Sports Head Injuries Take Many Forms, But All Could Prove Devastating, by Dr. Arthur Day

Dr. Arthur Day, neurosurgeon and professor, discusses the devastation that even a seemingly minor sports-related head injury can cause.

As competition in all sports continues to get tougher, coaches and parents need to be especially vigilant about the possibility of head injuries. In some cases, athletes who have suffered traumatic brain injuries exhibit minimal or even no outward symptoms. However, in the worst cases, these incidents result in severe impairment and even death.

While some people dismiss concussion as a minor event, the fact remains that concussions shake the brain and damage neurons and nerve fibers. Many coaches, trainers, and physicians perform a Standardized Assessment of Concussion on athletes who have experienced a blow to the head or a jolting accident. This five-minute series of exercises and questions offers a quick evaluation of a player’s status, but does not always prove effective at discerning subtle physical or mental alterations that could indicate the presence of an acute injury. Even if the athlete remained conscious, he or she may be unable to describe or even recognize memory loss or lack of concentration. The coaches and the athlete often write off other symptoms, such as a persistent headache or dizziness, because of the initial fall or hit or because of heat.

Concussions sometimes lead to a swelling in the brain called second impact syndrome. This condition, which can be fatal, results from a second concussion that occurs before an athlete has completely recovered from a prior concussion. Vascular congestion of the brain and intracranial pressure compress the brain and may even cause it to seep through minute holes in the skull. Second impact syndrome often follows a blow or hit by several minutes; players may suddenly collapse even after appearing to be perfectly fine just moments earlier.

About the author: With more than 40 years of experience, Dr. Arthur Day trains neurosurgeons in his capacity as the Vice Chair of Clinical Education in Neurosurgery at the University of Texas Medical School at Houston. He specializes in minimally invasive spine surgery, microsurgery techniques to treat brain tumors and vascular lesions of the brain and spinal cord, and diagnosis and surgical treatment for neurological sports injuries.

Copyright 2011 – Dr Arthur Day Neurosurgeon

Dr. Arthur Day on Concussions, Part I: Overview

An accomplished neurosurgeon with nearly four decades of experience in the field of medicine, Dr. Arthur Day possesses an extensive background across a wide range of neurological disciplines. In particular, Dr. Day has accrued a wealth of knowledge and professional experience in the field of sports medicine, which often requires a thorough understanding of athletics. In addition to neurological conditions such as pinched nerves, concussions represent another common sports injury that has received a large share of attention from the players, the media, and members of the medical profession.

From the Latin word concussus, which refers to an event that involves two objects striking together, a concussion is a brain injury that generally occurs when the head comes into hard contact with another object. Inside the protective barrier provided by the skull, the brain is suspended in a bed of cerebrospinal fluid, which cushions it against everyday bumps and jolts and prevents it from crashing against the hard inner surface of the skull. If a person incurs sudden and violent contact to the head, the brain can push through the cerebrospinal fluid and strike the skull, which has the potential to injure the brain.

Although concussions can vary widely in their severity, most concussions share many of the same physical symptoms, including a headache, dizziness, and a loss of balance. More severe concussions can produce a wider range of physical symptoms, including vomiting, double vision, tinnitus, and even convulsions. In some cases, victims of trauma to the head have developed posttraumatic epilepsy, although the exact linkage between structural brain injury and epilepsy is still not fully understood.

Concussions also have the potential to cause damage to a person’s emotional and cognitive faculties. Common cognitive symptoms in the wake of a concussion include difficulty focusing, confusion, general disorientation, slurred speech, and a vacant stare. In some cases, concussion victims experience posttraumatic amnesia, which prevents them from remembering the events leading up to the injury. Similarly, concussions can bring about changes in a person’s emotional state, often causing inappropriate displays of emotion, depression, anxiety, and loss of interest in favorite activities. Such emotional and cognitive symptoms may manifest themselves in the immediate aftermath of the injury, or they may take hours or even days to appear.

Copyright 2012 – Dr Arthur Day Neurosurgeon

News from the American College of Surgeons

Noted neurosurgeon and Vice Chairman of the Department of Neurosurgery at the University of Texas Health Science Center at Houston Dr. Arthur Day has held membership in the American College of Surgeons (ACS) since 1981. Dr. Day continues to look forward to new developments in the organization, such as the following:

In May 2011, ACS asked Congress to transition to a new form of physician payment for Medicare doctors. ACS would like the new system to eliminate the sustainable growth rate (SGR), and instead pay physicians fairly for providing quality health care. ACS Executive Director David Hoyt testified in front of the House Energy and Commerce Committee’s Subcommittee on Health to give his opinion on the outdated SGR system and to plead the case for a long-term solution. Dr. Hoyt explained that the first step toward Medicare reform is to immediately do away with the current fee-for-service model. He believes that a new payment system would both reduce costs and improve the quality of healthcare services.

