Dr. L. Robbins of the Robbins Headache Clinic recently posted some thoughts about (American) Football and the injuries that can lead to headache conditions. Here is a portion of what he wrote:

Concussions are part of football, with the severity ranging from mild (feeling dazed) to severe (out cold). … Some symptoms may linger for years. Players with multiple concussions have an increased chance of long-term problems that include chronic headache, lower GPAs, memory and emotional difficulties, dementia, and a host of other problems.

Equally disturbing are repeated knocks to the head that do not produce obvious concussion symptoms. A child who plays football from ages 7-18 will typically sustain thousands of hits to the head during games and practices over the years. High school players occasionally die from football. This may occur due to “second impact syndrome,” from returning too soon after the first concussion. Chronic traumatic encephalopathy (CTE) can result from many head impacts, and leads to death among NFL players and boxers. It recently has been identified in high school and college age players.

[read the full post here]

So what does Dr. Robbins recommend? Should we ban football?

Recognizing the difficulties, he makes some suggestions, such as:

Eliminating tackle football for those under 18.
Eliminating hitting in practice. As strange as this may sound to some, it was a policy used by John Gagliardi, arguably the most successful coach in the history of American football.
Use certified trainers.
Improved helmets, although Dr. Robbins admits these help only slightly when it comes to concussions. (Remember the Riddell helmet controversy?)
Educate players, coaches and parents about proper tackling techniques, keeping heads up, and reporting concussions.
A buddy system to help players report concussions.
Laws regarding concussions may help, but brain damage can occur even without concussions.

Regarding the concern about concussions, here’s the issue. A concussion is actually a MTBI – that is, a mild traumatic brain injury. Players should not go back in the game after a mild brain injury (that is, a concussion). Which means players often will not want to report a concussion. Which can cause very serious problems, especially if they get hit again. Post concussion syndrome – and worse.

That’s why there’s so much obsession over what many people still think of as an insignificant issue.

Obviously this issue goes beyond tackle football. Similar injuries can occur in football/soccer, basketball, as well as the more obvious sports such as rugby and boxing.

Thanks to Dr. Robbins for continuing the discussion. Read more about head trauma in sports here.

20 February 2013

20 minutes a day with an anti-migraine device…

James Discoveries & Stats, Treatments 6

It’s the latest migraine gadget that everyone is talking about. It’s the Cefaly Anti-migraine Device!

The Cefaly device is another application of neuro stimulation technology. Specifically, it’s transcutaneous electrical nerve stimulation (TENS), which delivers an AC electrical pulse to the supraorbital nerve.

How do you use it? In this case, the device is used as a preventative. It’s placed on your forehead for a few minutes each day.

A study published this month in the journal Neurology tried the device or a placebo (sham device) on 67 patients. The patients who used the real Cefaly device (group 1 below) showed a significant decrease in “migraine days” each month:

Now that may not look like a major improvement, but it did mean a decrease of 30%. And that’s an average – some saw a much greater improvement (38% had a drop of 50% in migraine days or more).

Convenient? The device has been compared to the visor worn by Geordi La Forge in Star Trek the Next Generation. I must protest – it looks more like the crown of an alien princess. It’s a band that goes on the forehead – small, easy to use, and drug-free.

Currently it comes with a significant price tag – US$368 on amazon, and $239.99 at Costco in Canada, for example. This will certainly keep a lot of people from giving it a try.

On the other hand, the initial results are encouraging for a device that’s non-invasive and not likely to give you the side effects that drugs would. If it works for you, several more pain-free days each month would probably be worth the cost.

But it is good news to see more of these devices being tested and hitting the market, because we’re learning more and more about what works best and for whom.

Study: Migraine prevention with a supraorbital transcutaneous stimulator
Cefaly website (international)
Cefaly Canada website

18 February 2013

Do You have Menstrual Migraine?

James Information 2

For more information:

15 February 2013

Migraine with Aura: Higher heart attack risk than smoking and diabetes?

James Discoveries & Stats, News 10

According to recent research, women who have migraine with aura are at an increased risk for “cardiovascular events”.

This study was actually an investigation into the Women’s Health Study, a large study, which we’ve talked about before, which collected all kinds of information about thousands of women over 15 years.

What were the biggest risk factors for cardiovascular events (CV), such as heart attack and stroke?

High Blood Pressure
Migraine with Aura
Diabetes
Family History of Heart Attack
Current Smoking
Obesity

That’s right, migraine with aura came in as the #2 risk factor for women.

There’s no doubt that this study will increase interest in the study of migraine and heart problems. The connection between the two is not yet understood, although theories are beginning to emerge.

But the link is not new. We’ve known for some time that there’s an increased risk of cardiovascular problems in migraineurs, and not just women who have migraine with aura (for example the same researcher, Dr. Tobias Kurth, reported that men with migraine seem to have an increased risk of heart attack).

Some good news has also come from the Women’s Health Study – for example, women with migraine with aura are less likely to be disabled after stroke.

Even with migraine, your risk is probably low unless it’s combined with other factors above. Still, this is a reminder that migraine can be dangerous, and it does need to be treated. It should also raise awareness for migraineurs and their doctors that they should be cautious of other risk factors, including medications that may increase their risk.

For more, read Migraine and Heart Disease: 7 Critical Things to Know Now.

For more on the study: Migraine with aura confers high CV risk in women