Concussions on His Mind

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Neil Jasey, the director of Traumatic Brain Injury Services at Kessler Institute for Rehabilitation, is also the medical director of the Northern New Jersey Traumatic Brain Injury Model System.

Photography: 

John Emerson

How dangerous are the repeated blows to the head of football players? According to head-trauma expert Neil Jasey, they can indeed be serious, but he says our view of the causes of concussions is too narrowly defined. His patients include athletes, car-accident victims, and even a woman who fell down steps while texting. Neil Jasey is the director of Traumatic Brain Injury Services at Kessler Institute for Rehabilitation, which has an affiliation with Rutgers. He is also the medical director of the Northern New Jersey Traumatic Brain Injury Model System, which conducts research into people with brain injury. Jasey NJMS’03 helped create the state’s concussion guidelines for injured student-athletes and establish a concussion clinic at Kessler.

RUTGERS MAGAZINE: The topic of concussions is in the news these days. What is a concussion, exactly?
NEIL JASEY: A concussion is an alteration or loss of consciousness due to a blow to the head, face or neck, or to another part of the body where forces are transmitted to the head. The primary symptoms include headache, sleep disturbances, fatigue, anxiety, and depression, along with problems with concentration, memory, and attention.

RM: When is care needed?
NJ: Right away is best. Athletic trainers assess for concussions and generally refer injured athletes to physicians. Patients fare better when they are treated early by a physician who is experienced in treating concussions. When they do not improve, they are often referred to Kessler. So, I see them at a later stage.

RM: What treatments are at Kessler?
NJ: I evaluate patients, along with a neuropsychologist, for any neurologic
or cognitive issues. For acute problems, we prescribe physical and mental rest—staying out of school or work and refraining from sports until there are no symptoms when the person is inactive. Patients are then reintroduced to normal activity.

For patients with chronic problems, we prescribe supplements, such as coenzyme Q-10, the B vitamins, fish oil, and ginkgo biloba, and controlled exercise. This helps reset the autonomic nervous system, which controls heart rate, respiratory rate, and blood pressure, among other things. For cognitive issues, we can prescribe stimulants, which can help with overstimulation and concentration.

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Athletes are among the many patients that head-trauma expert Neil Jasey treats for concussions. In recent years, the public has become more aware of the prevalence of concussions among former and current players of the National Hockey League and the National Football League. Sidney Crosby of the Pittsburgh Penguins, the NHL’s top star, has had two bouts with concussion-like symptoms. Tony Dorsett, a former running back for the Dallas Cowboys, revealed recently that he suffers from symptoms associated with chronic traumatic encephalopathy, a degenerative condition that many scientists say is caused by head trauma.

RM: What is your success rate?
NJ: When we see patients early enough, we have significant success in getting them back to what they want to do. Patients with more long-term issues show improvement, but may take longer to demonstrate adequate recovery.

RM: Are media accounts of the serious long-term effects of concussion real?
NJ: People are rightly worried about dementia and other consequences resulting from repeated concussions. Although there is a growing body of literature documenting and investigating the pathophysiological changes to the brain, we need more longitudinal studies to understand how symptoms progress over time. We also need to study the accumulated effects of sub-concussive impacts, which is very under-recognized.