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Sport-Related Concussions. Definition of Concussion. Post-traumatic impairment of neural status/brain is violently shook against the skull Also called Mild Traumatic Brain Injury (MTBI) Defined also as he got his “clock cleaned”, “bell rung ”; “leveled” , “seeing stars” .
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Definition of Concussion • Post-traumatic impairment of neural status/brain is violently shook against the skull • Also called Mild Traumatic Brain Injury (MTBI) • Defined also as he got his “clock cleaned”, “bell rung”; “leveled”, “seeing stars”
Symptoms of Concussions • Headache • Confusion/Disorientation • Tinnitus • Dizziness • Nausea • Amnesia • Post-traumatic • Retrograde • Irritability • Hyper-excitability • Loss of Consciousness • Unsteadiness • Visual Disturbance • Difficulty Concentrating
Leading Sports for Concussions • Football, Ice Hockey, men’s and women’s soccer • Football is the leading sport for sport-related concussions in the US for men and soccer for women • Study showed that female athletes are twice as susceptible to concussions as males
Second-Impact Syndrome • Cerebral edema: accumulation of excessive fluid in the substance of the brain. • Sustaining a concussion before the first concussion has fully healed • Abrupt increase in blood pressure • Accompanied by post-traumatic systemic catecholamine surge • Creates intracranial pressure (ICP), resulting in cerebral blood expansion
SIS continued • Usually fatal • Non-fatal: permanent severe functional disability • Severe: no permanent functional disability, but severe injury
Head Fatalities in Football • Table 1 • Football Fatalities, 1945–1999* • Head: 491 • Cervical Spine: 116 • Other: 105
Statistics • 65% of concussions occur during competition • 35% occur during practice • 90% of concussions occur without loss of consciousness • Accounts for 10% of all high school sports injuries
Impact on Hockey NHL Protocol for Concussion Evaluation and Management Protocol was revised Mar. 16, 2011 This revision takes players suspect of concussions to a quiet place to be evaluated Traditionally, players were examined on the bench e.g. Sydney Crosby, Eric Lindros, Scott Stevens, etc.
Problems with the Protocol • It is up to the player himself/herself to report symptoms to team physicians • If the player does not report symptoms, it will be assumed that there is no injury • Symptoms may not always be immediate, some cases have been reported that it can be up to 3-4 days until symptoms occur • Outside pressure/financial obligations
Concussion Tests • Concussion testing have become mandatory for all sports • Take test before season starts when you aren’t concussed • When concussed, you must match the score you got when first taking the test • The test includes…
Long-term Consequences • Leads to chronic depression, Alzheimer’s Disease, and Parkinson's Disease • e.g. Mohammad Ali • Suffers dementia pugilistica, also known as “Punch Drunk” • Paranoia, rampant mood fluctuations, alcohol and drug abuse, major depression with suicidal ideation, suicide attempts or completed suicide
Consequences cont. • Onset usually occurs around the age of 42