Brain Trauma June 2014

Neurological Damage in Contact Sports

and how it can be Prevented


As the number of
people participating in
contact sports
continues to grow
across the country and
around the world, so
does the risk of severe
neurological damage.
An estimated 3.8
million sports related
traumatic brain
injuries of mild to
moderate severity
occur in the U.S. each
year (Centers for
Disease Control and
Prevention, 2008).
Repeated mild brain
injuries occurring over
a relatively long period
of time can lead to both
neurological and
cognitive deficits, but
repeated brain trauma
can also lead to second
impact syndrome. The
management of an
athlete with a head
injury should therefore
proceed in the
following three steps:
Identify head
injury
Prevention of
second impact
syndrome
Prevention of
brain injury
from repeated
trauma
Being able to take care
of mild traumatic brain
Brain Trauma June 2014
injuries is imperative,
and it is essential to
provide athletes
engaging in contact
sports with regular
medical brain
checkups and
concussion
assessments. It is
crucial for the athlete
to be fully recovered
before returning to
play; Concussion
Guidelines are
available as well as
tomography scans to
check for mild
traumatic brain injury.
A failure to do so can
increase vulnerability
to another concussion,
which can result in loss
of cerebral auto
regulation and
subsequent cerebral
edema, potentially
resulting in herniation.
A simple yet
effective way to reduce
the potential of
neurological damage
from repetitive brain
trauma is by educating
coaches, parents and
players of the signs
and symptoms of mild
TBI. As a parent or
coach, two simple
steps that can be used
as preventative
measures are to
provide each player
with a medical
evaluation before
playing, and educate
players of the
symptoms of
concussions. That
being said, the
diagnosis of a potential
concussion can include
several or simply one
of the following clinical
findings:
1. Somatic
symptoms and
cognitive
symptoms
2. Loss of
consciousness or
other physical
signs
3. Sleep
disturbance
4. Behavioral
changes and
cognitive
impairment
Brain Trauma June 2014
If a player is believed
to have sustained a
concussion the
following procedure
should be employed
for optimal safety:
Take the athlete
out of the game
Have the athlete
evaluated by a
health provider
Only allow the
athlete to return
to play when
they have been
fully cleared by
a medical
professional.

Second impact
syndrome (SIS) is
prevalent in
adolescents, but can be
easily prevented. The
same preventative
measures that should
be employed for
concussions should
also be employed for
SIS, after a player
suffers a concussion it
is essential that they
do not return to play
without being fully
cleared by a medical
professional.
Computed
tomographies are
recommended over
MRI due to its
enhanced sensitivity to
detecting acute
intracranial bleeding.
The pressure of blood
to the brain increases
so rapidly that within 5
minutes brain death
may occur, the
symptoms begin with
the player collapsing
several minutes
following the impact
with conditions
worsening rapidly
after this. Dilated
pupils, coma, and then
respiratory failure
proceeds, immediate
action must be taken to
maintain an airway
and CPR should be
provided if necessary.

Whether you are a
coach, parent, or
athlete, make sure you
are aware of the
detrimental
neurological effects
Brain Trauma June 2014
one may suffer from
brain trauma. With
increased awareness
and proficiency in
dealing with mild
TBIs, more severe
brain injuries can be
avoided.



Reflective Note:
This brochure is intended for fellow Physical Therapists in an outpatient sport
clinic. Being involved in the world of sports it is imperative that they are made
aware of this topic. The brochure would be located around the office,
predominantly on the desks of the therapists. Suitable for a quick and informative
read during their break.












Brain Trauma June 2014
Sources:
- Khayyat, G. (2004, January 1). Sports Related Head Injury. - Center for Neuro
and Spine. Retrieved June 9, 2014, from
http://www.centerforneuroandspine.com/conditions/brain-
conditions/sports-related-head-injury/default.aspx
- Saunders, R. The Second Impact in Catastrophic Contact-Sports Head
Trauma. The journal of American Medical Association. Retrieved June 1, 2014,
from http://jama.jamanetwork.com/article.aspx?articleid=393703
- Sports-Related Recurrent Brain Injuries. Centers for Disease Control and
Prevention*, 3. Retrieved June 1, 2014, from
http://www.sciencedirect.com/science/article/pii/S1075421097900353