NYU Langone Medical Center in New York City officially launched its Concussion Center on March 19, with an event featuring presentations from a professional athlete and experts on the topic of brain injuries.
While the speakers discussed the advances in knowledge of concussions, many due to research involving diffusion tensor imaging and other advanced MRI techniques, they also emphasized what is left to be discovered.
“We need better biomarkers, better imaging predictors of who’s at greater risk,” said Steven L. Galetta, MD, chair of the department of neurology at NYU Langone Medical Center. There’s been a doubling of the concussion rate over the last decade, likely due to increased recognition of the condition and research about the potential long-term side effects of even mild head injuries.
In discussing the changing attitudes toward head injuries from the days where athletes had their “bell rung,” were given smelling salts and returned to play, Galetta recalled a saying that 50 percent of what is learned in medical school will be wrong, the problem is knowing which 50 percent it will be. “That’s the important thing about medicine,” he said. “You should always be willing to change your mind as scientific inquiry and research disproved what you’d believed in your heart. I think we are in the beginning stages in this regard when we talk about concussion.”
Following the presentation, Galetta spoke with Health Imaging on the role of radiology in monitoring concussions, and said that imaging is not needed in a typical concussion case unless symptoms worsen. “Most symptoms of concussion are going to clear within seven days and if somebody is progressing in the right direction the role of diagnostic imaging could be questioned.”
Galetta acknowledged that many patients with head injuries will automatically be imaged when brought to an emergency department, but perhaps the bigger role imaging, MRI in particular, can play is in research and in identifying the processes underpinning concussion symptoms. Head injuries take many forms, and a big question that needs to be answered is how any individual will respond following a concussion. While some can recover after multiple injuries, others can have persistent structural deficits after a single concussion. In athletics, MRI could hold the promise of uncovering biomarkers that determine which athletes are at most at risk for long-term complications if they return to play following a concussion, according to Galetta.
The Concussion Center provides comprehensive care for pediatric and adult patients with concussions. Steven Flanagan, MD, co-director of the Center and medical director of the Rusk Institute of Rehabilitation Medicine at NYU Langone Medical Center, said the goal is to provide a multidisciplinary approach to the treatment of head injuries, leveraging the combined knowledge of neurology, neuroradiology, orthopedic sports medicine, neuropsychology and other specialties.
Former National Hockey League player Adam Graves was also on hand to stress to the audience, some of whom were athletic trainers or athletes themselves, the importance of studying concussions.
“There’s nothing more important than a child’s mind, than a person’s mind,” he said.