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Tuesdays With Hildy: Concussions and Drain Bamage - Are They Worse Than We Think?

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The hit on Cam Janssen by Brad Winchester Saturday night was an unfortunate accident that could very well have had ramifications past that game, or past the next two weeks. Cam went down hard, and his coloring visibly changed to a pea-soup color. He was disoriented, couldn't get up for a few minutes, and generally looked like Barf from You Can't Do That On Television after being hit on the head with a frying pan. I was watching the game with my mother, who is a trained nurse, and her first reaction was "He's gone for a while." There wasn't a bit of a question - Cam had his card punched.

We can get pissed off at Winchester as much as we want to, accident or no, but it won't bring our resident tough guy back. Our resident tough guy might never be back the same as before - concussions make you play scared. They temper your game out of fear that the next big hit will be the last one. Players that played like pinballs go to playing like a bocce ball. On-ice, there will be problems for Janssen upon coming back. Off-ice, in the future, is where the questions lie.

There have been a recent spate of football player deaths in the news that may or may not be related to post-concussive trauma. The terrifying thing is, they've been suicides. Owen Thomas, a Penn State football player, killed himself in April out of the blue - his sudden mood changes and decision to take his own life baffled his family. Thomas had chronic traumatic encephalopathy, or dementia puglistica, a brain condition common in athletes who take constant hard blows to the head such as football players and boxers. From Wikipedia:

It is not well understood why this syndrome occurs.[6] Loss of neurons, scarring of brain tissue, collection of proteinaceous, senile plaques,hydrocephalus, attenuation of corpus callosumdiffuse axonal injuryneurofibrillary tangles and damage to the cerebellum are implicated in the syndrome.[7] The condition may be etiologically related to Alzheimer's disease.[7] Neurofibrillary tangles have been found in the brains of dementia pugilistica patients, but not in the same distribution as is usually found in Alzheimer's sufferers.[8] One group examined slices of brain from patients who had had multiple mild traumatic brain injuries and found changes in the cells' cytoskeletons, which they suggested might be due to damage to cerebral blood vessels.[9]

Basically, in laymen's terms, repeated blows to the head will turn you into an Alzheimer's patient by the age of 40, if not sooner. The mood changes associated with this disorder are not hormonal per se, but are due to damage to the brain structure and the structure of the axons of the neurons. The brain has plasticity, meaning that it can repair itself insomuch as to learn common tasks in a different way - it re-routs data. But it can't repair itself structurally. Constant damage from blows to the head, whether it be from a tackle, a punch, or a hard check, will damage the structure of the brain. Case closed.

Of course, this problem can happen without a concussion, or at least without a noted concussion. Small yet powerful hits to the head can also cause the issue to happen. Since it's structural and not chemical, the depression that accompanies it is mostly untreatable through traditional means, such as most medications and therapy. Basically, if you get whapped in the head enough, it's permanent.  The jitters that player gets when they return to the ice after a concussion is a very legit fear of never being mentally correct again.  From CNN:

CTE has been identified in the brains of late NFL football players John Grimsley, Mike Webster, Andre Waters, Justin Strzelczyk, Terry Long, Tom McHale and Chris Henry.

Grimsley died of an accidental gunshot wound to the chest. Webster, Long and Strzelczyk all died after long bouts of depression, while Waters committed suicide in 2006 at age 44. McHale was found dead last year of an apparent drug overdose. Henry died at the age of 26 after falling from a moving truck during a fight with his girlfriend.

It's a very real problem, and one that until recently hasn't gotten much attention. the pre-dominant focus has been on football players, but for someone who not only fights for a living but also throws his body around and checks people, a higher risk is run. There is no test for the problem while an individual is alive, and traditional screening methods might level a diagnosis of depression.

This is why hits to the head are such a problem, but it's not just traditional hits like Matt Cooke leveled on Marc Savard. It's the little ones, the ones that are an unavoidable part of the game. Education of the impact of these hits seems to be the only prevention that hockey players can have right now unless they begin wearing total shock resistant helmets - and even goalie masks don't protect from concussion, as we saw Friday night when Ondrej Pavelec hit his head on the ice.

Will the game change? Absolutely not? Should it?  No. The equipment and the education level of the players needs to, though, before we start reading about young hockey players taking their own lives.