Helmets tethered to necks are both involved with brain trauma injury ?

NationalGeographic.com

http://s.ngm.com/2011/02/big-idea/concussions-graphic-160.jpg

If you go to this National geographic location you can spin the players impact image around to see the huge variety of impacts sustained during a football season, 537 hits to the head to be precise. This is a massive number for one player. Also enclosed is the work from the same National Geographic article from their Feb 2011 issue

The Big Idea: Brain Trauma

Concussions Brains

Lasting Impact

New research suggests that even small hits to the head may lead to brain deterioration over time. So what can be done?

By Luna Shyr
Photographs by Ann C. McKee, Boston University/Bedford Veterans Hospital

Football draws as much attention lately for the knocks that players take as it does for their drives down the field. The emergence of research linking head collisions with behavioral and cognitive changes similar to those seen in Alzheimer’s patients puts the pummeling in a new context. Whether ramming opponents head-on or butting helmets, athletes may face the risk of long-term brain injury from hits accumulated over time.

Brain degeneration from repeated blows to the head has been known in boxers since the 1920s as dementia pugilistica, or punch-drunk syndrome. “Football is the current poster child for that,” says H. Hunt Batjer, a Northwestern University neurosurgeon who co-chairs the National Football League Head, Neck, and Spine Committee. “What’s come to the fore is the risk of repetitive minor hit injuries.” Recent research indicates that small impacts can cause damage as much as big ones, widening the field of concern to young athletes, hockey players—and soldiers subject to head-rattling blasts.

At the University of North Carolina, where football players receive an average of 950 hits to the head each season, neuroscientist Kevin Guskiewicz and colleagues have spent six years analyzing impact data from video recordings and helmets equipped with accelerometers. He and Batjer note that there are plans to test similar technologies on various NFL teams starting this year. “Are you better with five higher-end impacts or 50 lower-end ones? We don’t know,” says Guskiewicz. “We’re trying to see what the real issues are in the concussion puzzle.”

Guskiewicz believes that on-field monitoring and education are paths to progress. Already the spotlight on football-related brain trauma has resulted in new NFL practices, state laws, and congressional hearings on ways to protect young athletes. Batjer adds that military experts working on better helmets for soldiers are collaborating with the NFL. New helmet materials, and technology for on- and off-field testing, were the focus of a recent NFL conference in New York City.

On the medical side, there is hope for advanced brain-imaging techniques, experimental blood or spinal fluid tests, and even a genetic marker that would enable doctors to identify chronic traumatic encephalopathy (the same as punch-drunk syndrome, but not limited to boxers) early on. At the moment, the definitive mark of the disease—clumps of abnormal tau protein in the brain—can be seen only when the brain is sliced, stained, and studied under a microscope. CTE typically appears years after head traumas, and “we don’t want to diagnose a disease after death,” says Ann McKee, co-director of Boston University’s Center for the Study of Traumatic Encephalopathy.

Guskiewicz envisions databases that track all the hits athletes take throughout their playing years to help explain neurologic changes later in life. But, he says, “it’ll probably be my grandchildren who are analyzing that data.”

What is becoming apparent is that pre-testing an athlete toward creating a data bank for each individual player generating baseline data points, where things started from is becoming very obvious. This is what we will attemp  at McGill next year with the kind help from Coach Uttley for the McGill University Redmen Varsity Football team. Comparisons can only be made to previous states of the brain, given that the very brain shape architecture is now regarded as being in a plastic state of flux all the time. Our concept of a hard wired brain built like a computer as a mental picture does not seem very accurate as a descriptive.

Now should we be designing better helmets, or should head and neck support devices be investigated with helmets? The world’s race drivers wear the H.A.N.S Device, which supports the helmeted head with straps to a device fitted behind the neck underneath their six point harness. Head motions, head rotations are constrained with such a device. Another Canadian researcher is working on just such a concept:

To view a HANS device go to this location:

http://hansdevice.com/site/index.html

Hutchens HybridThe Hutchens Hybrid joins the HANS Device as the only head and neck restraint systems allowed by NASCAR for use by drivers in all its touring series. Both restraint systems meet SFI 38.1 certification, the only standard currently recognized by NASCAR to measure head load and rapid egress requirements.

