4 allele are more than twice as likely than those without ApoE4 to have unfavorable outcomes 6 months after head injury (Saulle and Greenwald 3).

Age is another risk factor when considering concussions. There is a variety of factors that need to be considered when using age as a risk factor.  At a young age, the brain has more plasticity than an older brain. The younger brain can handle the injury and recovery better than the older brain. HOWEVER, if repetitive concussions start at an early age then that means that there is a greater threat of serious long-term health risks such as chronic traumatic encephalopathy due to the length of time of exposure (over a lifetime) to repetitive concussions.

It is possible that a person’s health conditions that are absent or present during the preclinical stage of CTE may “influence the extent of neurodegeneration of the brain’s ability to compensate for any neurodegeneration. For instance, the presence of chronic inflammation, such as that which accompanies medical conditions such as obesity, hypertension, diabetes mellitus, atherosclerosis, and heart disease, may facilitate neurodegeneration and NFT formation” (Gavett, Stern, and McKee 7).



Statistics

Although many people are at risk of obtaining a concussion, just how many people in the U.S. (or the World) really do get a concussion a year is very difficult to ascertain. Many, many people just do not report the injury or go to a physician for treatment. The Center for Disease Control and Prevention is a credible, well-respected government agency that provides the expertise, information, and tools to help people and communities protect their health. There is way too much information and statistics about concussions and traumatic brain injury (TBI) to mention here, but I will list some links to CDC web pages that you can explore. There are valuable links all over each CDC web page so PLEASE explore each web page.

Just some facts to mention is that the CDC estimates that an estimated 1.7 million people sustain a TBI (traumatic brain injury) annually.

Overall in the United States, the highest combined rates of TBI-related ED (emergency department) visits, hospitalizations, and deaths occur in young children (aged <5 years), followed by adolescents (aged 15--19 years) and adults aged ≥75 years (2). Overall, males account for approximately 59% of all reported TBI cases in the United States (2). Older adults have the highest rates of TBI hospitalizations and deaths among all age groups (2), and TBI is the leading cause of injury-related death in children and young adults in the United States and other industrialized countries (5). The leading causes of TBI in the U.S. civilian population are falls (35%), motor vehicle--related injuries (17%), and a strike or blow to the head from or against an object (e.g., workplace or sports-related injuries [16.5%], assaults [10%], and other and unknown causes [21%] [2]). The incidence of blast-induced TBI in U.S. civilian populations is low, with a report of 0.2% of TBI cases in a major urban trauma.

Here are just a few links to all kinds of information AND statistics about concussions, sports-related concussions, mild traumatic brain injury (mTBI), and traumatic brain injury (TBI).

http://www.cdc.gov/traumaticbraininjury/data/index.html

http://www.cdc.gov/traumaticbraininjury/get_the_facts.html

http://www.cdc.gov/headsup/youthsports/

http://www.cdc.gov/TraumaticBrainInjury/basics.html/ 


Diagnosis and Treatment of Concussions

When it comes to diagnosing a concussion, usually concussions create a variety of symptoms as we listed above, such as: headache, dizziness, fainting, nausea, blurred vision, sensitivity to light, sensitivity to noise, memory loss, confusion, drowsiness, anxiety, irritability, and slurred speech.

For athletes, many schools incorporate special testing such as imPACT, SAC (Standardized Assessment of Concussion), or SCAT2 (Sport Concussion Assessment Tool). Basically, the athlete takes a test at a time when he/she is healthy (or not believed to have a concussion like at the beginning of a sport’s season.) This standardized scoring system takes into account symptoms, physical examination findings, cognitive function, balance, and coordination. The baseline results are extremely important for comparison, later when the athlete may be suspected of having a concussion. When the athlete is suspected of having a concussion, the athlete takes the test again. This time the results of the post concussion test is compared to the baseline results PRE concussion. The post concussion results can determine if the athlete has a concussion and the severity of the concussion.  When the post concussion test results have similar results as the pre concussion test than the athlete may be ready to play again.

