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CTE could end the game of Football as we know it

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These are the abstracts for the initial Omalu publications in Neurosurgery (2 NFL players). Keep in mind that these papers started the NFL backlash against Omalu both personally and professionally. Feel free to look at the methods and conclusions and judge for yourself.

Neurosurgery. 2005 Jul;57(1):128-34; discussion 128-34. Chronic traumatic encephalopathy in a National Football League player.

Omalu BI1, DeKosky ST, Minster RL, Kamboh MI, Hamilton RL, Wecht CH.

Author information

Abstract

OBJECTIVE:

We present the results of the autopsy of a retired professional football player that revealed neuropathological changes consistent with long-term repetitive concussive brain injury. This case draws attention to the need for further studies in the cohort of retired National Football League players to elucidate the neuropathological sequelae of repeated mild traumatic brain injury in professional football. METHODS:

The patient's premortem medical history included symptoms of cognitive impairment, a mood disorder, and parkinsonian symptoms. There was no family history of Alzheimer's disease or any other head trauma outside football. A complete autopsy with a comprehensive neuropathological examination was performed on the retired National Football League player approximately 12 years after retirement. He died suddenly as a result of coronary atherosclerotic disease. Studies included determination of apolipoprotein E genotype. RESULTS:

Autopsy confirmed the presence of coronary atherosclerotic disease with dilated cardiomyopathy. The brain demonstrated no cortical atrophy, cortical contusion, hemorrhage, or infarcts. The substantia nigra revealed mild pallor with mild dropout of pigmented neurons. There was mild neuronal dropout in the frontal, parietal, and temporal neocortex. Chronic traumatic encephalopathy was evident with many diffuse amyloid plaques as well as sparse neurofibrillary tangles and tau-positive neuritic threads in neocortical areas. There were no neurofibrillary tangles or neuropil threads in the hippocampus or entorhinal cortex. Lewy bodies were absent. The apolipoprotein E genotype was E3/E3. CONCLUSION:

This case highlights potential long-term neurodegenerative outcomes in retired professional National Football League players subjected to repeated mild traumatic brain injury. The prevalence and pathoetiological mechanisms of these possible adverse long-term outcomes and their relation to duration of years of playing football have not been sufficiently studied. We recommend comprehensive clinical and forensic approaches to understand and further elucidate this emergent professional sport hazard.

Neurosurgery. 2006 Nov;59(5):1086-92; discussion 1092-3. Chronic traumatic encephalopathy in a national football league player: part II.

Omalu BI1, DeKosky ST, Hamilton RL, Minster RL, Kamboh MI, Shakir AM, Wecht CH.

Author information

Abstract

OBJECTIVE:

We present the second reported case of autopsy-confirmed chronic traumatic encephalopathy in a retired professional football player, with neuropathological features that differ from those of the first reported case. These differing pathological features underscore the need for further empirical elucidation of the pathoetiology and pathological cascades of long-term neurodegenerative sequelae of professional football. METHODS:

A psychological autopsy was performed with the next-of-kin and wife. Medical and hospital records were reviewed. A complete autopsy was accompanied by a comprehensive forensic neuropathological examination. Restriction fragment length polymorphism analysis was performed to determine apolipoprotein-E genotype. RESULTS:

Pertinent premortem history included a 14-year span of play in organized football starting from the age of 18 years. The subject was diagnosed with severe major depressive disorder without psychotic features after retirement, attempted suicide multiple times and finally committed suicide 12 years after retirement by ingestion of ethylene glycol. Autopsy revealed cardiomegaly, mild to moderate coronary artery disease, and evidence of acute ethylene glycol overdose. The brain showed no atrophy, a cavum septi pellucidi was present, and the substantia nigra showed mild pallor. The hippocampus and cerebellum were not atrophic. Amyloid plaques, cerebral amyloid angiopathy, and Lewy bodies were completely absent. Sparse to frequent tau-positive neurofibrillary tangles and neuropil threads were present in all regions of the brain. Tufted and thorn astrocytes, as well as astrocytic plaques, were absent. The apolipoprotein-E genotype was E3/E4. CONCLUSION:

