While details of the death of Junior Seau are still undetermined, his death bears a striking resemblance to other suicides and deaths from violent means that have been associated with Chronic Traumatic Encephalopathy (CTE) in professional athletes. CTE results from repetitive closed head injury wherein degeneration of brain tissue and the build-up of tau protein occur. This results in a progressive condition where dementia-like changes occur, along with mood swings, cognitive decline, memory problems and physical impairments. Previous to this self-inflicted gunshot wound, Seau had been arrested for domestic violence and had driven his car off of a cliff (reportedly due to fatigue) in 2010, potential behavioral warning signs for CTE. While not known for being concussion prone, Seau, a 12 time Pro-Bowler, amassed over 1,500 tackles in his NFL career and was an aggressive player even from his younger days in football. His brain is likely to have sustained thousands of small to large concussive forces throughout such a lengthy career.

Seau's death via a self-inflicted gunshot wound to the chest closely parallels last year's death of Dave Duerson, NFL safety, who shot himself in the chest and died. Only later was it disclosed that Duerson shot himself in the chest so that his brain could be donated for study to discern the effects of repeated concussion. Duerson's brain was studied by the Sports Legacy Institute (SLI), a Boston University based foundation started by neurologist Robert Cantu and former Harvard football player Chris Nowinski to study the long-term effects of concussions. Their examination of Duerson's brain showed he had CTE, with similar findings in the brains of 20 other dead players. Perhaps in this desparate, tragic act, Junior Seau also was sparing his brain, which had already been through so much. May the Seau family find comfort and Junior Seau rest in peace.

The Brain Injury Association of America's (BIAA) Business Practice College is under way this week in Las Vegas. Rehabilitation industry leaders from across the country participate in this program, which offers sessions for CEOs, COOs, Human Resources and Marketing professionals. The group's focus is to share exemplary strategies ensuring access to, and development of quality healthcare. Lakeview Vice-Presidents Sue Bartlett, LCSW, CRC and Dianne Schwarz, MEd, OT will be presenting a general session to the group on Medicaid mechanisms and trends as they relate to brain injury and rehabilitation. Sue Bartlett has over two decades of experience in BI case management, contracting and development, while Dianne Schwarz recently joined Lakeview after many years in New York state government, involved with the care of over 7,000 individuals with BI and related conditions.
The Business Practice College opens with the annual meeting of the BIAA Business and Professional Council, Chaired by Lakeview's President/COO Dr. Tina Trudel. As noted at www.biausa.org, the Council's primary goal is to increase access to care. Membership in the Council offers opportunities to stay up-to-date on health care policies, participate in coordinated legislative action, share in brain injury health outcomes and business intelligence, and communicate and network with colleagues.

The romantic drama, 'The Vow', depicting a couple dealing with the aftermath of traumatic brain injury (TBI), was released just in time for Valentine's Day box-office success. Many have asked, could something like this really happen? Yes, in fact the story is loosely based on the true story wherein Krickitt Carpenter sustained a TBI and lost memories of falling in love with her husband (Kim Carpenter). Their compelling story about TBI and the power of love can be found all over the internet. However, there are a few caveats to remember: First is that individuals with TBI typically typically have minimal retrograde amnesia (memories learned before the TBI) and far more difficulty with anterograde amnesia (memories learned after the TBI); second, most individuals injured severely enough to suffer major retrograde amnesia also have other challenges such as personality, cognitive and/or physical changes; and lastly, divorce is unfortunately common after TBI - a challenge for all of us to reach out and support those couples we encounter who are finding their way through the often difficult post-TBI journey.

Unlike non-contact sports, football, hockey and other frequent high-impact sports are associated with risk for concussion, brain injury and chronic traumatic encephalopathy (CTE). For many, CTE is a new term and new idea, that repeated insults to the brain can lead to lifelong progressive, degenerative problems long after an athlete's sports career is over. CTE can cause personality change, memory loss, cognitive impairment and even dementia. While more widely accepted as a consequence of boxing, until recently, CTE and the risk of both symptomatic and asymptomatic concussion from hits to the head through other sports, was not fully appreciated. Implications for youth avoiding hits to the head, practicing without full contact and minimizing hits to the head in the game are critical, and should be a top priority for parents and coaches at all levels. For more information on CTE, visit the BU Center for the Study of Traumatic Encephalopathy http://www.bu.edu/cste/.