A new technology that evaluates pupil dilation may help identify brain injuries quickly and without special training. And that could speed up recovery.
Justin Markham caught an elbow playing basketball. Lauren Peek fell hard during a soccer match. Both suffered headaches and dizziness. Justin felt nauseated for days. It was weeks before Lauren could use a computer for more than a few minutes. Each suffered a concussion that went undetected until seeking medical help for ongoing symptoms.
The American Medical Society estimates that sports cause 3.8 million concussions yearly. About half go undiagnosed. That puts millions of people at risk for future head injuries and possibly permanent mental problems. But what causes that lasting damage, and why is diagnosis important?
God surrounded our Jell-O-like brains with a protective fluid cushion. But a powerful blow—such as from a tackle, fist, or projectile—can bounce the brain around. Hard hits can damage nerve cells—sometimes causing a concussion. Neuroscientists say blood vessels act as tiny wires that cut through the brain during jostling. Ouch!
Most people know concussions and the resulting chronic traumatic encephalopathy (CTE) are a big problem for pro football players. But about 90% of college and 20% of high school football players studied also showed signs of CTE.
CTE injuries can occur from any contact sport. The Centers for Disease Control emphasizes that young children can receive concussions on the playground—with monkey bars and swings the most common culprits. In those everyday settings, a neurologist isn’t likely to be nearby to offer an on-site diagnosis.
But diagnosis is important for healing, treatment, and prevention of further injury. So University of Washington researchers are developing a smartphone app called PupilScreen. It uses a phone’s camera to analyze a person’s pupils, identifying even mild variations in pupil response. Researchers want anyone to be able to use PupilScreen—parents, coaches, bystanders—to help diagnose brain injury right away.
Damage to cranial nerves (nerves that leave the brain directly—not via the spinal column) is sometimes apparent in eye function. That’s why doctors check pupil dilation after a head injury. Other symptoms of a concussion include dizziness, confusion, headaches, and nausea. With a mild blow, cells can return to normal. But a heavy hit may cause them to die. One concussion increases the seriousness of effects from future concussions. And continuing to play after a concussion doubles recovery time for teen athletes. With the PupilScreen app, there’s new possibility of identifying even mild injuries that might have gone overlooked. That gives more opportunity for maximum healing and protection—from the playground to the pro football field, and everywhere in between.
