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Posts Tagged ‘Concussion

Current Concepts in Sports Concussion: The Long-term Effects of Repetitive Mild Head Injuries in Sports

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Screen Shot 2014-10-13 at 1.55.11 PMAt least 300 000 sports-related concussions occur in the United States annually. With millions of American athletes, the long-term effects of repeated concussion or mild traumatic brain injury are an important topic. Unfortunately, there is a lack of strong data on the causality or prevalence of long-term effects among athletes. Chronic traumatic encephalopathy (CTE), a progressive neurodegenerative tauopathy, with associated clinical, behavioral, and neuropathological findings, is an important clinical entity in need of further study. Diffusion tensor imaging can elucidate trauma-induced white matter damage, but the diagnosis of CTE cannot be proven until postmortem neuropathology shows characteristic neurofibrillary and astrocytic tangles. Concern exists that athletes subject to repeated concussive and even subconcussive blows may be at risk of CTE, but no definitive data exist due to the difficulty in diagnosis. Animal models suggest that mild traumatic brain injuries lead to primarily a metabolic derangement with increased excitotoxic neurotransmitter release, extracellular potassium, and intracellular calcium. Further understanding of the underlying pathophysiology may eventually lead to better therapeutic and diagnostic options for the treating clinician.

From: The Long-term Effects of Repetitive Mild Head Injuries in Sports by Saigal et al.

Current Concepts in Sports Concussion is online and full-text access is free.

Written by NEUROSURGERY® Editorial Office

October 21, 2014 at 8:00 AM

Current Concepts in Sports Concussion: Current and Future Concepts in Helmet and Sports Injury Prevention

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Screen Shot 2014-10-13 at 1.53.48 PMSince the introduction of head protection, a decrease in sports-related traumatic brain injuries has been reported. The incidence of concussive injury, however, has remained the same or on the rise. These trends suggest that current helmets and helmet standards are not effective in protecting against concussive injuries. This article presents a literature review that describes the discrepancy between how helmets are designed and tested and how concussions occur. Most helmet standards typically use a linear drop system and measure criterion such as head Injury criteria, Gadd Severity Index, and peak linear acceleration based on research involving severe traumatic brain injuries. Concussions in sports occur in a number of different ways that can be categorized into collision, falls, punches, and projectiles. Concussive injuries are linked to strains induced by rotational acceleration. Because helmet standards use a linear drop system simulating fall-type injury events, the majority of injury mechanisms are neglected. In response to the need for protection against concussion, helmet manufacturers have begun to innovate and design helmets using other injury criteria such as rotational acceleration and brain tissue distortion measures via finite-element analysis. In addition to these initiatives, research has been conducted to develop impact protocols that more closely reflect how concussions occur in sports. Future research involves a better understanding of how sports-related concussions occur and identifying variables that best describe them. These variables can be used to guide helmet innovation and helmet standards to improve the quality of helmet protection for concussive injury.

From: Current and Future Concepts in Helmet and Sports Injury Prevention by Hoshizaki et al.

Current Concepts in Sports Concussion is online and full-text access is free.

Written by NEUROSURGERY® Editorial Office

October 20, 2014 at 8:00 AM

Current Concepts in Sports Concussion: The Current State of Concussion Education Programs

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Concussion is an important cause of morbidity in young student athletes. The prevention, accurate diagnosis, and prompt management of concussions require that players, parents, coaches, and medical personnel are accurately educated on current concussion data and guidelines. All states have laws that mandate concussion education for high school athletes. There is currently no uniform educational program to disseminate information to student athletes regarding concussions. This article highlights a few nationally recognized educational programs that aim to accurately and effectively inform all members of the athletic, academic, and medical communities about the importance and urgency of concussion.

From: Concussion 101: The Current State of Concussion Education Programs by Williamson et al.

Current Concepts in Sports Concussion is online and full-text access is free.

