Sport‐Related Traumatic Brain Injury

Abstract

Sport‐related traumatic brain injury (SRTBI) is a disease process with a high incidence, complex pathophysiology and heterogeneous outcomes. SRTBI is generally dichotomised into sport‐related concussion (SRC) and sport‐related structural brain injury (SRSBI). A variety of sporting events can lead to these injuries. The diagnosis of SRC relies on sound clinical judgment, although multiple adjuncts have been investigated. Prompt diagnosis is essential for the management of all SRTBI, and it is critical to differentiate SRC from a potential SRSBI. Depending on the specific SRTBI, a variety of treatment options are available ranging from conservative rehabilitation to, rarely, prompt neurosurgical intervention. Finally, clinical outcomes are inherently linked to the nature of the injury and vary from full recovery to patient death. Given the high incidence, importance of prompt diagnosis and heterogeneous outcomes, SRTBI is an essential topic not only for clinicians and researchers but also for athletes, parents, coaching staff and officials.

Key Concepts

  • Sport‐related concussion (SRC) has a high incidence and is largely differentiated from other SRTBI by negative neuroimaging.
  • Sport‐related structural brain injury has positive neuroimaging and is typically diagnosed with a noncontrast computed tomography (CT) scan of the head.
  • Second‐impact syndrome is exceedingly rare, but the associated high risk of morbidity remains a relevant driving force for SRC management.
  • Diagnosis of SRC remains clinical with sideline tools as adjuncts including but not limited to SCAT5, King‐Devick, and Sway. Clinical judgment and evaluation supersede all concussion assessment tools.
  • Recovery from SRC usually occurs within 14–28 days, and no focal neurologic deficit is expected.
  • Post‐concussive syndrome is commonly defined as the presence of concussive symptomatology for greater than 4 weeks.
  • The outcome of SRSBI is highly variable and dependent on the nature of the intracranial injury.

Keywords: sport‐related traumatic brain injury (SRTBI); sport‐related concussion (SRC); sport‐related structural brain injury (SRSBI); second‐impact syndrome (SIS)

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Further Reading

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Ahluwalia, Ranbir, Mummareddy, Nishit, Bonfield, Christopher M, and Yengo‐Kahn, Aaron M(Feb 2020) Sport‐Related Traumatic Brain Injury. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0025799]