Treatment of a concussion depends on the severity of the injury. Often, the typical very mild form of concussion is treated with rest and avoidance of physical exertion, and any activity that can create more damage to the brain. The physician is one of the most important professionals to help determine when the patient is able to resume normal activities.

Long-Term Effects of Concussions and Traumatic Brain Injuries

This is where a lot of recent attention has occurred. We are talking about the long-term effects of repetitive concussions. The key word is “repetitive.” When looking through the literature about concussions and the long-term effects of concussions, it is easy to see that there is quite a bit of knowledge about concussions, BUT not so much knowledge about the long-term effects of repetitive concussions. There is some very good scholarly research that has been done and continues to be done on the long-term effects of concussions. A list of some of the best research studies that have been published is listed farther down this web page. Many of the articles can be located on the Web, for FREE. There is MUCH MORE information in these resources than I can summarize on this web page.

When people talk about the long-term effects of concussions then the medical term chronic traumatic encephalopathy (CTE) is mentioned. Chronic traumatic encephalopathy (CTE) has been defined as a progressive neurodegenerative disease caused by repetitive trauma. “CTE was first described in 1928 when Dr. Harrison Martland, a New Jersey medical examiner began to note a constellation of symptoms in boxers.” Dr. Martland called the medical condition “Punch Drunk.”  “Punch Drunk was later termed dementia pugilistica, literally meaning dementia of a fighter. However, with the evolution of sports like American football, these symptoms were also being reported in athletes other than boxers and was renamed chronic traumatic encephalopathy in the 1960s” (Saulle and Greenwald 1).

The symptoms of concussions are immediate and obvious. However, typically the symptoms of CTE start later in life. For athletes, often the symptoms start after they retired from their sport. The symptoms and timeline for these symptoms can vary per person. Currently, the only way to definitively diagnose chronic traumatic encephalopathy is through postmortem neuropathological autopsy.      Mckee et al. provides, at least two different, very informative case studies of CTE in athletes. I will quote from one of the studies to give you a good idea of the long-term effects/results of chronic traumatic encephalopathy. A group of 51 athletes (various sports) with confirmed CTE presented a variety of symptoms such as “memory loss, irritability, outbursts of aggressive or violent behavior, confusion, speech abnormalities, cognitive decline, gait abnormalities, unsteadiness, headaches, slurred speech, and Parkinsonism.”


Prevention

Most of the literature suggests that the best answer to preventing chronic traumatic encephalopathy is to reduce the number of concussions that a person receives over a lifetime. I think that most would agree that is “easier said than done.” There are quite a few opinions in the literature on how to help reduce concussions for athletes. Better, safer equipment is a standard answer. However, safety equipment can only help so much.  Proper coaching and techniques can help. Rules may need to be changed for some contact-sports to promote safety.  Athletes need to understand how important it is to their health to report their concussion-like symptoms. Proper assessment and enforcement of treatment, such as REST is very important. Some of the articles listed below provide much more information on prevention to help you fill up those pages with text.

 

Summary

STILL, A LOT is NOT clear about the long-term effects of concussions, especially the relationship between repetitive concussions and chronic traumatic encephalography. However, physicians and scientists continue to research this topic. Following is a list of books, journal, and magazine articles that will provide enough information on concussions and chronic encephalopathy to help you write a research paper / report / essay OR give a speech. Many of the following journal and magazine articles can be found on the web, FOR FREE. There really is A LOT of information in these resources as well as other articles that can be found within resources such as PubMed and some other free online periodical computer databases.

We know that many students have to write a five  or ten-page paper. Some students need to give a five-minute speech or longer. We provided an example of an outline near the top of this web page. If you need MORE information to help expand your report or speech, we suggest that the following topics may be where it is easier to expand the report or speech:

Case Studies are where you can add a lot of material. “Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy after Repetitive Head Injury” has a number of case studies where you can add much more text to your essay. A 17-year old male football player is the case study in “Management of the Athlete with Concussion.”  The two Maclean’s articles “The Aftershocks” and “The Untold Story” present the case studies of NHL hockey players Sidney Crosby, Eric Lindros, and others.