In June 2010, the College presented the grand opening of its 10-story office building in Washington, D.C., that houses its Division of Advocacy and Health Policy. This division strives to create and promote public policy initiatives for both surgeons and patients. More than 150 people attended the event, with guests consisting of surgeons, health care professionals, local and federal government employees, and business leaders in the community.

Other news from the organization includes the offering of two ACS Comprehensive General Surgery Review Courses in 2011 through its Division of Education. The courses take place in Chicago, Illinois, in May and June. Concentrated four-day programs will provide a review of general surgery information, presented in case-based and didactic formats. Attendees will use self-assessment materials and electronically provided monthly review modules. General topics slated for coverage include surgery related to the breast, abdomen, and skin and soft tissues, as well as oncology. Additionally, faculty will address the subjects of perioperative care, surgical critical care, and trauma.

Another big event for ACS is the 2011 97th Annual Clinical Congress, which will take place in San Francisco, California, from October 23 to October 27. At the Clinical Congress, surgeons can expect panel sessions titled “Anastomotic Complications in Gastrointestinal Surgery: Bleeding, Leaks, Strictures” and “Advanced Emergency General Surgery: How to Stay Out of Trouble in the OR.” Other sessions will provide information on ethics, geriatric care, practice management, and vascular surgery. Some new topics will also debut at the 2011 Congress, such as “Creation and Maintenance of High Performance Teams in Surgery: An Educational and Operational Strategy” and “‘Meaningful Use’ of Electronic Health Records.” In addition, attendees of the Congress can view scientific exhibits, attend luncheons featuring discussions of difficult surgical cases led by experts in the field, and discuss membership in the organization at Town Hall Meetings.

In June 2010, the College presented the grand opening of its 10-story office building in Washington, D.C., that houses its Division of Advocacy and Health Policy. This division strives to create and promote public policy initiatives for both surgeons and patients. More than 150 people attended the event, with guests consisting of surgeons, health care professionals, local and federal government employees, and business leaders in the community.

Other news from the organization includes the offering of two ACS Comprehensive General Surgery Review Courses in 2011 through its Division of Education. The courses take place in Chicago, Illinois, in May and June. Concentrated four-day programs will provide a review of general surgery information, presented in case-based and didactic formats. Attendees will use self-assessment materials and electronically provided monthly review modules. General topics slated for coverage include surgery related to the breast, abdomen, and skin and soft tissues, as well as oncology. Additionally, faculty will address the subjects of perioperative care, surgical critical care, and trauma.

Another big event for ACS is the 2011 97th Annual Clinical Congress, which will take place in San Francisco, California, from October 23 to October 27. At the Clinical Congress, surgeons can expect panel sessions titled “Anastomotic Complications in Gastrointestinal Surgery: Bleeding, Leaks, Strictures” and “Advanced Emergency General Surgery: How to Stay Out of Trouble in the OR.” Other sessions will provide information on ethics, geriatric care, practice management, and vascular surgery. Some new topics will also debut at the 2011 Congress, such as “Creation and Maintenance of High Performance Teams in Surgery: An Educational and Operational Strategy” and “‘Meaningful Use’ of Electronic Health Records.” In addition, attendees of the Congress can view scientific exhibits, attend luncheons featuring discussions of difficult surgical cases led by experts in the field, and discuss membership in the organization at Town Hall Meetings.

Dr. Arthur Day on Carotid Artery Disease

Dr. Arthur Day has treated patients for a wide variety of cerebrovascular diseases, including brain aneurysms, stroke, vascular malformations, and carotid artery disease.

Located under the jaw on each side of the neck, the carotid arteries serve as the brain’s primary blood supply. When these arteries become blocked or are narrowed, a condition called carotid stenosis, carotid artery disease results. The plaque builds up and can cause a clot to form, which in turn can cause a stroke. Many factors can contribute to carotid artery disease, including high-blood pressure, heart disease, high cholesterol, diabetes, drug and alcohol abuse, smoking, kidney disease, and a family history of stroke.

Those who have this disease may experience no symptoms at all or may experience classic stroke symptoms, such as weakness in a part of their body, mental confusion, memory loss, blurred vision, speech difficulties, and loss of sensation.

Tests for carotid artery disease include a doctor listening to the blood flow of the arteries through a stethoscope to check for abnormal sounds. Clots that appear in the eyes’ blood vessels serve as visual warning that the patient may have the disease. In addition, cholesterol and triglyceride level tests can be performed, as well as a glucose test, to check for the disease. Other ways of detecting carotid artery disease include a magnetic resonance angiography, an ultrasound of the arteries, and a computerized tomographic angiography.