Our first and second cases both had long careers without multiple recorded concussions. Both manifested Major Depressive Disorder after retirement. Amyloid plaques were present in the first case and completely absent in the second case. Both cases exhibited neurofibrillary tangles, neuropil threads, and coronary atherosclerotic disease. Apolipoprotein-E4 genotypes were different. Reasons for the contrasting features in these two cases are not clear. Further studies are needed to identify and define the neuropathological cascades of chronic traumatic encephalopathy in football players, which may form the basis for prophylaxis and therapeutics.

PMID: 17143242 [PubMed - indexed for MEDLINE]

Best info in the conclusion..."further studies are needed" = "we have not found anything out that can be shown to be repeatable or of any use...we suggest you use your head at your own risk."

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Now with the benefit of taking a neurophysiology & neuropsychology class in undergrad (Go IU)...I did notice that it is near impossible to show causal pathology without a controlled twin-study, which in itself is near impossible. Which is why many studies go back n forth when it comes to the enigma of the brain & its functions.

The general media isn't necessarily aware of this and will run with anything they come across that will catch an ear.

For nobody else but Josh;

You said he had 2 subjects in his original paper...one being Mike Webster, yes/no? Did he acknowledge Webster's family history of depression/Alzheimer's/suicide, along with his known steroid & alcohol abuse? ...and if so, did he just consider the other subject his "control"-?

Again, I have read Omalu's method/conclusions, you have, please share his exact conclusion...how straight of a line did he paint his findings?

edit: I previously meant to type that I had NOT read the study. Is that realty the extent of his papers, Josh?

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These are the abstracts for the initial Omalu publications in Neurosurgery (2 NFL players). Keep in mind that these papers started the NFL backlash against Omalu both personally and professionally. Feel free to look at the methods and conclusions and judge for yourself.

Neurosurgery. 2005 Jul;57(1):128-34; discussion 128-34. Chronic traumatic encephalopathy in a National Football League player.

Omalu BI1, DeKosky ST, Minster RL, Kamboh MI, Hamilton RL, Wecht CH.

Author information

Abstract

OBJECTIVE:

We present the results of the autopsy of a retired professional football player that revealed neuropathological changes consistent with long-term repetitive concussive brain injury. This case draws attention to the need for further studies in the cohort of retired National Football League players to elucidate the neuropathological sequelae of repeated mild traumatic brain injury in professional football. METHODS:

The patient's premortem medical history included symptoms of cognitive impairment, a mood disorder, and parkinsonian symptoms. There was no family history of Alzheimer's disease or any other head trauma outside football. A complete autopsy with a comprehensive neuropathological examination was performed on the retired National Football League player approximately 12 years after retirement. He died suddenly as a result of coronary atherosclerotic disease. Studies included determination of apolipoprotein E genotype. RESULTS:

Autopsy confirmed the presence of coronary atherosclerotic disease with dilated cardiomyopathy. The brain demonstrated no cortical atrophy, cortical contusion, hemorrhage, or infarcts. The substantia nigra revealed mild pallor with mild dropout of pigmented neurons. There was mild neuronal dropout in the frontal, parietal, and temporal neocortex. Chronic traumatic encephalopathy was evident with many diffuse amyloid plaques as well as sparse neurofibrillary tangles and tau-positive neuritic threads in neocortical areas. There were no neurofibrillary tangles or neuropil threads in the hippocampus or entorhinal cortex. Lewy bodies were absent. The apolipoprotein E genotype was E3/E3. CONCLUSION:

This case highlights potential long-term neurodegenerative outcomes in retired professional National Football League players subjected to repeated mild traumatic brain injury. The prevalence and pathoetiological mechanisms of these possible adverse long-term outcomes and their relation to duration of years of playing football have not been sufficiently studied. We recommend comprehensive clinical and forensic approaches to understand and further elucidate this emergent professional sport hazard.