Written by NEUROSURGERY® Editorial Office

October 17, 2014 at 8:00 AM

Current Concepts in Sports Concussion: Accelerating Progress on the Road to Safer Sports

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Roger Goodell was invited by the Neurosurgical Society of America (NSA) to give the keynote speech as the NSA Medalist 2013. As President of the NSA, and Co-Chairs of the National Football league’s Head Neck and Spine Committee, we provided the introduction for Goodell. He was cited for his tireless advocacy on behalf of professional and student athletes. We noted that the National Football League has been a world leader in funding traumatic brain injury research and a catalyst for safety in youth and professional sports. Mr Goodell’s national leadership in thinking and acting boldly on the subject of traumatic brain injury prevention and treatment was the primary motivation for awarding him the NSA medal. What follows is a transcript of his NSA Medal Lecture to the Neurosurgical Society of America.

—H. Hunt Batjer and Richard G. Ellenbogen

From: Accelerating Progress on the Road to Safer Sports: Based on Remarks of NFL Commissioner Roger Goodell in the Neurosurgical Society of America (NSA) Medal Lecture by Goodell et al.

Current Concepts in Sports Concussion is online and full-text access is free.

Written by NEUROSURGERY® Editorial Office

October 15, 2014 at 8:00 AM

Current Concepts in Sports Concussion: Key Stakeholders and Multidisciplinary Participation

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Screen Shot 2014-10-13 at 1.46.20 PMAs unstructured play declines, organized sports leagues have become a highly popular form of physical activity in young people. As concussive injuries are garnering increased media attention and public awareness, there is a growing concern for athlete safety. Although athletic trainers and physicians play a large role in keeping athletes healthy and safe, this article investigates nontraditional, multidisciplinary teams that are involved in promoting athlete safety, including the role of equipment makers, coaches, referees, governing bodies of sport, lawmakers, and fans. As opposed to a focus on diagnosing or managing concussive injuries, this article seeks to promote injury prevention strategies.

From: Concussion: Key Stakeholders and Multidisciplinary Participation in Making Sports Safe by Guskiewicz et al.

Current Concepts in Sports Concussion is online and full-text access is free.

Written by NEUROSURGERY® Editorial Office

October 14, 2014 at 8:00 AM

Current Concepts in Sports Concussion: The Postconcussion Syndrome in Sports and Recreation

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Background: There are still many unanswered questions about postconcussion syndrome (PCS) in sports and recreation. The predictors of PCS are unknown, although a history of previous concussion has been suspected.

Objective: To explore the clinical features and demography of PCS in athletes.

Methods: A retrospective cohort study was performed by chart review of clinical and demographic data of 285 consecutive concussed patients, 138 of whom had sports-related PCS based on ≥ 3 postconcussion symptoms lasting ≥ 1 month.

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Written by NEUROSURGERY® Editorial Office

October 13, 2014 at 8:00 AM

Current Concepts in Sports Concussion: Emergent Treatment of Athletes With Brain Injury

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The focus of this article is the early recognition and emergent treatment of severe or catastrophic traumatic brain injury. The pathophysiology and management of mild traumatic brain injury are reviewed extensively in other sections. Classification of head injuries can be based on anatomic location (epidural, subdural, intraparenchymal), mechanism of injury (coup, contrecoup, linear, rotational), distribution (focal or diffuse), and clinical presentation. Severe head injuries include epidural hematoma, subdural hematoma, intracerebral contusion/hemorrhage, traumatic subarachnoid hemorrhage, diffuse axonal injury, and malignant brain edema syndrome, either alone or in combinations. Protective equipment, regulations, and athletic training have improved dramatically as a result of the recognition of potentially devastating neurological injuries from competitive play. Physicians and other healthcare professionals have become integral members of organized sport and must advocate for the players’ best interest. Once a neurological injury has been identified on field, it is imperative that prompt management and prevention of secondary injury occur. The goal of this article is to help provide a clear plan of action that is well thought out and rehearsed and that will lead to improved outcomes for the players, particularly those with severe or catastrophic brain injury.

From: Emergent Treatment of Athletes With Brain Injury by Morris et al.

Current Concepts in Sports Concussion is online and full-text access is free.

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