Long-Term Effects and Medical Information is where you can add A LOT of information. Some of the scholarly, journal articles listed below will give a lot of medical pathophysiology of just what happens medically when a concussion occurs. Just a few, of more articles that I could mention that will give detail, are “The Pathophysiology of Concussions in Youth” , “Chronic Traumatic Encephalopathy: A Potential Late Effect of Sport-Related Concussive and Subconcussive Head Trauma”, and “Neurobiological Consequences of Traumatic Brain Injury.”

Statistics: A few of the journal and magazine articles listed below will contain some statistics. HOWEVER, The Centers for Disease Control and Prevention (CDC) has an astonishing number of statistics, reports, and information about concussions and traumatic brain injury. There are quite a few links to explore at the CDC website.  The following link can get you started at the CDC: http://www.cdc.gov/TraumaticBrainInjury/   

Prevention: as we mentioned above, about the only way to prevent CTE is to reduce the number of concussions that a person receives. The following articles provide information that can help add more text to your report or more minutes to your speech. Please scroll way down this web page to see more information about each article.

“Stay Ahead of the Game: Get the Facts about Concussion in Sports.”  (Provides some good suggestions including information about the imPACT test.  If you need more information about prevention then you may want to start with this magazine article.)

“A Smack Upside the Head.”

“Management of the Athlete with Concussion.”  (There is some good information about tests such as SAC and SCAT2. imPACT is another standardization test for concussions. If you need more material, then you can find more information about these tests and give more details on how they work.)

“Chronic Traumatic Encephalopathy: A Review.”

“Long-Term Consequences: Effects on Normal Development Profile after Concussion.”

“Chronic Traumatic Encephalopathy: A Potential Late Effect of Sport-Related Concussive and Subconcussive Head Trauma.”

The information mentioned in the “Overview” above, came from information from the following resources. Most of the information came from websites, journals, and magazine articles.




BOOKS

  Cantu, Robert, and Mark Hyman. Concussions and Our Kids: America’s Leading Expert on How

  to Protect Young Athletes and Keep Sports Safe. Houghton Mifflin Harcourt, 2012.

The contents of this 2012 book contains: What is a concussion? -- Collision sports -- Non-collision sports -- Baseline testing -- Post concussion syndrome and second impact syndrome -- Chronic Traumatic Encephalopathy (CTE) -- Myths -- Moms and dads -- After concussions -- Reforms.

 

  Caroll, Linda. The Concussion Crisis: Anatomy of a Silent Epidemic. Simon & Schuster, 2011.

This 2011 book contains information on the following topics: Introduction -- Just a bump on the head -- Emerging epidemic -- Head games -- Sudden impact -- Through the cracks -- Playing defense -- Anatomy of a brain injury -- Deciphering the damage -- Pocketful of mumbles -- Ticking time bombs -- Seeds of change -- Epilogue -- Appendixes 1: Concussion symptoms -- Appendix 2: Resources for patients and families.

 

 

  Laskas, Jeanne Marie. Concussion. Random House, 2015.

"Jeanne Marie Laskas first met the young forensic pathologist Dr. Bennet Omalu in 2009, while reporting a story for GQ that would go on to inspire the movie Concussion. Omalu told her about a day in September 2002, when, in a dingy morgue in downtown Pittsburgh, he picked up a scalpel and made a discovery that would rattle America in ways he'd never intended. Omalu was new to America, chasing the dream, a deeply spiritual man escaping the wounds of civil war in Nigeria. The body on the slab in front of him belonged to a fifty-year-old named Mike Webster, aka "Iron Mike," a Hall of Fame center for the Pittsburgh Steelers, one of the greatest ever to play the game. After retiring in 1990, Webster had suffered a dizzyingly steep decline. Toward the end of his life, he was living out of his van, tasering himself to relieve his chronic pain, and fixing his rotting teeth with Super Glue. How did this happen?, Omalu asked himself. How did a young man like Mike Webster end up like this? The search for answers would change Omalu's life forever and put him in the crosshairs of one of the most powerful corporations in America: the National Football League. What Omalu discovered in Webster's brain-proof that Iron Mike's mental deterioration was no accident but a disease caused by blows to the head that could affect everyone playing the game-was the one truth the NFL wanted to ignore. Taut, gripping, and gorgeously told, Concussion is the stirring story of one unlikely man's decision to stand up to a multibillion-dollar colossus, and to tell the world the truth."