Neurosurgery. 2006 Nov;59(5):1086-92; discussion 1092-3. Chronic traumatic encephalopathy in a national football league player: part II.

Omalu BI1, DeKosky ST, Hamilton RL, Minster RL, Kamboh MI, Shakir AM, Wecht CH.

Author information

Abstract

OBJECTIVE:

We present the second reported case of autopsy-confirmed chronic traumatic encephalopathy in a retired professional football player, with neuropathological features that differ from those of the first reported case. These differing pathological features underscore the need for further empirical elucidation of the pathoetiology and pathological cascades of long-term neurodegenerative sequelae of professional football. METHODS:

A psychological autopsy was performed with the next-of-kin and wife. Medical and hospital records were reviewed. A complete autopsy was accompanied by a comprehensive forensic neuropathological examination. Restriction fragment length polymorphism analysis was performed to determine apolipoprotein-E genotype. RESULTS:

Pertinent premortem history included a 14-year span of play in organized football starting from the age of 18 years. The subject was diagnosed with severe major depressive disorder without psychotic features after retirement, attempted suicide multiple times and finally committed suicide 12 years after retirement by ingestion of ethylene glycol. Autopsy revealed cardiomegaly, mild to moderate coronary artery disease, and evidence of acute ethylene glycol overdose. The brain showed no atrophy, a cavum septi pellucidi was present, and the substantia nigra showed mild pallor. The hippocampus and cerebellum were not atrophic. Amyloid plaques, cerebral amyloid angiopathy, and Lewy bodies were completely absent. Sparse to frequent tau-positive neurofibrillary tangles and neuropil threads were present in all regions of the brain. Tufted and thorn astrocytes, as well as astrocytic plaques, were absent. The apolipoprotein-E genotype was E3/E4. CONCLUSION:

Our first and second cases both had long careers without multiple recorded concussions. Both manifested Major Depressive Disorder after retirement. Amyloid plaques were present in the first case and completely absent in the second case. Both cases exhibited neurofibrillary tangles, neuropil threads, and coronary atherosclerotic disease. Apolipoprotein-E4 genotypes were different. Reasons for the contrasting features in these two cases are not clear. Further studies are needed to identify and define the neuropathological cascades of chronic traumatic encephalopathy in football players, which may form the basis for prophylaxis and therapeutics.

PMID: 17143242 [PubMed - indexed for MEDLINE]

Best info in the conclusion..."further studies are needed" = "we have not found anything out that can be shown to be repeatable or of any use...we suggest you use your head at your own risk."

The NFL's response to Omalu's work (as shown by their actions):

Further studies aren't needed -- CTE hurts our bottom-line, so we're going to discredit and destroy anyone who promotes even the possibility of the existence of CTE, and use our shill journal Neurosurgery to prevent legitimate CTE studies from ever seeing the light of day.

Psy, If you think that is a proper response to Omalu's work, then we have nothing further to discuss about this issue.

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edit: I previously meant to type that I had NOT read the study. Is that realty the extent of his papers, Josh?

Yes, it is. What the NFL feared was that CTE would be taken seriously, because they KNEW how that would eventually affect public perception of professional football. There was nothing inflammatory about Omalu's work (think about it, if there was, the NFL would have sued the pants off of him).

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edit: I previously meant to type that I had NOT read the study. Is that realty the extent of his papers, Josh?

Yes, it is. What the NFL feared was that CTE would be taken seriously, because they KNEW how that would eventually affect public perception of professional football. There was nothing inflammatory about Omalu's work (think about it, if there was, the NFL would have sued the pants off of him).

??? I do not see this being a case study that should've raised anything more than a "no-sh*t" response out of the NFL, its players & fans alike.

Still waiting for a safe number of concussions a NFL player can have under his belt, yet still continue playing, then still have hopes of a good head on their shoulders as they get older...in your opinion.

