Making Sense of Head Injuries in Young Athletes
Making Sense of Head Injuries in Young Athletes
No universally accepted theory completely explains the biomechanics of concussion. There are, however, widely accepted characteristics of trauma to the brain. Historically speaking, concussion occurs when there is rotational or acceleration force applied to the brain and its associated structures. The accepted traditional forces that cause concussions are as follows:
A simple working definition of concussion for health care providers "a trauma-induced alteration in mental status that may or may not involve loss of consciousness (LOC)." The issue of LOC is an important clinical concern, since confusion among health care providers, trainers, coaches, and laypersons often results in inappropriate RTP of children or adolescents who have suffered head injury with resultant neurologic symptomology that falls short of an actual loss of consciousness. Poor decisions regarding RTP are often associated with sports that are not traditionally seen as associated with head injuries, for instance, a fall in a volleball player, the collision of 2 softball players, or a clash of heads among soccer players.
Pathophysiology
No universally accepted theory completely explains the biomechanics of concussion. There are, however, widely accepted characteristics of trauma to the brain. Historically speaking, concussion occurs when there is rotational or acceleration force applied to the brain and its associated structures. The accepted traditional forces that cause concussions are as follows:
Concussion may be caused by a direct blow to the head, face, neck, or elsewhere on the body with an "impulsive" force transmitted to the head.
Concussion typically results in the rapid onset of short-lived impairment of neurologic function that resolves spontaneously.
Concussion may result in pathological changes, but the acute clinical symptoms largely reflect a functional disturbance rather than a structural injury.
Concussion results in a graded set of clinical syndromes that may or may not involve loss of consciousness. Resolution of the clinical symptoms typically follows a sequential course.
Concussion is typically associated with grossly normal structural neuroimaging studies.
A simple working definition of concussion for health care providers "a trauma-induced alteration in mental status that may or may not involve loss of consciousness (LOC)." The issue of LOC is an important clinical concern, since confusion among health care providers, trainers, coaches, and laypersons often results in inappropriate RTP of children or adolescents who have suffered head injury with resultant neurologic symptomology that falls short of an actual loss of consciousness. Poor decisions regarding RTP are often associated with sports that are not traditionally seen as associated with head injuries, for instance, a fall in a volleball player, the collision of 2 softball players, or a clash of heads among soccer players.