Trevor Ashline, designer of the original Hutchens device and president of Safety Solutions, said his new Hybrid easily passed the rigorous SFI 38.1 testing process, with impressive angular impact numbers, and exceeded the stringent NASCAR head and neck restraint criteria.

“While our R3 and Hutchens II devices meet all SFI 38.1 safety criteria and enjoy widespread use within other national sanctions like NHRA, IHRA, ARCA, SCCA, IMCA, APBA, HSR, Porsche Club and USAC, the Hybrid represents the next evolution of safety technology in head and neck restraint systems,” Ashline said. “We’re thrilled with NASCAR’s approval of the Hybrid, which will now allow drivers at all levels of racing access to the very best head and neck restraint systems on the market.”

Anesthesiologist: Neck Collars Would Protect Against Concussion Better Than Helmets

By Rachel Fields | November 04, 2011

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© Copyright ASC COMMUNICATIONS 2011.

University of Toronto anesthesiologist Joseph Fisher, MD, says a collar no tighter than a set of headphones worn around the neck during games could protect athletes from head injuries during sports, according to a Star report.

Dr. Fisher and his colleagues say the collar would create a sort of “airbag” in the skull to save the brain from concussions. According to the report, Dr. Fisher believes that prominent sports injury experts looking to decrease concussion rates have been wasting time working on helmets.

He says while a helmet may protect the skull from cracking upon impact, it does not stop the brain from moving about in the liquid cerebral fluids surrounding it. This movement causes much of the brain damages involved in concussions.

He says instead, a collar would constrict the neck only slightly and narrow the internal jugular veins enough to prevent the brain from moving.

Here’s another descriptive version with Dr Fisher from thestar.com November 2, 2011

Collars around the neck may save athletes’ heads

November 2, 2011 11:11:00

Joseph Hall

Sports Reporter

A group of prominent scientists is suggesting a stunningly simple strategy to prevent the athletic head injuries that are devastating professional sports — a collar or band around the neck.

The researchers — who include University of Toronto anesthesiologist Dr. Joseph Fisher — say a collar no tighter than a set of headphones worn around the neck during games would create a sort of “airbag” in the skull to save the brain from concussions.

“That’s a pretty ‘wow’ avenue of approach,” says Fisher, also a senior scientist in human physiology at the Toronto General Research Institute.

“All of a sudden now we’ve gone from bigger helmets and things like that to something that . . . would be a simple, inexpensive, universally applied little device.”

Fisher says sports injury experts seeking to end the concussion plague have been largely wasting their time working on helmets, which do little to abate the key cause of those head injuries.

While a helmet may protect the skull from being cracked on impact, it does little to stop the brain from moving about in the liquid cerebral fluids and blood that bathe it. It’s this sloshing movement that is responsible for much of the brain damage that constitutes concussions, Fisher says.

“With the brain sloshing around the skull, it’s absorbing all sorts of the concussive energies,” he explains. “And this absorption of energy causes disruption of all the neurons and the connections and so on.”

By constricting the neck just a little, however, the “internal” jugular veins that drain blood from the skull are narrowed just enough to top up the brain bathing fluids and prevent the delicate organ from moving.

To explain, Fisher says to picture a clear plastic bottle containing water and an object suspended in the fluid. If the bottle is not quite full, the suspended object will move around chaotically if the container is dropped to the ground. If the bottle is topped up with water, however, the suspended object remains still upon impact.

The neck pressures required to keep the skull similarly full of movement retarding blood don’t need to be any greater than those experienced by a person wearing a tight collar shirt.

The device itself would be remarkably simple to build and market, Fisher says. “It’s actually so easy it’s beyond belief,” he says.

Indeed, it could be constructed by fitting the neck guards already worn by many hockey players with a couple of strategically placed cotton balls that would compress the relevant jugulars.

“And you’re done, that’s it. This isn’t like a million dollar project, it’s something that will cost you ten bucks if it works,” Fisher says.

Former Philadelphia Flyers captain Keith Primeau, whose career was cut short in 2006 by concussions, says he’d welcome any new idea that could combat the devastating injuries. But Primeau says any move to introduce neck gear to the hockey would likely have to start in youth leagues, as NHL players are notoriously reluctant to try new equipment.