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I'm happy a 3 concussions of a certain degree and you have to hang them up...especially if one claims to care about the well-being of the players & thinks the NFL should share the same concern.

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edit: I previously meant to type that I had NOT read the study. Is that realty the extent of his papers, Josh?

Yes, it is. What the NFL feared was that CTE would be taken seriously, because they KNEW how that would eventually affect public perception of professional football. There was nothing inflammatory about Omalu's work (think about it, if there was, the NFL would have sued the pants off of him).

??? I do not see this being a case study that should've raised anything more than a "no-sh*t" response out of the NFL, its players & fans alike.

Still waiting for a safe number of concussions a NFL player can have under his belt, yet still continue playing, then still have hopes of a good head on their shoulders as they get older...in your opinion.

Then why did they seek to discredit the report? If the league's response was, "no sh*t" why ask for a retraction?

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edit: I previously meant to type that I had NOT read the study. Is that realty the extent of his papers, Josh?

Yes, it is. What the NFL feared was that CTE would be taken seriously, because they KNEW how that would eventually affect public perception of professional football. There was nothing inflammatory about Omalu's work (think about it, if there was, the NFL would have sued the pants off of him).

??? I do not see this being a case study that should've raised anything more than a "no-sh*t" response out of the NFL, its players & fans alike.

Still waiting for a safe number of concussions a NFL player can have under his belt, yet still continue playing, then still have hopes of a good head on their shoulders as they get older...in your opinion.

Then why did they seek to discredit the report? If the league's response was, "no sh*t" why ask for a retraction?

Idk...Lawyers need to lawyer. Omalu did not claim the NFL was not doing all in its power to make the game as safe as possible.

It would've been easy to say "we have a dangerous sport which we are continually trying to make safer, for the long-term benefit of all who play football, at any level...we appreciate all research on these matters."

It would be also be easy to see why the NFL would want to halt a potential "red-scare" because of a published 2 person case-study.

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I'm happy a 3 concussions of a certain degree and you have to hang them up...especially if one claims to care about the well-being of the players & thinks the NFL should share the same concern.

If a player was forced into retirement after 3 concussions, you'd see hockey-style goon players hired to do nothing more than to plant one on the noggin of a rival's star player in the hopes of making them retire. Pay a gorilla half a million dollars to get kicked out of a couple of games (and cover his fines from the league, of course) and take three 15-yard penalties, and you never have to face Odell Beckham again!

Instead of protecting players' safety, the rule would crank up the danger by several orders.

Edited by Axe Elf

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I'm happy a 3 concussions of a certain degree and you have to hang them up...especially if one claims to care about the well-being of the players & thinks the NFL should share the same concern.

If a player was forced into retirement after 3 concussions, you'd see hockey-style goon players hired to do nothing more than to plant one on the noggin of a rival's star player in the hopes of making them retire. Pay a gorilla half a million dollars to get kicked out of a couple of games (and cover his fines from the league, of course) and take three 15-yard penalties, and you never have to face Odell Beckham again!

Instead of protecting players' safety, the rule would crank up the danger by several orders.

More than likely...but there's no middle ground, if the NFL cannot keep a player like Welker off the field for his own safety, they should not be expected to take care of him as he ages into a vegetable.

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edit: I previously meant to type that I had NOT read the study. Is that realty the extent of his papers, Josh?

Yes, it is. What the NFL feared was that CTE would be taken seriously, because they KNEW how that would eventually affect public perception of professional football. There was nothing inflammatory about Omalu's work (think about it, if there was, the NFL would have sued the pants off of him).

??? I do not see this being a case study that should've raised anything more than a "no-sh*t" response out of the NFL, its players & fans alike.

Still waiting for a safe number of concussions a NFL player can have under his belt, yet still continue playing, then still have hopes of a good head on their shoulders as they get older...in your opinion.

Then why did they seek to discredit the report? If the league's response was, "no sh*t" why ask for a retraction?