Once detected, carotid artery disease can be treated with medications and a special diet to bring down cholesterol and blood pressure levels. Blood thinning medications, including Coumadin and Plavix, are often prescribed for this condition, and sometimes a surgery, called carotid endarterectomy, is necessary to remove the plaque buildup. Carotid artery disease can cause strokes as well as a transient ischemic attack, which refers to an episode that resembles a stroke but lasts usually less than a day; this type of attack is commonly considered a warning sign that a stroke is on the way.

There are simple ways to help prevent carotid artery disease, such as staying away from alcohol and drugs, exercising regularly, quitting smoking, and eating a healthy diet. It is a good idea to get routine physicals and have your blood pressure and cholesterol levels checked.

The University of Texas Health Science Center at Houston

With more than 30 years of experience in the field of neurosurgery, Dr. Arthur Day currently acts as a Professor of Neurosurgery at The University of Texas Health Science Center at Houston (UTHealth), which is known for its comprehensive academic health programs and its schools of medicine, biomedical sciences, and nursing and public health. With a community that numbers more than 10,000 that includes faculty, students, staffers, and residents, UTHealth acts as the largest health education institution in Texas.

UTHealth possesses impressive rankings and 19 of its medical school faculty were named among America’s Top Doctors. In addition, out of 535 schools, UTHealth came in at number 60 in funding from the National Institutes of Health. U.S. News & World Report LP has ranked the School of Nursing in the top 5 percent of nursing schools, and the School of Public Health has held the number one spot in doctoral health education.

Primary teaching hospitals affiliated with UTHealth include The University of Texas MD Anderson Cancer Center, Memorial Hermann-Texas Medical Center, the Lyndon B. Johnson General Hospital, Texas Heart Institute at St. Luke’s Episcopal Hospital, and The University of Texas Harris County Psychiatric Center at Houston. At these institutions, students are afforded learning opportunities as well as fellowships and residencies.

Dr. Arthur Day and the Mischer Neuroscience Institute (Part 1)

Dr. Arthur Day recently joined the neurosurgery faculties at The University of Texas Medical School at Houston and its affiliated facility, the Mischer Neuroscience Institute (MNI). Dr. Day assumes the roles of Professor of Neurosurgery at the university’s medical school and Director of Clinical Education at the Mischer Neuroscience Institute.

The institute was created by The University of Texas Medical School in collaboration with Memorial Hermann-Texas Medical Center. The MNI, one of the premier neuroscience centers in the country, brings together prominent clinicians and innovative researchers to promote advances in the neurologic specialties. The institute offers treatment for disorders and diseases of the brain and spinal cord for patients from all over the world.

It is one of the only institutions in the United States dedicated to provide complementary treatment programs that fully integrate the latest findings in neurosurgery, neurology, and neurorehabilitation. As the first center in Houston to offer a stroke program and stroke education to the community and to create a dedicated research program, the Mischer Neurologic Institute has significantly improved the delivery of rapid response for stroke patients.

continued at Part 2.

Dr. Arthur Day’s work with Legendary Baseball Journalist Peter Gammons

Dr. Arthur Day received his Doctor of Medicine from Louisiana State University in New Orleans, and then completed his residency in Neurological Surgery at the University of Florida in Gainesville. He currently serves as a Professor of Neurosurgery at the University of Texas Houston Medical School. Prior to that time, he served as Professor and Chairman of the Department of Neurosurgery, as well as the Director of the Cerebrovascular Center and the Neurological Sports Injury Center of Brigham & Women’s Hospital in Boston and at Harvard Medical School.

Dr. Day was recently featured in Boston Magazine for his work with Peter Gammons, the legendary baseball journalist who suffered a life-threatening brain aneurysm several years ago. In the Boston Magazine article, Mr. Gammons comments on the impressive care he received from Dr. Arthur Day, noting that other physicians had assessed his recovery time at a year and a half. Due to Dr. Day’s expertise, Mr. Gammons was able to return to work in only two and a half months.

Also referred to as a cerebral or intracranial aneurysm, a brain aneurysm is an abnormal swelling of one of the arteries located within the brain. Often discovered only after a rupture occurs, a brain aneurysm can lead to a hemorrhagic stroke, severe damage to the brain, and even death. Every year, 30,000 people suffer from aneurismal subarachnoid hemorrhage, or the bursting of the enlarged vessel segment. An estimated 10 to 15 percent of these cases result in fatalities before hospital care can be given, and more than 50 percent of individuals who suffer a trauma of this kind die within a month. Of those who survive an aneurysm, many are left with some form of permanent neurological disability. Although brain aneurysms most often occur in adults ages 35-60, people of all ages are susceptible, women being more likely to suffer from aneurysms than men. There are many treatment options available for both ruptured and intact brain aneurysms that can enable a person to live a healthy, functional life.

Due to the pioneering work of physicians such as Dr. Day, instances of fatalities and permanent brain damage resulting from aneurysms are steadily decreasing.