 

  Meehan, William P.  Kids, Sports, and Concussion : A Guide for Coaches and Parents.

  Praeger, 2011.  


Meehan provides a user-friendly explanation on a variety of topics related to concussion:
Introduction -- Definitions and team members : who will help care for the athlete with a sport-related concussion? -- What is a concussion? -- Sport-related concussion : how common is it? -- Sports equipment : can helmets or mouth guards prevent concussion? -- New medical information : why is concussion taken so seriously nowadays? -- "Neuropsychological" or "neurocognitive" testing : what is it and should my athlete have it? -- The acute assessment and management of sport-related concussion : what do I do when an athlete sustains a concussion? -- Potential therapies : what can be done to help my athlete recover? -- Assessing recovery from concussion : when is it safe for my athlete to return to sports? -- Prevention : is there a way to prevent my athlete from sustaining a concussion? -- The cumulative effects of concussion : how many is too many? -- The female athlete : are girls and boys different when it comes to concussion? -- Setting up a concussion program -- The future : what medical research may lead to in the future -- In their own words : athletes from the Sports Concussion Clinic of Children's Hospital Boston -- Appendix: Sports concussion assessment tool (SCAT 2).

 

  Mueller, Frederick, and Robert Cantu. Football Fatalities and Catastrophic Injuries, 1931-2008.

  Carolina Academic Press, 2011.


Part of the introduction of this book states: "Chapters discuss the history of football injuries by decade (1931-40, 1941-50, etc.) and critically analyze important circumstances in football that have played a role in fatality and catastrophic football injuries (equipment, rules, coaching, medical care, etc.). Additional chapters cover the history of brain and spinal injuries and how the detection and treatment have changed during the past 75 years, as well as heart-related and heat stroke fatalities. A chapter also discusses the history of NOCSAE [National Operating Committee on Standards for Athletic Equipment] and its effect on helmet standards and the reduction of football fatalities and catastrophic injuries."

 

  Omalu, Bennet. Play Hard Die Young : Football Dementia, Depression and Death.

  Neo-Forenxis Books, 2008. 


The contents of this book includes: My professional opinion -- 1. It took us by surprise! -- 2. Why would a football player suffer from dementia and major depression? -- 3. What two and one-tenth brains taught us about dementia and suicide -- 4. The 5. response of the National Football League -- 6. Depression : neurology and family factors -- 7. What should we do? -- pt. 2. The lives and fates of three football players -- 8. Michael "Iron Mike" Webster -- 9. Terry "T-bone" Long -- 10. Andre "Spanky" Waters -- Epilogue -- 11. Why this book was written.

 

Journal Articles


Many college assignments require the use of scholarly JOURNAL articles. For some topics, that is not always easy to find. However, with the subject of concussion and chronic traumatic encephalopathy, there are some excellent scholarly journal and research study articles on this topic. Some of these credible research studies are able to be located at a variety of credible locations on the Web, FOR FREE.

 

  Daneshvar, Daniel H., et al.  "Long Term Consequences: Effects on Normal Development

  Profile after Concussion." Physical Medicine & Rehabilitation Clinics of North

  America, vol. 22. no. 4, 2011, pp. 683-700.

Some of the topics covered are: long-term effects of post concussion syndrome; effects of behavior; when to retire after a concussion; degenerative disease such as Alzheimer’s and Parkinson, chronic traumatic encephalopathy, and motor neuron disease. About a page of information is given for “implications on athletic participation” that includes advice on prevention.