Idk...Lawyers need to lawyer. Omalu did not claim the NFL was not doing all in its power to make the game as safe as possible.

It would've been easy to say "we have a dangerous sport which we are continually trying to make safer, for the long-term benefit of all who play football, at any level...we appreciate all research on these matters."

It would be also be easy to see why the NFL would want to halt a potential "red-scare" because of a published 2 person case-study.

As is always the case, the coverup is worse than the crime. Maybe they learned something from this.

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I'm happy a 3 concussions of a certain degree and you have to hang them up...especially if one claims to care about the well-being of the players & thinks the NFL should share the same concern.

If a player was forced into retirement after 3 concussions, you'd see hockey-style goon players hired to do nothing more than to plant one on the noggin of a rival's star player in the hopes of making them retire. Pay a gorilla half a million dollars to get kicked out of a couple of games (and cover his fines from the league, of course) and take three 15-yard penalties, and you never have to face Odell Beckham again!

Instead of protecting players' safety, the rule would crank up the danger by several orders.

More than likely...but there's no middle ground, if the NFL cannot keep a player like Welker off the field for his own safety, they should not be expected to take care of him as he ages into a vegetable.

How about three concussions or x significant change to your baseline neurological test and you then have to sign a waiver that prevents you from receiving head injury related medical care upon the conclusion of your career? Or something like that...

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I'm happy a 3 concussions of a certain degree and you have to hang them up...especially if one claims to care about the well-being of the players & thinks the NFL should share the same concern.

If a player was forced into retirement after 3 concussions, you'd see hockey-style goon players hired to do nothing more than to plant one on the noggin of a rival's star player in the hopes of making them retire. Pay a gorilla half a million dollars to get kicked out of a couple of games (and cover his fines from the league, of course) and take three 15-yard penalties, and you never have to face Odell Beckham again!

Instead of protecting players' safety, the rule would crank up the danger by several orders.

More than likely...but there's no middle ground, if the NFL cannot keep a player like Welker off the field for his own safety, they should not be expected to take care of him as he ages into a vegetable.

How about three concussions or x significant change to your baseline neurological test and you then have to sign a waiver that prevents you from receiving head injury related medical care upon the conclusion of your career? Or something like that...

That's between a doctor and the player.

What is probably the most reasonable is if an independent (very important, given the corrupting influence of the NFL on "team doctors") neurologist recommends no more football, and the player chooses to play anyway that the player sign an agreement indemnifying the NFL as a condition for being allowed to play against the neurologist's medical advice.

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One problem, a truly independent doctor would recommend retirement after ONE significant concussion...which would lead to what % of the NFL playing like a kite without a string...an easy 50+% ?? Good luck disbanding the Players' Union.

Edited by psygolf

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I'm happy a 3 concussions of a certain degree and you have to hang them up...especially if one claims to care about the well-being of the players & thinks the NFL should share the same concern.

If a player was forced into retirement after 3 concussions, you'd see hockey-style goon players hired to do nothing more than to plant one on the noggin of a rival's star player in the hopes of making them retire. Pay a gorilla half a million dollars to get kicked out of a couple of games (and cover his fines from the league, of course) and take three 15-yard penalties, and you never have to face Odell Beckham again!

Instead of protecting players' safety, the rule would crank up the danger by several orders.

More than likely...but there's no middle ground, if the NFL cannot keep a player like Welker off the field for his own safety, they should not be expected to take care of him as he ages into a vegetable.

How about three concussions or x significant change to your baseline neurological test and you then have to sign a waiver that prevents you from receiving head injury related medical care upon the conclusion of your career? Or something like that...

That's between a doctor and the player.

What is probably the most reasonable is if an independent (very important, given the corrupting influence of the NFL on "team doctors") neurologist recommends no more football, and the player chooses to play anyway that the player sign an agreement indemnifying the NFL as a condition for being allowed to play against the neurologist's medical advice.

