Youth Brain Injuries

Youth Brain Injuries Can Occur Without Concussions

A new study suggests the effects of youth brain injuries can be seen in young athletes even when they have not been diagnosed with a concussion. Typically concussions are thought to be one of the main risk factors associated with trauma to the brain, but the new research suggests that may not be the case, at least when it comes to youth. Although studies have shown that developing brains can be deeply affected by concussions, in fact even moderate impact could cause changes to an athlete’s brain.

Young Athletes Could Be Exposed to Brain Trauma

Recent studies have shown that even one concussion could have more serious consequences on developing brains than previously thought. Even in those cases, however, at least one concussion was diagnosed in the participants who experienced a brain injury. The new study suggests young athletes at least could suffer brain trauma without having experienced a concussion.

Specifically, researchers used data from Head Impact Telemetry System (HITs) software to investigate young, male football players who ranged in age from eight to thirteen. Athletes were fitted with helmets that had sensors to record the frequency and severity of impacts. Researchers analyzed the data about head impacts to determine the severity of the impact the athletes were exposed to over the course of a season, including both games and practices. Both before and after their football season, the football players went through an evaluation including MRI and neuroimaging to identify changes in their brains.

What researchers found was that the 25 athletes who were not were diagnosed with a concussion still showed changes to their brain’s white matter. They also found that the athletes with the highest cumulative head impact exposure showed fractional anisotropy (FA)—the movement of water molecules along the brain’s nerve fibers—at similar rates to patients diagnosed with mild traumatic brain injury.

“This study adds to the growing body of evidence that a season of play in a contact sport can result in brain changes at MR imaging, even in the absence of concussion,” the authors concluded.

Researchers did not study whether the changes would have long-term effects on the athletes but noted that the issue should be studied more closely to determine if there was a link to long-term negative effects. Furthermore, the study only included football players, which are often associated with an increased risk of concussions, but other sports could also show similar risks of youth brain injuries.

“Most investigators believe that concussions are bad for the brain, but what about the hundreds of head impacts during a season of football that doesn’t lead to a clinically diagnosed concussion?” said the study’s lead author, Christopher T. Whitlow, M.D., Ph.D., M.H.A., associate professor and chief of neuroradiology at Wake Forest School of Medicine in Winston-Salem, N.C.

Protection Against Youth Brain Injuries

The issue could be troubling to the many parents who have children involved in football. Approximately 1.23 million youth between the ages of six and 12 played tackle football in 2015, and 1.142 million played flag football. Parents who are relieved that their children haven’t been diagnosed with a concussion or other serious personal injury might now have greater cause for concern. As more information is learned about the potential for serious consequences associated with concussions, there could now be a risk of youth brain injuries not linked to concussions.

Many sports have taken steps to protect athletes from concussions, including having specific guidelines about when an athlete can return to play following a traumatic brain injury. Coaches and team doctors know to watch for symptoms of concussions, including confusion, ringing in the ears, nausea, and fatigue. The new study calls into question whether players and their coaches should now be on the lookout for brain trauma that could occur even without the obvious signs of a concussion and without the type of serious impact typically associated with a concussion or traumatic brain injury.

More research must be done concerning the risk of youth brain injuries in sports, but as additional information about the long-term effect of concussions on adults—including issues such as chronic traumatic encephalopathy faced by former NFL players—the greater the risks young athletes face as they grow and continue to play the sports they love.

Young Athletes and Chronic Traumatic Encephalopathy

Most recently, Boston University brain researchers announced that Kevin Turner—who played in the NFL for eight seasons—had chronic traumatic encephalopathy (CTE) when he died at age 46. Turner died from complications associated with amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease), but researchers reportedly said the ALS was brought on by CTE. In fact, they noted that Turner had one of the most severe cases of CTE they had ever seen. Furthermore, they linked the severity of his condition to his having played football since the age of five, which may have put his developing brain at risk for more serious injury. According to researchers from Boston University, athletes as young as 18-years-old have been found to have CTE.

In 2015, a judge approved a $1 million settlement between the National Football League and 5,000 former players, which resolved a lawsuit alleging the NFL did not do enough to protect players from repeated concussions despite having knowledge of the risks.


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