More brain injury awareness needed to curb concussions, CDC says

Sports medicine physician Joseph H. Rempson, MD, received several concussions as a soccer player in high school and college in the late 1970s and early 1980s. At the time, such head injuries commonly were dismissed as getting your bell rung.

After the dazed feeling wore off, we just got back in the game and played, said Dr. Rempson, chief of the Dept. of Rehabilitation at Overlook Medical Center in Summit, N.J. We had persistent headaches [and] we had A students who became C students, but we didn't know what the problem was.

In recent years, the medical community and the rest of the nation have gotten a better understanding about the severity of such injuries and their lasting impact. During the past decade, public awareness and concerns about traumatic brain injuries have surged, due in part to the identification of a progressive brain disease among more than 40 former National Football League players and reports of more than 200,000 cases of TBI in members of the U.S. military.

The Centers for Disease Control and Prevention has advocated that TBIs, including the more mild cases known as concussions, should be considered a serious public health problem. Although efforts have been made to improve prevention and early treatment of these injuries, a new CDC report says such measures don't go far enough.

TBI is an important public health problem that requires more attention, societal engagement and research, said the report, posted online July 12 in the CDC's Morbidity and Mortality Weekly Report.

The agency is calling for improvements to injury surveillance systems that report national and state TBI data. Those changes would help researchers and others understand the epidemiology and long-term outcomes of such brain injuries.

Public health experts first must get a better understanding of the major causes of TBIs and then implement appropriate intervention strategies, said Arlene Greenspan, DrPH, acting branch chief of the CDC's Health Systems and Trauma Systems Branch.

There are things we know that we can do about TBIs that aren't uniformly being carried out, she said.

Primary care doctors should expect to bear much of the responsibility for identifying and caring for such patients, because of an insufficient number of physicians who specialize in brain injuries, said neurologist Brent Masel, MD. He is president and medical director of the Transitional Learning Center in Galveston, Texas. The center cares for people with brain injuries.

In the entire U.S., there are about 200 physicians who are fellowship-trained in brain injury, he said. That's not enough.

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More brain injury awareness needed to curb concussions, CDC says