One problem, a truly independent doctor would recommend retirement after ONE significant concussion...which would lead to what % of the NFL playing like a kite without a string...an easy 50+% ?? Good luck disbanding the Players' Union.

Not true. There are guidelines by the American Academy of Neurology that outline return to play recommendations based on concussions...its a case by case basis, but the symptoms following concussion + any findings on brain imaging play a big role in this advice. The vast majority of neurologists would not recommend retirement after a single concussion, except in rare instances.

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I'm happy a 3 concussions of a certain degree and you have to hang them up...especially if one claims to care about the well-being of the players & thinks the NFL should share the same concern.

If a player was forced into retirement after 3 concussions, you'd see hockey-style goon players hired to do nothing more than to plant one on the noggin of a rival's star player in the hopes of making them retire. Pay a gorilla half a million dollars to get kicked out of a couple of games (and cover his fines from the league, of course) and take three 15-yard penalties, and you never have to face Odell Beckham again!

Instead of protecting players' safety, the rule would crank up the danger by several orders.

More than likely...but there's no middle ground, if the NFL cannot keep a player like Welker off the field for his own safety, they should not be expected to take care of him as he ages into a vegetable.

How about three concussions or x significant change to your baseline neurological test and you then have to sign a waiver that prevents you from receiving head injury related medical care upon the conclusion of your career? Or something like that...

That's between a doctor and the player.

What is probably the most reasonable is if an independent (very important, given the corrupting influence of the NFL on "team doctors") neurologist recommends no more football, and the player chooses to play anyway that the player sign an agreement indemnifying the NFL as a condition for being allowed to play against the neurologist's medical advice.

One problem, a truly independent doctor would recommend retirement after ONE significant concussion...which would lead to what % of the NFL playing like a kite without a string...an easy 50+% ?? Good luck disbanding the Players' Union.

Not true. There are guidelines by the American Academy of Neurology that outline return to play recommendations based on concussions...its a case by case basis, but the symptoms following concussion + any findings on brain imaging play a big role in this advice. The vast majority of neurologists would not recommend retirement after a single concussion, except in rare instances.

Are you now discrediting studies that suggest permanent brain damage can come from even one concussion? ...how very NFL of you.

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I'm happy a 3 concussions of a certain degree and you have to hang them up...especially if one claims to care about the well-being of the players & thinks the NFL should share the same concern.

If a player was forced into retirement after 3 concussions, you'd see hockey-style goon players hired to do nothing more than to plant one on the noggin of a rival's star player in the hopes of making them retire. Pay a gorilla half a million dollars to get kicked out of a couple of games (and cover his fines from the league, of course) and take three 15-yard penalties, and you never have to face Odell Beckham again!

Instead of protecting players' safety, the rule would crank up the danger by several orders.

More than likely...but there's no middle ground, if the NFL cannot keep a player like Welker off the field for his own safety, they should not be expected to take care of him as he ages into a vegetable.

How about three concussions or x significant change to your baseline neurological test and you then have to sign a waiver that prevents you from receiving head injury related medical care upon the conclusion of your career? Or something like that...

That's between a doctor and the player.

What is probably the most reasonable is if an independent (very important, given the corrupting influence of the NFL on "team doctors") neurologist recommends no more football, and the player chooses to play anyway that the player sign an agreement indemnifying the NFL as a condition for being allowed to play against the neurologist's medical advice.

One problem, a truly independent doctor would recommend retirement after ONE significant concussion...which would lead to what % of the NFL playing like a kite without a string...an easy 50+% ?? Good luck disbanding the Players' Union.

Not true. There are guidelines by the American Academy of Neurology that outline return to play recommendations based on concussions...its a case by case basis, but the symptoms following concussion + any findings on brain imaging play a big role in this advice. The vast majority of neurologists would not recommend retirement after a single concussion, except in rare instances.

Are you now discrediting studies that suggest permanent brain damage can come from even one concussion? ...how very NFL of you.

