Controversy over Association of Brain Injury and Long-Term Brain Disorders

Detroit, MIA controversy is brewing over comments made by a brain injury doctor to Congress last week. According to the January 6 issue of the New York Daily News, Dr. Ira Casson told the House Judiciary Committee convened in Detroit on January 4 that there is insufficient evidence to link concussions and other traumatic brain injuries to neurological disorders later in life.

Dr. Casson was until November serving as co-chair of a committee on mild traumatic brain injury for the National Football League (NFL).

"My position is that there is not enough valid, reliable or objective scientific evidence at present to determine whether or not repeat head impacts in professional football result in long-term brain damage," Casson said.

However, there are those who strongly disagree. Robert Cantu is the co-director of the Center for the Study of Traumatic Encephalopathy at Boston University. He counters that the link between concussion and long-term brain disorders was established 80 years ago by a New Jersey coroner who concluded that head injuries led to dementia in boxers.

Dr. Lewis Maharam, a past president of the New York chapter of the American College of Sports Medicine, said he was shocked when he learned of Casson's comments. "It's ridiculous and no sports medicine physician I know would agree with him," Maharam said. "It is common knowledge that repeated injuries to the head cause brain damage."

The disagreement and controversy further fuels debate over the danger posed by contact sports played by children and adolescents, such as hockey or football. While helmets successfully protect the skull and other exterior soft tissue from injury, they do little to prevent the brain from striking the inside of the skull when a person moving at an increased velocity comes to a sudden stop. The latter can be demonstrated by falling while skiing, or striking one's head hard against a fixed object.

It is not uncommon for athletes to suffer a series of concussions during a sports career, professional or otherwise. Concussions are usually survivable in the mild-to-medium category and expectation for a full recovery is not unreasonable, but the issue now is what impact old brain injuries can have, either in isolation or cumulative, on long-term health of the brain.

"The links between concussions and dementia, depression and irrational emotional behavior are well-documented," Cantu said.