Concussions among athletes: “Today, everyone feels concerned”

Concussions among athletes: “Today, everyone feels concerned”
Concussions among athletes: “Today, everyone feels concerned”

the essential
The first specialized consultation in France for athletes with head trauma was born at the Toulouse University Hospital to follow rugby players. Ten years later, it concerns many disciplines and has developed outside the region. With significant health issues at stake.

When the Toulouse University Hospital, in 2014, set up the first specialized consultation for rugby players suffering from concussion, it was time to raise awareness. It was urgent to inform athletes and doctors about the recovery time necessary for the brain when a shock wave passes through it, after a blow or a violent tackle for example.

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“The brain undergoes a chemical and metabolic alteration. In the majority of cases, the injury is benign and heals on its own but, sometimes, the risks are greater, particularly if the shocks are repeated, of seeing the symptoms of headaches or neck pain lasts several weeks or even months”, summarizes Dr David Brauge, neurosurgeon and initiator of the specialized consultation.

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Risks of other injuries

In the absence of loss of consciousness, the concussion may go unnoticed. The first consequence is measured in terms of performance: the athlete is less good, his ability to concentrate and process information is impaired by the shock wave that passed through his brain. “The risk of injury while following can be multiplied by 1.5 to 3 times,” adds Dr. David Brauge. As for the interruption of electrical flow in the brain, it can lead to problems with memory, balance, and even depressive episodes.”

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Ten years after the first specialist consultations in Toulouse, the question of preserving the health of concussed athletes is still present. And she found her place. “Everyone is concerned and feels concerned,” says Dr. Brauge, invited last week by the National Academy of Medicine to present the latest data on the subject. The theme has gone well beyond the framework of rugby: more than 50% of consultations concern other disciplines (judo, boxing, handball for example). Neurosurgeons and neurologists are no longer the only ones to treat concussions; general practitioners and sports doctors have been widely made aware. “In my weekly consultation, I see between 4 and 8 athletes, particularly cases that are more difficult to detect or take care of,” says the neurosurgeon who benefits from the assistance of a neuropsychologist.

“Even when the stakes are high, athletes stop”

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Specialized care has also developed outside the Occitanie region and several federations have taken measures to protect their athletes. “The context has evolved. The tests to diagnose a concussion, at the side of the field or in a doctor’s office, have become more efficient. And, above all, athletes now accept being placed on rest, including during important moments of their sporting season Remember the case of TFC player, Brecht Dejaegere, victim of two concussions close together at the end of last season: he was able to play in the final of the Coupe de France but the staff accepted that. he stopped and arranged his preparation while the financial stakes are enormous in football, he was an important player for the team and we are talking about new and little-known injuries among footballers”, notes the Dr. David Brauge. “And, for adolescents – an age group where the brain is still maturing – many federations are taking longer shutdown measures than for adults, even if they are well.”

The challenge: being able to predict the long-term consequences

One of the challenges today is to study the longer-term consequences of concussions. “It is difficult to give a precise answer to athletes who ask us what impact this will have on the second part of their life. No examination is capable of predicting it, we can only give a set of arguments based on a multimodal approach (brain imaging, biology, tests, etc.) We understand more and more about concussions but, in the long term, we are still in an unwritten area of ​​medicine,” concludes Dr. David Brauge. He hopes to find funds to finance research work within the ToNIC unit (Inserm/Université Toulouse III Paul-Sabatier) on the early detection of the long-term after-effects of concussions.

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