This article can be located online, FOR FREE at: http://www.ncbi.nlm.nih.gov/pmc/articles/PM

 

  Gavett, Brandon E., Robert A. Stern, and Ann C. McKee. "Chronic Traumatic Encephalopathy:

  A Potential Late Effect of Sport-Related Concussive and Subconcussive Head Trauma."

  Clinics in Sports Medicine, vol. 30, no.1, 2011, pp. 179-88.

Definitely, this journal article is written in medicalese. Probably, someone with a health-related background will be able to understand this article. Part of the conclusion gives you an idea what is covered: “CTE is a neurodegenerative disease that occurs later in the lives of some individuals with a history of repeated head trauma. The exact relationship between repetitive mild traumatic brain injury, with or without symptomatic concussion, and CTE is not entirely clear, although it is possible that repetitive axonal injury sets up a series of metabolic, ionic, and cytoskeletal disturbances that trigger a pathological cascade leading into CTE in susceptible individuals.” Some of the subject headings are: clinical signs and symptoms of CTE; neuropathology of CTE including gross pathology and microscopic neuropathology; potential late effect of repeated head injuries, diagnosis of CTE; and risk and protective factors. There is a long reference list at the end of this article that can lead you to more articles in other publications. 

This article can be located online, FOR FREE at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC299569
9/

 

  List, Jonathan, Stephanie Oit, Martin Bukowski, Robert R. Lindenberg, and Agnes Floel.

  "Cognitive Function and Brain Structure after Recurrent Mild Traumatic Bain Injuries in

  Young-To-Middle-Aged Adults." Frontiers in Human Neuroscience, vol. 9, 2015, p. 228. 

"Recurrent mild traumatic brain injuries (mTBIs) are regarded as an independent risk factor for developing dementia in later life. We here aimed to evaluate associations between recurrent mTBIs, cognition, and gray matter volume and microstructure as revealed by structural magnetic resonance imaging (MRI) in the chronic phase after mTBIs in young adulthood. Our results suggest persistent detrimental effects of recurrent mTBIs on CT already in young-to-middle-aged adults. If additional structural deterioration occurs during aging, subtle neuropsychological decline may progress to clinically overt dementia earlier than in age-matched controls, a hypothesis to be assessed in future prospective trials." This journal article can be found for free at: http://www.ncbi.nlm.nih.gov/pubmed/?term=list+cognitive+function+and+brain+structure++after+recurrent

 

  McKee, Ann C., et al. "Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy

  After Repetitive Head Injury."  Journal of Neuropathology and Experimental Neurology, 

  vol. 68, no. 7, 2009, pp. 709-35.

This scholarly, journal article is kind of a “review” article. A very short history of chronic traumatic encephalopathy is given. However, one of the real important features of this article is that the authors present a number of CASE STUDIES of athletes that show the physical and mental results of a career with repeated concussions. A majority of the article is difficult to understand for the layperson. Much of the article explains in medical/physiology terms what happens to the body/brain when a concussion occurs. However, there is just enough very good information that anyone can understand to give the reader a good picture of the health dangers of repeated concussions and chronic traumatic encephalopathy (CTE).

“Chronic Traumatic Encephalopathy In Athletes: Progressive Tauopathy After Repetitive Head Injury” AND Saulle's “Chronic Traumatic Encephalopathy: A Review” really are two EXCELLENT  JOURNAL articles that present astonishing evidence on the long-term dangers of repeated concussions which can lead to chronic traumatic encephalopathy (CTE). “Chronic Traumatic Encephalopathy In Athletes: Progressive Tauopathy After Repetitive Head Injury” can be located online, FREE at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945234/

 

  Mckee, Ann C. and Daniel H. Daneshvar. "The Neuropathology of Traumatic Brain Injury."

 

Handbook of Clinical Neurology, vol. 127, 2015, pp. 45-66.

