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Head Injuries and Sports: an Interview with Bennet Omalu, MD

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Head Injuries and Sports: an Interview with Bennet Omalu, MD Head Injuries and Sports: An Interview With Bennet Omalu, MD BY MICHAEL DREGNI hese days, Bennet Omalu, MD, is known as the man who singlehandedly took on the NFL over the issue of head injuries. His campaign to publicize the plight of former football players who died from cumulative knocks to the Thead put the league on the defensive. The NFL fought back, trying to discredit Omalu and downplay the brain disease he discovered, CTE, or chronic traumatic encephalopathy. His story was told in the 2015 film Concussion, where he was played by Will Smith. In 2002, Omalu was working as a forensic pathologist in the county coroner’s office in Pittsburgh, Pa., when he did an autopsy of all-star pro football player “Iron Mike” Webster. Omalu determined that Webster’s brain had been injured by the cumulative effect of numerous subconcussive head injuries he suffered over his 17 seasons in the NFL. From 2004 through 2008, Omalu did autopsies of NFL play- Bennet Omalu, MD ers, wrestlers, and military veterans including, but not limited to, Terry Long, Justin Strzelczyk, Andre Waters, Chris Benoit and Tom McHale, and determined CTE to be an underlying cause or contribu- tory factor to the death of these athletes and military veterans. Today, Omalu is the chief medical examiner for California’s San Joaquin County as well as a clinical professor of pathology and laboratory medicine at University of California, Davis. He explained details of CTE — and discussed his views on allowing children to play football. Q&A Experience Life: Can you please force trauma or acceleration– can also cause CTE. define chronic traumatic deceleration injuries. It is a type CTE manifests with a encephalopathy for the lay of brain damage, which can be broad spectrum of symptoms, reader? permanent and progressive, and which may include but are not can be caused by repeated blows limited to mood disorders like Bennet Omalu: Chronic to the head over time in all types depression, bipolar disorder, Traumatic Encephalopathy, of human activities including impulsivity, drug and alcohol or CTE, is a major part of the sports. Single or episodic blows abuse, loss of memory, loss of traumatic encephalopathy to the head like we have in intelligence and language, loss syndromes, which arise when motor-vehicle crashes, which of executive thinking, and other the human brain suffers blunt result in severe brain injuries, cognitive capacities. ExperienceLife.com / EXPERIENCE LIFE / 1 EL: We often hear the of the brain, just like for other EL: Knowing what we know now generalized statement that dementias. However, we do about repeated blows to the “concussions cause CTE.” But, not need a definitive degree of head, should children expose from my understanding, CTE is certainty to make a diagnosis in themselves to activities that caused by cumulative blows to a living person. could damage their brains, like the head — correct? And these So yes, we can now diagnose football, hockey, or boxing? blows can be both minor and CTE in living people. But in major, from subconcussions to the near future we can develop BO: No child under the age of true concussions. biological and radiological 18 — which is when the brain markers for CTE, which will be becomes fully developed — BO: Yes, CTE is not caused by clinical-assessment tools that should be allowed to participate concussions. Subconcussions will aid the physician in a more in high-impact, high-contact and concussions are diseases by definitive diagnosis of CTE in a sports, including boxing, themselves, which are separate living patient. American football, ice hockey, from CTE. Subconcussions wrestling, mixed martial arts, and concussions belong to the and rugby. Children cannot join acute traumatic encephalopathy the military or vote, or drive a syndromes. You can develop car, or sky-dive until they are 18. CTE without suffering For the less-contact, less- a concussion. impact sports like soccer, we CTE can be caused by a should take heading the ball single blow to the head, episodic We must protect out of the game for children blows to the head, or repetitive our children from all under the age of 18, and children blows to the head, with or types of intentional should not play soccer as we without concussions, with or exposure to the risk play it today until they are without helmets. of brain injury." about 12 to 14 years old, when There is nothing like a safe they have developed the motor blow to the head. In all that we and visuo-spatial neurological do, we should avoid blows to capacities that are required the head. for complex, less-contact, less- impact sports like soccer and EL: Do you think we will EL: And someday will we have a lacrosse. Children should engage someday be able to diagnose treatment, or even cure, for it? in noncontact sports like track CTE in living people? and field, basketball, volleyball, BO: Yes, someday, I believe, badminton, lawn tennis, BO: Yes, today, we can diagnose we may develop a more swimming, table tennis, etc. CTE in living people based definitive treatment modality Knowing what we know now, on the manifesting symptoms for CTE, which can slow down we must protect our children from and a history of exposure, the progression of the disease, all types of intentional exposure but it will be a presumptive or reduce the probability of to the risk of brain injury. High- diagnosis, just like we do for suffering from the disease. I impact, high-contact sports other types of dementias. believe pharmacological agents possess extremely high risks of Definitive diagnosis remains will be more promising than brain injury. We should keep our with postmortem examination technological devices. children away from such risks. ExperienceLife.com / EXPERIENCE LIFE / 2 .
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