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Chapter 27. Sports Injuries

Daniel J. Harvey, Ph.D.; Jason Freeman, Ph.D.; Donna K. Broshek, Ph.D.; Jeffrey T. Barth, Ph.D.
DOI: 10.1176/appi.books.9781585624201.683509

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Excerpt

The majority of sport-related head injuries are mild traumatic brain injury (mTBI) events, traditionally referred to as concussions. Per consensus definition, "concussion is. . . a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces" (Aubry et al. 2002, p. 57). Five specific common features are noted: 1) causation by a direct blow to the head, face, neck, or elsewhere on the body with an "impulsive" force transmitted to the head; 2) a typically rapid onset of short-lived impairment of neurological function that resolves spontaneously; 3) acute clinical symptoms primarily reflecting functional disturbance versus structural injury; 4) a resulting graded set of clinical syndromes that may or may not involve loss of consciousness (LOC), with resolution of clinical and cognitive symptoms generally following a sequential course; and 5) typical association with grossly normal structural neuroimaging studies. Five domains of specific signs and symptoms of acute concussion are noted in Table 27–1; problems in one or more of these domains raise the index of suspicion for diagnosis of concussion.

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Table Reference Number
Table 27–1. International Conference on Concussion in Sport: five clinical domains of symptoms and signs of acute concussion
Table Reference Number
Table 27–2. Cantu grading: severity of concussion
Table Reference Number
Table 27–3. American Academy of Neurology practice parameters for concussion severity
Table Reference Number
Table 27–4. Cantu guidelines for return to play after concussion
Table Reference Number
Table 27–5. International Symposium on Concussion in Sport acute concussion evaluation and graduated return-to-play protocol

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