Current Topics in Sports-related Head Injuries: A Review

Abstract

We review the current topic in sports-related head injuries including acute subdural hematoma (ASDH), concussion, and chronic traumatic encephalopathy (CTE). Sports-related ASDH is a leading cause of death and severe morbidity in popular contact sports like American football in the USA and judo in Japan. It is thought that rotational acceleration is most likely to produce not only cerebral concussion but also ASDH due to the rupture of a parasagittal bridging vein, depending on the severity of the rotational acceleration injury. Repeated sports head injuries increase the risk for future concussion, cerebral swelling, ASDH or CTE. To avoid fatal consequences or CTE resulting from repeated concussions, an understanding of the criteria for a safe post-concussion return to play (RTP) is essential. Once diagnosed with a concussion, the athlete must not be allowed to RTP the same day and should not resume play before the concussion symptoms have completely resolved. If brain damage has been confirmed or a subdural hematoma is present, the athlete should not be allowed to participate in any contact sports. As much remains unknown regarding the pathogenesis and pathophysiology of sportsrelated concussion, ASDH, and CTE, basic and clinical studies are necessary to elucidate the crucial issues in sports-related head injuries.

On the way to the Tokyo Summer Olympic Games (2020). Prevention of severe head and neck injuries in judo: it’s time for action

“…When practising backwards ukemi , beginners are instructed to look at the knot in their belt or curl their body to keep the neck flexed. Although the precise mechanism of head injuries by osoto-gari remains unclear, rotational and shearing forces between the brain and dura from the impact to the back of the head may have a key role in bridging vein ruptures 5. When players cannot keep the neck flexed while being thrown backwards, the neck extends and the head rotates backwards and then rebounds after hitting the mat.…”

“…When players cannot keep the neck flexed while being thrown backwards, the neck extends and the head rotates backwards and then rebounds after hitting the mat. The brain, however, continues to rotate backwards because of inertia, resulting in a gap between rotational movements of the brain and skull 5. To avoid this situation, it is important for players to suppress neck extension while being thrown backwards.…”

Acute Subdural Hematoma in a Judo Player with Repeated Head Injuries

“…9 For cases with persistent concussion symptoms, coronal or thinslice brain-imaging studies are recommended to detect a small ASDH around a bridging vein. 2 Although definitive guidelines for judo-related head injuries have yet to be established, once ASDH is detected in a judo practitioner, return to play should not be allowed. 2 …”

“…2 Although definitive guidelines for judo-related head injuries have yet to be established, once ASDH is detected in a judo practitioner, return to play should not be allowed. 2 …”

Anti-inflammatory protein TNFα-stimulated gene-6 (TSG-6) reduces inflammatory response after brain injury in mice

“…Additionally, a link between mild traumatic brain injuries and Alzheimer or chronic traumatic encephalopathy has long been suspected (9). At present, long term effects of repeated TBI have been seen in multiple sports-related injuries, including posttraumatic parkinsonism, post-traumatic dementia and chronic post-concussion syndrome (10)(11)(12)(13). Thus, studying the short and long-term consequences of TBI at a cellular and molecular level may lead to a new understanding and perhaps better long-term management of such injuries via new and/or refined treatment strategies.…”