Brain Injury Law Blog : Head Injury : Coma : Personal Injury : Las Vegas Nevada Lawyer & Attorney Tim Titolo

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Following up on the recent post on this blog about traumatic brain injury in sports and repetitive injury, the Las Vegas Review Journal devoted a lengthy article on what Clark County Public Schools are doing to protect its athletes.

All too often, student athletes are put back into play with an unresolved concussion.  This becomes a repetitive injury situation where pugilistic Parkinson's develops later in life.  Emphasis in professional sport brain injury in boxing and football has trickled down into the high school and college setting.

 "The school district's procedure issued in August 2008 expanded rules for head injury management that were already in place. The procedure states that an athlete who has suffered a concussion cannot return to practice or competition until having clearance from a physician, an approved score on a computerized neurocognitive test called ImPACT..."

"Schools around the country have begun using the ImPACT assessment to help gauge an athlete's recovery from a concussion. Clark County athletic trainers said the test is invaluable."...

Photo by DAVID STROUD/LAS VEGAS REVIEW-JOURNAL

"Freshmen athletes in the school district are charged a $5 fee to take the test. The initial exam is called a "baseline test" because results are compared to a later test the athlete takes after they have suffered a concussion.

The test consists of six components: word memory, design memory, X's and O's matching, matching shapes to numbers, matching colors and counting backwards from 25 to 1 while remembering letters."  These tests are similar, on a summary level,  to full battery neuropsychological testing done by experts in that field.

Congress voted to set Federal Guidelines for managing concussions in student athletes.  The bill, known as Concussion Treatment and Care Tools Act, requires a government organized conference within two years for medical and athletic officials to set the guidelines.

University of Nevada Las Vegas is also making concussion awareness a priority.  

"In April, the NCAA Executive Committee adopted a policy requiring schools to have a concussion management plan that required the removal of an athlete who showed any signs of a concussion in practice or an event.

UNLV, meanwhile, is in its fourth year of administering a neurocognitive test to its athletes similar to the one used in local high schools, said Kyle Wilson, UNLV's director of athletics training.

'One of the big problems is, if someone has a head injury, you can't see that,' Wilson said. 'That's why we've incorporated some of the 'baseline' testing.'

Comparison of baseline with post injury status is the key to understanding when and when not to put a player back into play.  This is true of all brain injury however is not always available.  In other words, in known risk activity such as contact sports, blast injury, getting baseline cognitive testing is a somewhat prophylactic effort.  But in cases of car accident, fall and other less risky activity, likely brain injury is not expected and no baseline neurocognitive testing is available.

Local neuropsychologists, Thomas Kinsora, Ph.D. and Staci Ross, Ph.D., helped develop the ImPACT test used in high schools and run Sports Concussion Specialists of Nevada.  They believe the baseline testing is crucial because of the variability of symptoms in brain injury.