Mild TBI has been shown to be a preeminent cause of early mortality and morbidity as evident through mounting evidence of the long-term sequelae of single, and repetitive, mild TBI. Repetitive mild TBI has been linked to chronic traumatic encephalopathy, which can manifests as depression, aggression, and decline in memory. Increased public awareness of these sequelae has led to further education, legislation, and changes in various sports aimed at decreasing the incidence of mild TBI. The California Medical Association has called for increased awareness of mild TBI in its House of Delegates Resolution 123-11. The CDC developed the Heads Up Program to provide information to the public. The Zackery Lynstadt Law and subsequent permutations passed in other states have mandated coaches, educators and parents to be informed. There is a long list of government health warnings of the dangers of other behaviors such as cigarette smoking, alcohol consumption, and exposure to asbestos. These noticeable warnings do have an influence on behavior, as the prevalence of heavy smoking in the United States has decreased greatly between 1965 and 2007 since the institution of clear and conspicuous warnings, and other legislation. Given the impact that conspicuous warnings had on decreasing cigarette consumption, we strongly recommend that in activities with a high risk for sustaining a mild TBI, there should be clear and reasonable warnings posted on the exit of all locker rooms. This could read as: "WARNING: YOU ARE ABOUT TO ENGAGE IN AN ACTIVITY WITH A HIGH INCIDENCE OF MILD TRAUMATIC BRAIN INJURY, WHICH HAS A HIGH LIKELIHOOD FOR PERMANENT BRAIN DAMAGE. SO TREAT YOUR BRAIN WITH THE KNOWLEDGE THAT IT IS THE ONLY BRAIN YOU WILL EVER HAVE." This warning would serve as a strong reminder to not engage in unsafe behaviors that lead to mild TBI.
Robert Bitonte, MD, MA, JD, LLM
Bianca Tribuzio, DO
Kim Armenta, DO