Article

Concussion in professional football: repeat injuries--part 4.

Mild Traumatic Brain Injury Committee, National Football League, New York, New York, USA.
Neurosurgery (Impact Factor: 3.03). 11/2004; 55(4):860-73; discussion 873-6. DOI: 10.1227/01.NEU.0000137657.00146.7D
Source: PubMed

ABSTRACT A 6-year study was conducted to determine the signs, symptoms, and management of repeat concussion in National Football League players.
From 1996 to 2001, concussions were reported by 30 National Football League teams using a standardized reporting form filled out by team physicians with input from athletic trainers. Signs and symptoms were grouped by general symptoms, somatic complaints, cranial nerve effects, cognition problems, memory problems, and unconsciousness. Medical actions taken and management were recorded.
Data were captured for 887 concussions in practices and games involving 650 players. A total of 160 players experienced repeat injury, with 51 having three or more concussions during the study period. The median time between injuries was 374.5 days, with only six concussions occurring within 2 weeks of the initial injury. Repeat concussions were more prevalent in the secondary (16.9%), the kick unit on special teams (16.3%), and wide receivers (12.5%). The ball return carrier on special teams (odds ratio [OR] = 2.08, P = not significant) and quarterbacks (OR = 1.92, P < 0.1) had elevated odds for repeat injury, followed by the tight end (OR = 1.24, P = not significant) and linebackers (OR = 1.22, P = not significant). There were similar signs and symptoms with single and repeat concussion, except for a higher prevalence of somatic complaints in players on their repeat concussions compared with their first concussion (27.5% versus 18.8%, P < 0.05). More than 90% of players were managed by rest, and 57.5% of those with second injuries returned to play within a day. Players with three or more concussions had signs, symptoms, and treatment similar to those with only a single injury.
The most vulnerable players for repeat concussion in professional football are the ball return carrier on special teams and quarterbacks. Single and repeat concussions are managed conservatively with rest, and most players return quickly to play.

0 Bookmarks
 · 
131 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Current characterizations of chronic traumatic brain injury (CTBI) in boxing, football and other sports are reviewed in the context of the history of research on sub-concussive brain trauma in athletes. Methods: The utility of exposure models for understanding CTBI in boxers is examined and concerns regarding the paucity of findings supportive of an exposure model for CTBI in football players are discussed. Results and conclusions: Recommendations for development of exposure models for sport-specific phenotypic characterizations of CTBI are presented.
    Brain Injury 10/2014; 29(2). DOI:10.3109/02699052.2014.965211 · 1.86 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Primary objective: The aim of this literature review was to systematically describe the sequential metabolic changes that occur following concussive injury, as well as identify and characterize the major concepts associated with the neurochemical cascade. Research design: Narrative literature review. Conclusions: Concussive injury initiates a complex cascade of pathophysiological changes that include hyper-acute ionic flux, indiscriminant excitatory neurotransmitter release, acute hyperglycolysis and sub-acute metabolic depression. Additionally, these metabolic changes can subsequently lead to impaired neurotransmission, alternate fuel usage and modifications in synaptic plasticity and protein expression. The combination of these metabolic alterations has been proposed to cause the transient and prolonged neurological deficits that typically characterize concussion. Consequently, understanding the implications of the neurochemical cascade may lead to treatment and return-to-play guidelines that can minimize the chronic effects of concussive injury.
    Brain Injury 01/2015; 29(2). DOI:10.3109/02699052.2014.965208 · 1.51 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Concussions and subconcussive impacts sustained in American football have been associated with short- and long-term neurologic impairment, but differences in head impact outcomes across playing positions are not well understood. The American Medical Society for Sports Medicine has identified playing position as a key risk factor for concussion in football and one for which additional research is needed. This study examined variation in head impact outcomes across primary football playing positions in a group of 730 NCAA Division I Football Championship Series athletes, using a self-report questionnaire. Although there were no significant differences between position groups in the number of diagnosed concussions during the 2012 football season, there were significant differences between groups in undiagnosed concussions (p=0.008) and "dings" (p<0.001); offensive linemen reported significantly higher numbers than most other positions. Significant differences were found between position groups in the frequencies of several post-impact symptoms including dizziness (p<0.001), headache (p<0.001), and seeing stars (p<0.001) during the 2012 football season, with offensive linemen reporting significantly more symptoms compared to most other groups. There were also positional differences in frequency of returning to play while symptomatic (p<0.001) and frequency of participating in full contact practice (p<0.001). Offensive linemen reported having returned to play while experiencing symptoms more frequently and participating in more full-contact practices than other groups. These findings suggest that offensive linemen, a position group that experiences frequent but low-magnitude head impacts, develop more post-impact symptoms than other playing positions, but do not report these symptoms as a concussion.
    Journal of Neurotrauma 08/2014; DOI:10.1089/neu.2014.3582 · 3.97 Impact Factor

Full-text (2 Sources)

Download
27 Downloads
Available from
May 27, 2014