On 2/18/09, an article on the website for the Lacrosse Magazine was posted with the title, Head Games: Post-Concussion Syndrome in the NLL. The article was written by Theresa Smith and was a well-intentioned attempt to raise awareness about mild traumatic brain injury and persisting symptoms. However, there are some aspects of the article that need to responded to so as to prevent confusion about this complex topic.

To begin with, the article states that lacrosse player, Dan Carey, suffered a “severe concussion,” when the fact is that there are no peer-reviewed, consensus based criteria to define a severe concussion and that use of the term is misleading, with potential negative consequences. This is discussed in greater detail is the linked article embedded in the prior sentence.

The article discusses Carey’s symptoms as post-concussive while at the same time mentioning that he has neck pain and that doctors had not made a conclusive diagnosis. It is well known in the scientific literature that symptoms that are described as “post-concussive” are non-specific in that they can occur in many other conditions (McCrea, 2008), including whiplash.

The article makes reference to a player being out of sports for three years due to “post concussion syndrome” without clarifying that the vast majority of people who suffer a mild traumatic brain injury fully recover within days to weeks (McCrea, 2008). The article makes no mention of the numerous non-brain injury related factors that are known to be associated with prolonged recovery from a concussive injury (McCrea, 2008) and seems to assume that all persisting symptoms must be caused by brain injury.

Lastly, the article cites Mammoth coach Bob MacMahon as saying, "Any time you see stars, that's a concussion.” The media should not rely on athletes or coaches to define a concussion (mild traumatic brain injury) because the fact is that none of the diagnostic criteria for mild traumatic brain injury include seeing stars, Tweety birds, giant red lumps raising upwards from the head, or any other popular sterotypes seen in the cartoons.

The article does make a good point that patients should not play through concussive injuries. Specifically, they should not return to play until symptoms have resolved at rest and at exertion, in consult with a physician familiar with such injuries.

Lacrosse Magazine was contacted about these concerns on 2/20/09 and a response will be awaited.

REFERENCES

McCrea, M. (2008). Mild traumatic brain injury and postconcussion syndrome. The new evidence base for diagnosis and treatment. New York: Oxford University Press.