I am deferring to the neurologists who diagnose concussions in professional athletes and having been doing so for more than 50 years. I would suggest you look into the AAN outlines for yourself.

I am not aware of any legitimate research that connects a single concussion with CTE. Virtually all the studies -- including Omalu's -- have stated that CTE is the result of MULTIPLE concussions, which is far different. Probably more like second impact syndrome (you can Google it if you like).

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Topical:

Co-worker was informed a couple of days ago that his cousin's 16 year old son committed suicide by shooting himself. He had a pretty serious concussion from a water-skiing accident a few years ago, he recovered to what seemed full health, but the entire family all commented that he never acted like the same boy...moody, aggressive, in & out of trouble all of a sudden, and kicked out of several schools.

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I'm happy a 3 concussions of a certain degree and you have to hang them up...especially if one claims to care about the well-being of the players & thinks the NFL should share the same concern.

If a player was forced into retirement after 3 concussions, you'd see hockey-style goon players hired to do nothing more than to plant one on the noggin of a rival's star player in the hopes of making them retire. Pay a gorilla half a million dollars to get kicked out of a couple of games (and cover his fines from the league, of course) and take three 15-yard penalties, and you never have to face Odell Beckham again!

Instead of protecting players' safety, the rule would crank up the danger by several orders.

More than likely...but there's no middle ground, if the NFL cannot keep a player like Welker off the field for his own safety, they should not be expected to take care of him as he ages into a vegetable.

How about three concussions or x significant change to your baseline neurological test and you then have to sign a waiver that prevents you from receiving head injury related medical care upon the conclusion of your career? Or something like that...

That's between a doctor and the player.

What is probably the most reasonable is if an independent (very important, given the corrupting influence of the NFL on "team doctors") neurologist recommends no more football, and the player chooses to play anyway that the player sign an agreement indemnifying the NFL as a condition for being allowed to play against the neurologist's medical advice.

One problem, a truly independent doctor would recommend retirement after ONE significant concussion...which would lead to what % of the NFL playing like a kite without a string...an easy 50+% ?? Good luck disbanding the Players' Union.

Not true. There are guidelines by the American Academy of Neurology that outline return to play recommendations based on concussions...its a case by case basis, but the symptoms following concussion + any findings on brain imaging play a big role in this advice. The vast majority of neurologists would not recommend retirement after a single concussion, except in rare instances.

Are you now discrediting studies that suggest permanent brain damage can come from even one concussion? ...how very NFL of you.

I am deferring to the neurologists who diagnose concussions in professional athletes and having been doing so for more than 50 years. I would suggest you look into the AAN outlines for yourself.

I am not aware of any legitimate research that connects a single concussion with CTE. Virtually all the studies -- including Omalu's -- have stated that CTE is the result of MULTIPLE concussions, which is far different. Probably more like second impact syndrome (you can Google it if you like).

Are there any studies that can claim it, and why would you immediately call anything that you are not aware as "illegitimate"-?

Edited by psygolf

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Topical:

Co-worker was informed a couple of days ago that his cousin's 16 year old son committed suicide by shooting himself. He had a pretty serious concussion from a water-skiing accident a few years ago, he recovered to what seemed full health, but the entire family all commented that he never acted like the same boy...moody, aggressive, in & out of trouble all of a sudden, and kicked out of several schools.

Obviously very sad.

A full picture would be best described by knowing the following:

1. Was that his first concussion?

2. Had he suffered any subsequent concussions?

3. What was his doctor's initial recommendation?

4. Was he referred to a neurologist, and what was the neurologist's recommendation?

5. What did any brain imaging show (CT/MRI)?

Without all of that information, you simply don't know enough details to determine the triggers for his CTE-like behavior.

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I'm happy a 3 concussions of a certain degree and you have to hang them up...especially if one claims to care about the well-being of the players & thinks the NFL should share the same concern.