“It’s like visors,” he says. “We all know that if you don’t wear a visor there’s a chance you could lose your eye, but that doesn’t mean every guy wears a visor.”

(Personally I find this comment very shallow. We are talking about reducing brain injury, this is simply out of depth to equate helmets to visors. Players should not be given the choice, we should be providing them with the best designs for both protecting vision plus their brains. If they don’t want to wear them, don’t play, it’s their choice.)

Fisher himself wears a set of headphones — bent to compress his internal jugulars — around his neck while biking to and from work each day. (I think the writer made a error here, I believe it should read as, ‘compressing his external jugulars,’ otherwise he would be conking out)

Humans and other mammals have two sets of jugular veins running down the neck. The “external” jugulars run along the side, just under the skin and bulge when a person is angry or agitated. The “internal” ones run below the top layer of neck muscles closer to the trachea and drain the blood from the brain and skull.

To show the protective effects of slight internal jugular constriction, Fisher and his colleagues looked at mice, some of which were fitted with collars while others were left collar-free. They then subjected the rodents to slight head traumas while anesthetized. Later autopsies showed significant damage to the collar-free cohort, he says.

The collar wearing rats, however, bore none of the markers that indicate concussions had occurred.

“We’ve shown proof of principle in animals that we can prevent traumatic brain injuries with a simple (method),” says Fisher.

His paper has been accepted for publication by the journal Neurosurgery.

Other contributors include West Virginia University neurosurgeon Dr. Julian Bailes, a former team physician with the Pittsburgh Steelers who also conducted an NFL Players Association sponsored study on head injuries.

Fisher says that like any new medical theory, the idea still needs further scientific validation. But, he says, there is no downside to wearing a collar and that several Division 1 NCAA football teams have already expressed an interest in their use.

I’m not enthused with Dr Fisher’s explanation of a clear plastic bottle falling to the ground with an object, (the brain), ‘sloshing’ around inside the fluids of the brain case. Another clarification, the brain is tethered in many contact places it is not free moving at all it is floating yes in terms of buoyancy, but to say that it is sloshing is simply not an accurate analogy. Also his rats appear to be wearing miniature HANS devices which will constrain head motion plus head rotation, no? What I think Dr Fisher is describing is the similar approach of the wood-pecker strategy that these mammal birds have minimal fluid space so with abrupt contact, force transmission passes directly through the elastic tissue of the brain. Dr Fisher is not describing the human brain as a tensegrity shape design which as I have stated many times is a self rotating event about the brain stem during concussive deceleration. The brain, because of its tensegrity shape will always self rotate, it’s one of the design constraints of Nature. This will happen irregardless if you are wearing a collar or not I fear. What you should really try to accomplish is compress the neck with prevention of rotation at the same time. Our body joints are essentially tensegrity structures, the torso, the knee, the ankle. So if we are intelligent we mimic Nature to make a tensegrity attachment from the helmet to the shoulder pads so that forces are transferred into the torso. How so? I have already designed this sort of attachment for protocol testing as a modified shoulder pad-helmet device. I got the insight last Friday. I had been reading about tensegrity as a bone mechano-transducer, all of a sudden BINGO the neck helmet design snapped into my minds eye.

The crusader knights had the similar idea back in the thirteenth century, helmets were attached to the breast plates. It would be fascinating to try to find documented concussions with these knights especially if certain neck attached helmets worked better than other, free moving helmets alone, in terms of concussion reduction. Sometimes good ideas just keep coming around, floating up from the past.

If you’re interested in purchasing a HANS check this site please:

http://www.rallysport.ca/safety/hans_device.htm

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About cerebrovortex

Montreal Grandmother, Agnes Kent was saved by Raul Wallenberg from certain death, when he provided papers for her and her Mom to escape away from the Nazis. Today when asked what that escape meant, she replied,"Remind people, that while statesmen and whole countries remained silent and did nothing, a single individual chose to act, with ramifications that proved enormous. Similar choices confront us today. Write that simple truth she said, it can never be repeated often enough because the world keeps forgetting it."
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