Structural brain injury in sports-related concussion

Zuckerman, Scott L.; Kuhn, Andrew W; Dewan, Michael C.; Morone, Peter J.; Forbes, Jonathan A.; Solomon, Gary S.; Sills, Allen K.

doi:10.3171/2012.10.focus12279

Cited by 21 publications

(20 citation statements)

References 99 publications

(107 reference statements)

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“…Arachnoid cysts are typically harmless congenital CSF collections found in 1 % of the population and often found incidentally. Approximately 0.1 % of arachnoid cysts can bleed spontaneously and pose an increased risk for chronic subdural hematoma [41][42][43]. However, they have not been found to pose any additional risk to patients with concussion.…”

Section: Discussionmentioning

confidence: 99%

Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging

et al. 2015

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In this cohort of pediatric PCS patients, brain imaging in the chronic phase (defined as more than 2 weeks after concussion) was pursued in almost half the study sample, had low diagnostic yield, and had poor cost-effectiveness. Based on these results, outpatient management of pediatric patients with long-term post-concussive symptoms should rarely include repeat neuroimaging beyond the acute phase.

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Section: Discussionmentioning

confidence: 99%

Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging

et al. 2015

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“…To The ediTor: We read the review of Zuckerman et al 5 on structural brain injury in sports-related concussion (Zuckerman SL, Kuhn A, Dewan MC, et al: Struc tural brain injury in sports-related concussion. Neurosurg Focus 33(6):E6, December 2012), which suggests a number of interesting issues.…”

Section: Concussionmentioning

confidence: 98%

Letter to the Editor: Concussion

Šoša¹,

Bosnar²

2013

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“…16,17,93 Traumatic injuries documented on neuroimages of athletes with sports-related head injuries range in severity from nondisplaced basal and calvarial skull fractures, to cerebral contusions, to life-threatening subdural hematomas and diffuse cerebral edema. 115 In the pediatric population, evidence-based clinical decision rules have been devised to help guide the judicious use of CT scanning in the emergency room setting. 58,82 In contrast, evidence-based guidelines for the use of MRI, which avoids being exposed to ionizing radiation, in the evaluation and management of pediatric SRC patients are lacking.…”

Section: Discussionmentioning

confidence: 99%

Retirement-from-sport considerations following pediatric sports-related concussion: case illustrations and institutional approach

Ellis

McDonald

Cordingley

et al. 2016

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Neurosurg Focus 40 (4):E8, 2016S portS-related concussion is a form of traumatic brain injury (TBI) that affects millions of North Americans annually. 27,60,73 Historically, SRC has been viewed as a functional disturbance of cerebral metabolism and blood flow that results in temporary alterations in neurological functioning that resolve within 7-10 days. 68,69 More recently, however, increasing attention has focused on the more serious effects of concussion and subconcussive injuries including abnormalities documented on advanced structural neuroimaging studies and the longterm risk of developing cognitive impairment, mood disorders, and neurodegenerative diseases including chronic traumatic encephalopathy (CTE). 7,29,44,48,49,51,65,70,71,80,94,98,99 To mitigate the risks of more serious brain injury following SRC, experts offer consensus statements containing supervised return-to-play (RTP) guidelines that promote the safe return of athletes to the field of play after concussion symptoms have fully resolved. 4,68,69 These guidelines may reduce the risk of second-impact syndrome, a very rare and poorly defined condition thought to arise from loss of cerebral autoregulation and resultant diffuse cerebral edema. 67 However, they do not provide direction as to whether athletes should be advised to avoid future contact and collision sports because of the risk of adverse short-and long-term outcomes associated with future concussion. Over the years, several authors have offered recommendations about when athletes should be advised to retire from contact or collision sports, but most have focused on collegiate and professional athletes. 16,18,20,21,23,43,66,76,91,93 Although some authors suggest a more conservative approach should be applied to child and adolescent athletes, 16,23 indications for retirement from sports remain controversial and there are limited reports that discuss these issues in application to pediatric SRC patients. Because decisions regarding athlete retirement are complex and must be tailored to the individuals in the absence AbbreviAtioNs CTE = chronic traumatic encephalopathy; PCS = postconcussion syndrome; RTP = return to play; SCI = spinal cord injury; SCIWORA = SCI without radiographic abnormality; SRC = sports-related concussion; TBI = traumatic brain injury. The decision to advise an athlete to retire from sports following sports-related concussion (SRC) remains a persistent challenge for physicians. In the absence of strong empirical evidence to support recommendations, clinical decision making must be individualized and should involve a multidisciplinary team of experts in concussion and traumatic brain injury. Although previous authors have advocated for a more conservative approach to these issues in child and adolescent athletes, there are few reports outlining considerations for this process among this unique population. Here, the authors use multiple case illustrations to discuss 3 subgroups of clinical considerations for sports retirement among pediatric SRC patients including the ...

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Structural brain injury in sports-related concussion

Cited by 21 publications

References 99 publications

Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging

Post-concussion syndrome (PCS) in a youth population: defining the diagnostic value and cost-utility of brain imaging

Letter to the Editor: Concussion

Retirement-from-sport considerations following pediatric sports-related concussion: case illustrations and institutional approach

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