This is a GREAT Academic Summary. All kinds of aspects of this condition is covered such as different injuries, prognosis, “Chronic effects of traumatic brain injury” and more. There are graphics that could be used for a presentation. This journal article can be found for free at: http://www.ncbi.nlm.nih.gov/pubmed/25702209

 

 

  Saulle, Michael, and Brian D. Greenwald. "Chronic Traumatic Encephalopathy: A Review."

  Rehabilitation Research and Practice, 2012, pp.1-9. doi: 10.1155/2012/816069

“Chronic Traumatic Encephalopathy: A Review” is an EXCELLENT “review” journal article. The entire article can be retrieved through the scholarly, medical, FREE database called PubMed. PubMed is a credible database full of all kinds of scholarly, medical articles. The database is maintained by U.S. National Library of Medicine / National Institute of Health.  This particular article is a “review” article. This means that authors searched through A LOT of the scholarly research studies on this topic and presents in this specific article a summary (or review) what the scholarly literature says about a variety of topics related to chronic traumatic encephalopathy (CTE). This one journal article has A LOT of very good information about the history, epidemiology (cause), statistics, who is at risk and why (such as genetics), clinical presentation (diagnosis), pathophysiology (the physical, medical things that happen in the body), treatments/prevention, and future considerations. If you need JUST one source, then this excellent article has such a variety of information on chronic traumatic encephalopathy that it could be the one source that you need to write a four or five-page paper. Okay, we admit that you might need one or two more sources to help fill up those research paper pages, BUT there really is a lot of good information within this article. A majority of the information is understandable, too. You do not have to have a degree in the health field in order to understand most of what is presented in this journal article.
This journal article can be found, FREE, online at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337491/  You can choose to read the “full-text” OR click on the PDF edition link (scanned image of the pages).


  Sharp, David J. and Peter O. Jenkins. "Concussion is Confusing Us All." Practical Neurology,

 

vol. 15, no..3, pp. 172-186.

This is a VERY GOOD overview / summary of this condition.  This, as most of the articles found in PubMed, is a scholarly journal article. The journal article can be found online for free at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4453625.

 

 

  Stein, Thor D., Alvarez, Victor E., and McKee, Ann C. "Concussion in Chronic Traumatic

 

Encephalopathy." Current Pain and Headache Reports, vol. 19, no. 10, 2015, p. 47.

Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease that occurs in association with repetitive mild traumatic brain injury. It is associated with a variety of clinical symptoms in multiple domains, and there is a distinct pattern of pathological changes. The abnormal tau pathology in CTE occurs uniquely in those regions of the brain that are likely most susceptible to stress concentration during trauma. CTE has been associated with a variety of types of repetitive head trauma, most frequently contact sports. In cases published to date, the mean length of exposure to repetitive head trauma was 15.4 years. CTE and exposure to repetitive head trauma is also associated with a variety of other neurodegenerations, including Alzheimer disease. In fact, amyloid β peptide deposition is altered and accelerated in CTE and is associated with worse disease. Here, we review the current exposure, clinical, and pathological associations of CTE. The journal article can be found online for free at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4633042.

 

  Su, John K. and Joel F. Ramirez. "Management of the Athlete with Concussion."  The

  Permanente Journal, vol. 16, no. 2, 2012, pp. 54-6.

Provides a case study of a high school football player who suffered a helmet-to-helmet collision.  This is a very good case study in a scholarly journal that provides information about symptoms, treatment, and information about useful tools such as the Standardized Assessment of Concussion (SAC) and the SCAT2 tests. These tests can help in the diagnosis and the decision-making process of when the athlete is ready to play again.
This three-page case study can be found online, FOR FREE at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3383163/

 

 

  Tucker, Andrew M. "Update on Sports Concussion." Current Reviews in Musculoskeletal

 

Medicine, vol. 7, no. 4, 2014, pp. 336-372.