If a player was forced into retirement after 3 concussions, you'd see hockey-style goon players hired to do nothing more than to plant one on the noggin of a rival's star player in the hopes of making them retire. Pay a gorilla half a million dollars to get kicked out of a couple of games (and cover his fines from the league, of course) and take three 15-yard penalties, and you never have to face Odell Beckham again!

Instead of protecting players' safety, the rule would crank up the danger by several orders.

More than likely...but there's no middle ground, if the NFL cannot keep a player like Welker off the field for his own safety, they should not be expected to take care of him as he ages into a vegetable.

How about three concussions or x significant change to your baseline neurological test and you then have to sign a waiver that prevents you from receiving head injury related medical care upon the conclusion of your career? Or something like that...

That's between a doctor and the player.

What is probably the most reasonable is if an independent (very important, given the corrupting influence of the NFL on "team doctors") neurologist recommends no more football, and the player chooses to play anyway that the player sign an agreement indemnifying the NFL as a condition for being allowed to play against the neurologist's medical advice.

One problem, a truly independent doctor would recommend retirement after ONE significant concussion...which would lead to what % of the NFL playing like a kite without a string...an easy 50+% ?? Good luck disbanding the Players' Union.

Not true. There are guidelines by the American Academy of Neurology that outline return to play recommendations based on concussions...its a case by case basis, but the symptoms following concussion + any findings on brain imaging play a big role in this advice. The vast majority of neurologists would not recommend retirement after a single concussion, except in rare instances.

Are you now discrediting studies that suggest permanent brain damage can come from even one concussion? ...how very NFL of you.

I am deferring to the neurologists who diagnose concussions in professional athletes and having been doing so for more than 50 years. I would suggest you look into the AAN outlines for yourself.

I am not aware of any legitimate research that connects a single concussion with CTE. Virtually all the studies -- including Omalu's -- have stated that CTE is the result of MULTIPLE concussions, which is far different. Probably more like second impact syndrome (you can Google it if you like).

Are there any studies that can claim it, and why would you immediately call anything that you are not aware as "illegitimate"-?

I didn't. But there is sham research out there published in bogus journals where authors are basically paying the journal to publish their work. This is what the NFL was (wrongfully, deceitfully and pathologically) trying to paint Omalu as doing once CTE became part of the public consciousness.

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Approximately one and a half years ago, the N.F.L. made an unrestricted gift to Boston University to support C.T.E. research. The terms of the gift were made very clear: it would have to be completely unrestricted, that is, without any oversight or direction from the N.F.L. regarding how the money is to be used or reporting to the N.F.L. about our findings. The B.U. C.S.T.E. researchers do not get paid by the N.F.L. The monies were used to support our research in general, including our research in other sports such as hockey, and across all ages and levels of play. In other words, there were no strings attached.

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Approximately one and a half years ago, the N.F.L. made an unrestricted gift to Boston University to support C.T.E. research. The terms of the gift were made very clear: it would have to be completely unrestricted, that is, without any oversight or direction from the N.F.L. regarding how the money is to be used or reporting to the N.F.L. about our findings. The B.U. C.S.T.E. researchers do not get paid by the N.F.L. The monies were used to support our research in general, including our research in other sports such as hockey, and across all ages and levels of play. In other words, there were no strings attached.

The NFL's recent problems with "unrestricted" gifts have only increased suspicion about them with regard to the CTE issue:

http://deadspin.com/espn-nfl-blocks-16-million-from-being-used-to-fund-ma-1749256676

"The NFL denies that it “pulled” any funding, which is doubtless technically accurate—Outside the Lines is reporting that the league exercised veto power, not that it pulled already-committed money—but beside the point. Aside from the league making clear through whatever precise means that its money isn’t to be used to fund studies run by doctors it doesn’t approve of, the big thing here is that the NFL apparently lied when it called the gift “unrestricted.”"

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2016 CTE Researchers newsletter to the NFL & its players:

"If you want to reduce your risk of getting CTE, stop playing football."

(but even if you do stop without getting concussion #1, you still might develop it, you have our condolences)

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