Concussion in Sports: Guidelines for the Prevention of Catastrophic Outcome

Department of Neurology, University of Colorado School of Medicine, Denver.
JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 12/1991; 266(20):2867-9. DOI: 10.1001/jama.1991.03470200079039
Source: PubMed


Concussion (defined as a traumatically induced alteration in mental status, not necessarily with loss of consciousness) is a common form of sports-related injury too often dismissed as trivial by physicians, athletic trainers, coaches, sports reporters, and athletes themselves. While head injuries can occur in virtually any form of athletic activity, they occur most frequently in contact sports, such as football, boxing, and martial arts competition, or from high-velocity collisions or falls in basketball, soccer, and ice hockey. The pathophysiology of concussion is less well understood than that of severe head injury, and it has received less attention as a result. We describe a high school football player who died of diffuse brain swelling after repeated concussions without loss of consciousness. Guidelines have been developed to reduce the risk of such serious catastrophic outcomes after concussion in sports.

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    • "Complete recovery of postural control after cerebral concussion is an important determinant of an athlete's readiness to return to competitive activity. Athletes who return to competitive activity too early after injury are potentially more vulnerable to injury recurrence, the consequences of which can be dramatic (Kelly et al., 1991). The assessment of postural control provides an indirect means of identifying concussion-related neurophysiological abnormality (Guskiewicz, Ross, & Marshall, 2001). "
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    ABSTRACT: Fields studying movement generation, including robotics, psychology, cognitive science, and neuroscience utilize concepts and tools related to the pervasiveness of variability in biological systems. The concept of variability and the measures for nonlinear dynamics used to evaluate this concept open new vistas for research in movement dysfunction of many types. This review describes innovations in the exploration of variability and their potential importance in understanding human movement. Far from being a source of error, evidence supports the presence of an optimal state of variability for healthy and functional movement. This variability has a particular organization and is characterized by a chaotic structure. Deviations from this state can lead to biological systems that are either overly rigid and robotic or noisy and unstable. Both situations result in systems that are less adaptable to perturbations, such as those associated with unhealthy pathological states or absence of skillfulness.
    Human movement science 07/2011; 30(5):869-88. DOI:10.1016/j.humov.2011.06.002 · 1.60 Impact Factor
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    • "Concussions/mild traumatic brain injuries account for the majority (85%–90%) of all head injuries (Jennett and MacMillan, 1981; King, 1997; Thornhill et al. 2000; von Wild and Wenzlaff, 2005) and they have been recognized as a major public concern due to the risk of long lasting symptoms (Rutherford, 1989; King, 1997) and the cumulative effects of multiple head trauma (Gronwall and Wrightson, 1975; Rabadi and Jordan, 2001). Concussions are particularly prevalent in contact sports such as boxing, American football, ice hockey, rugby and soccer (Tegner and Lorentzon, 1996; Delaney et al. 2001; Kelly et al. 2001; Kushner, 2001), where they represent a major medical problem (Kelly et al. 1991; Johnston et al. 2001; Stålnacke et al. 2003). In soccer, concussions are reported to constitute 2%–4.5% of all injuries. "
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    ABSTRACT: Objectives The aim of the study was to analyse whether the controlled heading of soccer balls elicits increased serum concentrations of a biochemical marker of brain tissue damage S-100B. Methods Nineteen male soccer players were randomly divided into two groups, A and B. Group A headed a soccer ball falling from 18 m five times, while group B served as controls (no heading). Blood samples were taken before and 0.5 h, 2 h and 4 h after the heading for analysis of S-100B. Results No statistically significant (p > 0.05) increases in serum concentrations of S-100B were encountered in group A at 0.5 h (0.109 ±0.024 μg/L), 2 h (0.098 ± 0.026 μg/L), and 4 h (0.113 ± 0.035 μg/L) when the blood samples obtained before and after the heading were compared (0.157 ± 0.134 μg/L). No statistically significant difference was found when the serum concentrations of S-100B were compared between groups A and B either before or after heading. Conclusions Heading a soccer ball dropped from a height of 18 m five times was not found to cause an increase in serum concentrations of S-100B, indicating that the impact was not sufficient to cause biochemically discernible damage of brain tissue.
    Biomarker insights 02/2008; 3(3):87-91.
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    • "The pathophysiology of second impact syndrome is thought to be cerebrovascular congestion or a loss of cerebrovascular autoregulation leading to considerable brain swelling (Cantu, 1998; Kelly & Rosenberg, 1997). Most cases of second impact syndrome have been reported in children (e.g., Bruce et al., 1981) or adolescents (Kelly et al., 1991; McQuillen, McQuillen, & Morrow, 1988). "
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    ABSTRACT: A mild traumatic brain injury in sports is typically referred to as a concussion. This is a common injury in amateur and professional athletics, particularly in contact sports. This injury can be very distressing for the athlete, his or her family, coaches, and school personnel. Fortunately, most athletes recover quickly and fully from this injury. However, some athletes have a slow recovery, and there are reasons to be particularly concerned about re-injury during the acute recovery period. Moreover, some athletes who have experienced multiple concussions are at risk for long-term adverse effects. Neuropsychologists are uniquely qualified to assess the neurocognitive and psychological effects of concussion. The National Academy of Neuropsychology recommends neuropsychological evaluation for the diagnosis, treatment, and management of sports-related concussion at all levels of play.
    Archives of Clinical Neuropsychology 12/2007; 22(8):909-16. DOI:10.1016/j.acn.2007.09.004 · 1.99 Impact Factor
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