Over the past 20 years, sports concussion has become one of the most researched topics in sports medicine. Significant resources have been allocated to the study of this issue, with a dramatic increase in information concerning most aspects of this common sports injury. In light of this considerable increase in research, this review is offered to provide clinicians involved in the care of athletes a summary of key features of the evaluation and management of sports concussion with attention to recent contributions to the literature. Some of the topics covered is short history, epidemiology, evaluation, treatment and return to play, complications of concussion, and prevention. The journal article can be found online for free at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4596213.


Magazine Articles / REPORTS

  "Nonfatal Traumatic Brain Injuries Related to Sports and Recreation Activities among Persons

  Aged  <=19 years --- United States, 2001--2009."  Morbidity and Mortality Weekly Report, 

  vol. 68, no. 7, 2009, pp. 709-35.

The Centers for Disease Control and Prevention (CDC) is a government agency that monitors and provides A LOT of information about health risks. One of the publications of the CDC is the weekly Morbidity and Mortality Weekly Report. The October 7, 2011 weekly issue of this publication provides valuable statistics about concussions as well as links to more information on this topic.

Here is an excerpt: “During 2001--2009, an estimated 2,651,581 children aged ≤19 years were treated annually for sports and recreation--related injuries. Approximately 6.5%, or 173,285 of these injuries, were TBIs (Table 1). Approximately 71.0% of all sports and recreation--related TBI ED visits were among males; 70.5% were among persons aged 10--19 years. An estimated 2.5% of children and adolescents with sports and recreation--related injuries were hospitalized or transferred to other facilities, compared with an estimated 6.6% of those with sports and recreation--related TBIs. From 2001 to 2009, the estimated number of sports and recreation--related TBI visits to EDs increased 62%, from 153,375 to 248,418, and the estimated rate of TBI visits increased 57%, from 190 per 100,000 population to 298. During this same period, the estimated number of ED visits for TBIs that resulted in hospitalization ranged from 9,300 to 14,000 annually but did not show a significant trend over time.

Overall, the activities associated with the greatest estimated number of TBI-related ED visits were bicycling, football, playground activities, basketball, and soccer (Table 2). Activities for which TBI accounted for >10% of the injury ED visits for that activity included horseback riding (15.3%), ice skating (11.4%), golfing (11.0%), all-terrain vehicle riding (10.6%), and tobogganing/sledding (10.2%).
This credible CDC document can be found online, FOR FREE at:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6039a1.htm

 

 

  Beil, Laura. "A Smack Upside the Head." Men’s Health, March 2012, p. 92.

Many of the articles listed above are scholarly journal articles intended for a medical or allied health-related audience. However, Men’s Health is a magazine intended for the general public. The information within this magazine article is understandable and informative. Some of the information mentioned is that a “vast majority of concussion victims are ordinary citizens.” “The American Association of Neurological Surgeons reports that more sports-related head injuries in 2009 occurred on bicycles than on football, baseball, and softball fields combined.” “But experts acknowledge that we don’t know the true scope of the TBI epidemic. The CDC’s tally of annual TBIs treated in ERs or admitted to hospitals is about 1.7 million, but almost no one believes this figure accounts for all of them. There’s a vast undercounting of the concussions in the general population.”  This article gives a real good easy-to-understand explanation on what happens to the brain when a concussion occurs. Some information on symptoms and treatment is provided. A list of the 12 sports with the most “head-banging” injuries is given near the end of the article.

This is a VERY GOOD magazine article on the subject of sports-related concussions. 
This article can be located online for FREE at:
http://www.menshealth.com/health/smack-upside-head?fullpage=true


 

 

  Boyer, Cynthia. "Stay Ahead of the Game: Get the Facts about Concussion in Sports."

  Exceptional Parent,  1 Mar. 2011, pp. 22-23.

