NEW YORK TIMES: …The key to beating the concussion crisis lies in dealing with what’s happening inside the skull, not outside of it. Because the brain doesn’t fill the skull, there’s room for it to rattle, be bruised or sheared, not just with every collision but with every sudden stop and even start — a phenomenon sometimes described as “brain slosh.” For athletes in contact sports, brain slosh has long been seen as inherent and unavoidable. But to make progress against concussions, we have to give priority in future research to minimizing brain slosh during game play. This means that we need sports leagues, policy makers and health care providers to emphasize primary prevention instead of damage control…
Newer helmets don’t seem to make much of a difference, either. Studies appearing in theBritish Journal of Sports Medicine and the American Academy of Pediatrics found nearly identical rates of sports-related concussions among different helmet brands and models, including older helmets and new. Why? Think about shipping fragile porcelain — do we use steel or titanium containers, or Bubble Wrap? The same principle applies when protecting the brain. Helmets fulfill their primary purpose of preventing skull fractures and lacerations, but they do not reduce concussions. It is the delicate brain within the skull that is damaged because it does not fit snugly. Athletes would benefit from a tighter fit for the brain — a Bubble Wrap effect — during play, but what are the factors within our control that might provide that effect? We have some leads.
At the Cincinnati Children’s Hospital Medical Center, we released a study that found that high school football players who played at higher altitudes sustained a 30 percent reduction in total concussion incidence. We hypothesized that higher altitude increased the volume in the cerebral venous system, a natural Bubble Wrap that surrounds the brain, and that this created a snugger fit inside the skull that protected the athletes from sustaining concussions. We are currently analyzing N.F.L. concussion data from the 2012 and 2013 regular seasons to see if this effect obtains among professionals… (more)
