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ShareAugust 1, 2005 — Using a handheld unit attached to a laptop, doctors can now check in just five to seven minutes if a patient has suffered from concussion, by testing cognitive functions such as reaction time and memory. The quick response -- compared to a more-common paper-and-pen test that can take up to two hours -- can for example tell a football coach whether it is safe for to put an injure player back in.
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ATLANTA--A big hit during a football game ... The impact of a car crash. Both can cause serious head injuries.
Emory School of Medicine emergency medicine physician David Wright, sees just about everything in the ER, but a concussion -- or any alteration in mental status after a blow to the head -- can be one of the most complicated to diagnose.
Right now, doctors diagnose a concussion with a pen and paper test that can take up to two hours. It's not practical on a football field where a coach has to decide in minutes whether to put a player back in.
"Oftentimes the player won't admit to having a concussion," Dr. Wright says. "They want to go back out and play." He has teamed up with biomedical engineer Michelle LaPlaca of Georgia Tech, to create a device to assess the situation in five to seven minutes.
"We wanted to be able to administer a shortened neuropsychological test in an environment that is potentially noisy and has a lot of distractions and to minimize those distractions," Dr. LaPlaca tells DBIS.
It's called DETECT and has three components: a laptop computer, headset and a handheld unit. It's used to test cognitive functions like reaction time and memory.
Dr. LaPlaca says, "It has to be a sensitive test, and that's what we're in the process of validating now."
It's currently being tested in Emory's emergency room and soon on the field.
"My hope is that it saves lives," Dr. Wright says -- saving lives on and off the playing field.
While most college and professional teams have skilled medical professionals on the sidelines, Dr. Wright says junior high and high school teams often don't. He says this and the emergency room are the two places he believes the detect device will benefit most.
BACKGROUND: Biomedical engineers have built a portable device to quickly detect mild traumatic brain injury (concussion) in the heat of sports competition, on the battlefield, in the emergency room, or any other situation where time is critical. DETECT can zero in on problems associated with concussions in about 7 minutes, in almost any setting.
THE PROBLEM: More than 750,000 mild traumatic brain injuries occur each year in the U.S., many during a game. If the injury is misdiagnosed, and the player goes back on the field, a second impact injury shortly after the first can lead to permanent brain damage or possibly death. But in the heat of a sports competition, such injuries can be missed.
HOW IT WORKS: The device to quickly detect mild brain injuries includes software, a portable computer, a controller like that used in video games, earphones and headgear with a video display. People with mild brain injury will struggle with certain mental tasks that draw on different areas of the brain, such as working memory and complex reactions. DETECT picks up on these difficulties and alerts the tester that a concussion has occurred. The system is able to block out unwanted light and sound that could interfere with the test.
WHAT CAUSES BRAIN INJURY: Any kind of blow to the head can cause trauma and concussion. A blood vessel could tear under the skull, causing blood to accumulate in that area that will gradually displace the brain -- a life-threatening situation if not treated promptly. Other trauma can result from a car accident, or when a person is violently shaken, such as while riding a roller coaster. As the head whips sharply back and forth, the brain can pull away from one side of the skull and smash into the other side with sufficient force to rupture tiny blood vessels. The trickling blood accumulates in the small space between the brain and the skull, and the resulting pressure can lead to permanent brain damage or death if left untreated.
SYMPTOMS OF CONCUSSION: Temporary unconsciousness, headache and sometimes a loss of memory surrounding the time of the injury. Vomiting and nausea are also common reactions.
Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.
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