Exceptional Parent is a respected magazine that is devoted to providing child development information to the public, especially parents. Cynthia Boyer provides helpful, easy-to-understand information about concussions including: understanding concussion, ways to prevent and prepare, what to look for, after the diagnosis, and calls to action. This article can be found online, for FREE within the “The Free Library” at http://www.thefreelibrary.com/Stay+aHEAD+of+the+game%3A+get+the+facts+about+concussion+in+sports.-a0252006480

  Boyer, Cynthia. "Stay Ahead of the Game: Get the Facts about Concussion in Sports."

  The Free Library, 1 Mar. 2011, pp. 22-23, www.thefreelibrary.com/Stay+aHEAD+of+the+game%3A+get+the+facts+about+concussion+in+sports.-a0252006480.


  Gulli, Cathy, and Charlie Gillis. "The Aftershocks." Maclean’s, 28 Feb. 2011, pp. 46-50.


  Gulli, Cathy. "The Untold Story." Maclean’s, May 30-June 6 2011, pp. 56-62.

Above, I am going to list the two separate Maclean’s magazine articles, together. The content of both articles are similar and are EXCELLENT for showing the public the dangers of repetitive concussions. Both provide good “case studies” of two famous hockey stars. “The Aftershocks” gives information about Sidney Crosby’s concussion. “The Untold Story” is about “Eric Lindros and other pro hockey players speak for the first time about depression, anxiety, and suicidal thoughts. Cathy Gulli reports on the mental and emotional toll of head injuries.” Between the two articles, there is A LOT of information that can help with writing a research paper / essay OR giving a speech on the health risks of concussions, as well as CTE. Added features in the “The Aftershocks” story is information about experimental test lab results and also a very brief history of NHL and its attempts to make the sport safer. “The Untold Story” is more about the effects that the trauma of repetitive injuries had on NHL athletes. This article gives valuable “case studies.”  These two articles are intended for the general public so the information is written in a way that is easy-to-understand.


Websites

Medline Plus is a very credible, valuable online source for all kinds of health-related topics. Medline Plus is a service of U.S. National Library of Medicine / National Institute of Medicine. The information that can be found at Medline Plus is for a variety of interests. A lot of the information is in an easy-to-understand language for the general public. However, there are resources listed for the health professional that can lead to more research, such as clinical trial research studies.
The topic Traumatic Brain Injury and the topic Concussion provide a number of resources that you can access online that give very good overall information about traumatic brain injuries, including concussions (CTE).  The information provided includes the latest news, causes, treatment, prevention and more.

Traumatic Brain Injury is located within Medline Plus at:http://www.nlm.nih.gov/medlineplus/traumaticbraininjury.html

Concussion is located with Medline Plus at http://www.nlm.nih.gov/medlineplus/concussion.html#cat1

 

The Centers for Disease Control and Prevention (CDC), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting public health activities in the United States. The CDC provides A LOT of credible information about ALL KINDS of health issues, including concussions. There are plenty of articles as well as statistics.  Just a few links, among many, are:

Statisitics:http://www.cdc.gov/traumaticbraininjury/data/index.html

http://www.cdc.gov/traumaticbraininjury/get_the_facts.html

http://www.cdc.gov/headsup/youthsports/

http://www.cdc.gov/TraumaticBrainInjury/basics.html/ 



How to Cite this Web Page According to The MLA Handbook Eighth Edition 2016

 

"The Dangers of Concussions and Chronic Traumatic Encephalopathy (CTE)."

 

The College and Career Library, 20 Nov. 2016,

www.booksinformationandmore.com/concussionschronictraumaticencephalopathy.html.

 

Accessed 27 Nov. 2016

Double-space the lines. Use hanging indentation with the second line (if needed) and is indented about 7 or 10 spaces.  The title of the web page is "The Dangers of Concussions and Chronic Traumatic Encephalopathy (CTE)."  There is no official author so place the title first and in quotes as seen above. The official website is called The College and Career Library and is placed in ITALICS.   20 Nov. 2016 is when the web page was updated. Type, or cut and paste, the URL into the citation. After the URL, you can type the date that you accessed the web page, such as 27 Nov. 2016.

This website was updated November 20, 2016.

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