Effectiveness of a football over helmet padding system in reducing peak acceleration of the head and severity index.

The purpose of this study was to determine if: (a) a football helmet equipped with the Guardian Cap meets the National Operating Committee on Standards for Athletic Equipment (NOCSAE) football helmet standards and (b) if the Severity Indexes and peak accelerations produced during the NOCSAE impact tests were smaller for a football helmet equipped with the Guardian Cap over-helmet padding system than for the same helmet without the Guardian Cap. A total of 54 drop impact tests were completed, 27 on the football helmet alone and 27 on the football helmet equipped with the Guardian Cap. Tests were completed on seven different locations on the helmet at four different velocities and two different temperatures as per NOCSAE test standards. When the helmet was outfitted with the Guardian Cap, the highest Severity Index (SI) recorded was 751 at the rear impact location as compared to an SI of 842 at the same impact location on the helmet alone. Overall, the average SI when the Guardian Cap was attached was 324 ± 195 as compared to an overall average of 368 ± 219 for the helmet alone. The average peak acceleration (gmax) for the helmet with the Guardian Cap was 85 g’s ± 23 as compared to 91 g’s ± 26 for the helmet alone. These data for the Guardian Cap covered football helmet were below the maximum SI allowed by NOCSAE to be a certified football helmet. The SI and peak accelerations for the Guardian Cap covered football helmet were smaller than the SI and peak accelerations for the helmet alone on the NOCSAE impact tests. Medical professionals, coaches, players and parents can use this information to make informed decisions on the role of the Guardian Cap in possibly preventing or limiting the risk of concussions in football

Interventional spinal procedures in the presence of a Chiari malformation: a potential contraindication.

Although Chiari malformations are much more prevalent than once believed, no study has described treatment with an interventional spinal procedure. The purpose of this report was to discuss the clinical course of a patient who was diagnosed with a Chiari malformation and treated with three cervical epidural injections. In 2012, a 50-yr-old woman presented to a neurology clinic with chronic suboccipital headaches, diplopia, and increasing numbness/tingling in her upper extremities. Magnetic resonance imaging confirmed a type I Chiari malformation and a cervical syrinx. The patient was treated with three cervical epidural injections, after which her symptoms exacerbated. Consequently, a posterior fossa suboccipital craniectomy with C1 laminectomy and excision of extradural and intradural adhesions was performed. After surgical intervention, notable neurologic improvements were observed. Given the marked worsening of symptoms, the present report suggests that interventional spinal procedures may be a contraindication in the presence of a Chiari malformation with a syrinx