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This coming Sunday is Super Bowl Sunday. Millions of people will tune in to watch the Denver Broncos and the Carolina Panthers battle it out in Super Bowl 50. But there’s another battle brewing off the field about the safety of this popular sport. The issue? More and more research points to the harmful effects of head trauma.

This is a huge problem for football as well as many other sports that involve contact between players. This includes boxing, martial arts, rugby, and wrestling, of course. But also hockey, soccer, baseball, and basketball, among others. A helmet-to-helmet hit. A player’s head striking the ground. A player being punched, kicked, or struck in the head. A head-to-head collision. Blows to the head like these can cause a traumatic brain injury, or TBI.

A concussion is the most common form of TBI. Most people who experience a concussion will recover fully. But in some cases, a concussion may cause more long-lasting harm to the brain. It may even lead to something called chronic traumatic encephalopathy, or CTE. Multiple concussions appear to raise the risk of CTE. But, it’s not known how severe a concussion has to be or how many concussions a person has to have to trigger CTE. And it’s not clear how many people develop CTE.

CTE involves damage to nerve cells in the brain that gets worse over time. But most symptoms don’t appear right away. You may have signs and symptoms of a concussion right after a blow to the head. But the more serious long-term effects, if there are any, may take 10 years or more to appear.

In the early stages, symptoms of CTE tend to be mild. They get more severe over time. Researchers often group the symptoms into the following 4 stages.

  • Stage I: Headaches and trouble paying attention and focusing
  • Stage II: Depression and short-term memory loss
  • Stage III: Trouble thinking and making decisions
  • Stage IV: Dementia and aggression

Other symptoms can include poor impulse control and mood swings. Trouble with drugs and alcohol. Thoughts of suicide. Trouble speaking, walking, and even swallowing. In other words, CTE can have very serious and harmful effects on how a person thinks, feels, and behaves.

At this time, there are no tests to diagnose CTE. But there are ways to check for brain injuries, including brain-imaging tests. Other tests can be done to assess overall brain health. And a person’s health history, including any history of concussions, may also help doctors assess brain health.

While there is no known treatment for CTE right now, researchers continue to study CTE with the hope of learning much more. In the meantime, the best thing athletes or parents can do is try to help lower the risk of concussions. If you or your child plays contact sports, wear the right type of protective gear for the sport. If headgear is worn, be sure that it is well-fitted, worn correctly, and kept in good shape.

What should you do if you injure your head or your child has a head injury? Call your doctor right away or call 911 if you notice any of the following symptoms:

  • Vomiting or dizziness that lasts
  • Loss of consciousness that lasts longer than 30 seconds
  • Seizure(s); drowsiness, confusion or disorientation
  • Large bumps or bruises on the head
  • Headache that gets worse over time
  • Short term memory issues
  • Weakness or numbness that persists
  • Slurred speech or other changes in speech
  • Changes in behavior, such as mood swings, crankiness, or crying a lot
  • Changes in physical coordination, such as stumbling or clumsiness
  • Vision or eye issues, such as pupils that are not equal sizes or are enlarged

Your doctor can assess the injury and treatment options. Ask your doctor what you or your child can and can’t do and when and how to resume activities. Also, make sure to monitor any signs and symptoms, and call your doctor right away if any get worse. Stay away from sports and jarring activities until signs and symptoms have fully resolved.