Jacoby Brissett concussion: NFL chief medical officer defends overdue diagnosis for Colts QB

Colts quarterback Jacoby Brissett was diagnosed with a concussion after the Colts’ reduction to the Steelers on Sunday. On Tuesday, the league’s chief medical officer, Dr. Allen Sills, explained why Brissett wasn’t removed from the game.

Brissett was slow to get right up after popular in the fourth one fourth. Colts medical staff taken care of him on the field and walked him to the sideline therefore they could go through standard concussion examining with Brissett. He passed.

The protocol says that players should be evaluated for concussions by team medical staff and an unbiased neurotrauma consultant who is not associated with the team.

“What happened found in this example is [Brissett] went in to the tent, and the crew physician and the athletic trainers started the sideline analysis,” Sills stated Tuesday. “The unaffiliated neurotrauma consultant had not been on the sideline at that time for the reason that unaffiliated neurotrauma consultant was in the locker room doing that locker room analysis on another player.”

Despite the fact that Brissett passed the initial test, Colts medical staff waited and performed the check again after the unaffiliated neurotrauma consultant got back to the sideline.

“The player, again, passed that evaluation. Had no symptoms, got no findings,” Sills said. “There was nothing to suggest anything that was unusual at that point. Predicated on that, and once again, in conjunction with a personal injury video assessment, everyone in the equation experienced that there was no diagnosis of a concussion. The player returned to the game.”

The Colts continued to screen Brissett through the entire game.

“He was approached by crew medical staff and had contact items throughout the game to ensure that no symptoms were appearing and that there was nothing that would change the prior diagnosis,” Sills said.

After the game was over, team medical staff and the neurotrauma consultant checked him once again in the locker room. Brissett still didn’t express any symptoms of a concussion. That modified after a bit more time had passed.

“At some point, 20 to thirty minutes after the game, it experienced like there might be the emergence of lots of very mild symptoms,” Sills stated. “Due to that, he was once again brought back to the medical staff. The medical staff – once again, in conjunction with the independent and unaffiliated neurotrauma consultant – evaluated the player again.”

And Brissett even so didn’t have any standard signs or symptoms of a concussion. But because he did have some “very moderate symptoms,” the team made a decision to err privately of caution.

“He, again, was usual neurologically in all of the tests,” Sills stated. “But because there were some very moderate symptoms that came out, and using what I’d refer to as precaution, the crew decided that at that time they would place him in the concussion protocol and take care of him for that diagnosis.”

Sills, a good neurosurgeon whose career focus has been treating sports athletes, emphasized that it’s not unusual for concussion symptoms to be delayed or even to evolve over time.

“Concussion is an extremely heterogeneous harm,” Sills said. “There are several people that have certain symptoms, and others that contain very divergent symptoms. Some persons manifest a whole lot of symptoms right away. Some persons have only 1 symptom and afterwards will add three or four, and some persons don’t have any observeable symptoms early on and could develop symptoms on a delayed basis.”

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That makes it difficult for doctors to accurately diagnose concussions. And that’s problematic, taking into consideration the link between brain trauma NFL players encounter and long-term traumatic encephalopathy, commonly known as CTE.

Regarding to Sills, the Colts adopted the concussion protocol effectively with Brissett. In a perfect environment, he wouldn’t have already been allowed to return to the field. But because his symptoms didn’t arrive until after the video game, there was no chance for team medical staff to know he was concussed.

“It’s section of the frustration of us as medical practitioners trying to care for athletes with these injuries,” Sills said. “But we recognize that concussion isn’t one harm. It’s a spectrum of injuries. It’s going to have a whole lot of different presentations.

“Even now, part of what we, simply because the medical profession, have to do is better understand why injury so we are able to better categorize it and continue our efforts to diagnose it.”

Sills said he believes this recent edition of the concussion protocol is the foremost version that the league has had up to now. But Brissett’s diagnosis after he came back to the field to finish the game drives home the fact that it is certainly far from perfect.

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