Neurosurgical Emergencies in Sport

Sindelar, Brian; Bailes, Julian E.

doi:10.1016/j.ncl.2017.03.006

Cited by 10 publications

(33 citation statements)

References 93 publications

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“…12 Lesi pada substansia alba paling sering memengaruhi lobus frontal dan temporal, namun dapat juga memengaruhi bagian otak lainnya seperti korpus kalosum dan batang otak. 13 Pada saat terjadi trauma pada otak, langsung terjadi kerusakan dan diskontinuitas akson pada situs impaksi. Kerusakan akson pada otak dapat bersifat ireversibel dan dapat menimbulkan penurunan kesadaran hingga kematian.…”

Section: Mekanisme Daiunclassified

Diffuse Axonal Injury dan Temuannya

et al. 2022

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Diffuse axonal injury (DAI) adalah cedera mikroskopis yang terjadi di akson pada substansia alba di traktus neuron otak, korpus kalosum, dan batang otak. Biasanya keadaan ini ditandai dengan koma setelah cedera kepala traumatis yang menyebabkan edema dan iskemia pada otak. Keadaan ini sering berujung pada morbiditas maupun mortalitas. Penyebab tersering DAI adalah kecelakaan lalu lintas kendaraan roda dua dengan kecepatan tinggi. Pasien DAI dengan nilai Glasgow Coma Scale (GCS) yang rendah sering dihubungkan dengan faktor prognostik buruk yang berhubungan dengan mortalitas. Diagnosis klinis DAI dapat dibuat berdasarkan visualisasi radiologis, namun diagnosis pasti baru dapat ditegakkan dengan pemeriksaan jaringan post mortem. Pada pemeriksaan makroskopis akan ditemukan gambaran hemoragik pada substansia alba, namun pada autopsi biasanya gambaran tersebut sudah menyusut dan meninggalkan gambaran lesi berwarna cokelat, selanjutnya pada kerusakan yang sudah lama dapat menyebabkan penyusutan volume otak. Ciri kerusakan pada DAI dibedakan menjadi tiga, yaitu kerusakan supratentorial difus pada akson (derajat I), lesi fokal di korpus kalosum (derajat II), dan lesi pada rostral batang otak (derajat III). Pada pemeriksaan mikroskopis tahap awal dapat muncul gambaran "axonal bulb" yang selanjutnya berubah menjadi gambaran aksonal negatif seiring berjalannya waktu.

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Section: Mekanisme Daiunclassified

Diffuse Axonal Injury dan Temuannya

et al. 2022

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“…9,15,17 Classically an initial loss of consciousness is observed, followed by a lucid interval, before progressive deterioration ensuses. 9,15…”

Section: Etiology and Pathophysiologymentioning

confidence: 99%

“…[62][63][64]66 Subdural hematomas are often associated with significant underlying brain injury which can be compounded by perihematomal inflammation of parenchymal brain tissue, leading to worse prognoses than epidural hematomas. 9,15,67,68 Cadaveric and finite element models have been used to describe the effects of rotational acceleration on the rupture of bridging veins leading to acute subdural hematomas. [69][70][71][72][73] Vein rupture is primarily caused by changes in acceleration rather than a direct impact, and football players have been found to sustain acute subdural hematomas through highimpact forces to the torso leading to high acceleration-strain rates in the head.…”

Section: Etiology and Pathophysiologymentioning

confidence: 99%

“…78,[109][110][111] Athletes having sustained a loss of consciousness, or with additional clinical concerns (ie seizures, changes in mental status, and neurological deficits), must be removed from the game and further evaluated in a hospital setting. 15,16 Any athlete who exhibits focal neurologic deficits such as visual changes, cranial nerve palsies, or motor deficits is presumed to have a severe TBI, and requires emergent transport to a hospital for additional evaluation. 15,16 Initial recognition of TBI severity and SRC can be performed quickly using a variety of validated sideline neurologic evaluation tools, such as the SCAT5 (see Appendix 1, Supplemental Digital Content 1, http://links.…”

Section: Spine Committee's Concussion Diagnosis and Managementmentioning

confidence: 99%

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Overview of Traumatic Brain Injury in American Football Athletes

Canseco

Franks

Karamian

et al. 2021

Clinical Journal of Sport Medicine

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The aim of this review is to provide a summary of the epidemiology, clinical presentation, pathophysiology, and treatment of traumatic brain injury in collision athletes, particularly those participating in American football. Data Sources: A literature search was conducted using the PubMed/MEDLINE and Google Scholar databases for publications between 1990 and 2019. The following search phrases were used: "concussion," "professional athletes," "collision athletes," "mild traumatic brain injury," "severe traumatic brain injury," "management of concussion," "management of severe traumatic brain injury," and "chronic traumatic encephalopathy." Publications that did not present epidemiology, clinical presentation, pathophysiology, radiological evaluation, or management were omitted. Classic articles as per senior author recommendations were retrieved through reference review. Results: The results of the literature review yielded 147 references: 21 articles discussing epidemiology, 16 discussing clinical presentation, 34 discussing etiology and pathophysiology, 10 discussing radiological evaluation, 34 articles for on-field management, and 32 articles for medical and surgical management. Conclusion: Traumatic brain injuries are frequent in professional collision athletes, and more severe injuries can have devastating and lasting consequences. Although sport-related concussions are well studied in professional American football, there is limited literature on the epidemiology and management of severe traumatic brain injuries. This article reviews the epidemiology, as well as the current practices in sideline evaluation, acute management, and surgical treatment of concussions and severe traumatic brain injury in professional collision athletes. Return-toplay decisions should be based on individual patient symptoms and recovery.

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“…However, it is not limited to that region entirely as regions of the brainstem and corpus callosum have also been affected quite frequently according to literature [6,7]. Axonal injury to the brain is at times an irreversible trauma, which results in loss of consciousness and even death.…”

Section: Keynote Characteristicsmentioning

confidence: 99%

Diffuse Axonal Injury: A Devastating Pathology

Ordookhanian¹,

Tsai²,

Kaloostian³

et al. 2018

Traumatic Brain Injury - Pathobiology, Advanced Diagnostics and Acute Management

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Traumatic brain injury (TBI) also known as intracranial injury is the result of a lesion within the brain due to an external force. Common forms of TBI result from falls, violence, and/or vehicle crashes; the classification of this pathology is dependent on the severity of the lesion as well as the mechanism of trauma to the head. One of the most common onsets of traumatic brain injuries result from mild to severe lesions to the white matter tracts of the brain called diffuse axonal injury (DAI); however, additional forms of TBI's can present in non-penetrating forms. Penetrating forms of TBI's such as trauma to the head via a foreign object do also contribute to the many millions of TBI cases per year, but we will not discuss these traumatic injuries as in depth within this chapter. The onset of diffuse axonal injury will vary on a per-patient basis from mild to severe, based on a standardized neurological examination rated on the Glasgow Coma Scale (GCS), which indicates the severity of brain damage present. While there is a spectrum of severity for DAI patients, a concussion is typically observed within a larger majority of patients in addition to other overwhelming trauma.

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Neurosurgical Emergencies in Sport

Cited by 10 publications

References 93 publications

Diffuse Axonal Injury dan Temuannya

Diffuse Axonal Injury dan Temuannya

Overview of Traumatic Brain Injury in American Football Athletes

Diffuse Axonal Injury: A Devastating Pathology

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