Fists, not football: There is no concussion protocol for domestic violence survivors

But it’s not just sports where concussions occur. The most common cause of concussion in NCAA athletes is a car accident. The most common cause of a concussion overall is a fall. And a hidden demographic of people experience brain injuries at an alarming rate: domestic violence survivors.

Every minute, 32 people in the United States experience violence at the hands of an intimate partner. Roughly half of American women and 40% of American men will experience domestic violence at least once in their lives. Most incidents go unreported. One study found that just one in five victims sought medical help immediately after suffering a head injury. Nearly all these injuries involve a blow to the neck or head. 

Current research indicates that more than 75% of domestic violence survivors suffer one or more traumatic brain injuries. In my experience, the most common response to the question, “How many concussions have you suffered,” is “Too many to count.” 

On any given Sunday, you will see up to 30 medical professionals standing on the sidelines of a professional football game. At a high school game, you are likely to see paramedics within eyesight of the players on the field. There are no medical providers who stand outside the home of domestic violence survivors waiting for an injury to occur. There is no concussion protocol for those who are abused.

In addition to repeated impacts to the head, domestic violence survivors often suffer strangulation, being choked, resulting in decreased oxygen to the brain, loss of bladder and bowel function, seizures, and sometimes death.

The long-term consequences of repeated concussion and strangulation include sleep disturbance, dizziness, personality changes, and memory problems. The most common complaint of a domestic violence survivor who suffers one or more concussions is headaches. One silver lining is that these symptoms are treatable.

Thanks to widespread education and awareness campaigns, athletes have benefited from a sea change in how brain injuries are recognized and treated. We need to bring that same standard of care to survivors of domestic violence by establishing a concussion protocol tailored to their needs.

We must ensure domestic violence survivors receive concussion screenings when they reach the doctor’s office or emergency department — regardless of whether they exhibit clear signs of a traumatic brain injury. New technologies can make brain injury screening simple and accurate. 

Diagnostic tests, like Abbott’s Alinity i TBI test, can help providers evaluate people for traumatic brain injuries with a small blood sample, by measuring two blood biomarkers in the brain. We recently implemented this testing capability at the WVU Rockefeller Neuroscience Institute. We’re one of the first to adopt the brain injury test, where results come back in just 18 minutes. That quick turnaround is especially useful in situations where a provider may have limited time with a survivor who is hesitant to seek medical care. Finally, we must offer everything we provide to athletes: cognitive screening, concussion rehabilitation, and VIP treatment.

At the WVU Rockefeller Neuroscience Institute in Morgantown, we design a comprehensive, tailored treatment plan for each patient, which may also include psychiatry, physical rehabilitation, and speech and vision therapy. Personalized approaches like this one help resolve subtle, lingering problems and prepare patients to protect their brain health after they check out of the hospital. Survivors of domestic violence are our VIPs.

Society has rightly taken steps to ensure athletes receive top-notch treatment whenever they experience a traumatic brain injury. Survivors of domestic violence are every bit as deserving of that level of attention and care.

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