1/5. Concussion in sports and recreation.More than 800 sports-related concussions occur in the united states each day, sometimes involving high-profile athletes whose injuries reach public awareness through sports broadcasts and news media. Although nonphysicians are often present and relied upon for the detection of concussion in the sports setting, the proper diagnosis and management of this neurological problem require a physician's thoughtful attention to the athlete's signs and symptoms. This article offers a diagnostic protocol and treatment recommendations as well as a useful grading scale and management strategy for return to competition.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/5. Concussion in sports. Guidelines for the prevention of catastrophic outcome.Concussion (defined as a traumatically induced alteration in mental status, not necessarily with loss of consciousness) is a common form of sports-related injury too often dismissed as trivial by physicians, athletic trainers, coaches, sports reporters, and athletes themselves. While head injuries can occur in virtually any form of athletic activity, they occur most frequently in contact sports, such as football, boxing, and martial arts competition, or from high-velocity collisions or falls in basketball, soccer, and ice hockey. The pathophysiology of concussion is less well understood than that of severe head injury, and it has received less attention as a result. We describe a high school football player who died of diffuse brain swelling after repeated concussions without loss of consciousness. Guidelines have been developed to reduce the risk of such serious catastrophic outcomes after concussion in sports.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
3/5. Minor head injury.The evaluation and treatment of minor head injuries are reviewed, with particular emphasis on those problems of head injury commonly seen by family physicians. Clinical history, physical examination, and radiologic studies that are of value in diagnosing minor head injuries are highlighted.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
4/5. Recovery of intellectual ability after closed head-injury.Seven children with intellectual and personality changes after closed head-injury were followed-up with neuropsychological and psycho-educational evaluations. Two cases are presented in detail. Persistent intellectual changes documented on standardized tests were not always apparent to parents or physicians, and recovery of intellectual abilities lagged behind the disappearance of neurological abnormalities. Some of the children required special class placement for several years after the injury. personality changes were thought to be secondary to stress on impaired perceptual and cognitive abilities, and the desirability of limiting such stress is emphasized.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
5/5. Concussive convulsions. incidence in sport and treatment recommendations.Concussive convulsions (CC) are nonepileptic phenomena which are an immediate sequelae of concussive brain injury. Although uncommon, occurring with an approximate incidence of 1 case per 70 concussions, these episodes are often confused with post-traumatic epilepsy which may occur with more severe structural brain injury. The pathophysiological mechanism of CC remains speculative, but may involve a transient traumatic functional decerebration with loss of cortical inhibition and release of brainstem activity. The phenomenology of the CC is somewhat akin to convulsive syncope, with an initial tonic phase occurring within 2 seconds of impact, followed by a clonic or myoclonic phase which may last several minutes. Lateralising features are common during the convulsions. There is no evidence of structural or permanent brain injury on clinical assessment, neuropsychological testing or neuroimaging studies. Long term outcome is universally good with no evidence of long term epilepsy and athletes are usually able to return to sport within 2 weeks. The correct management of these episodes centres on the appropriate management of the associated concussive injury and the exclusion of other cerebral injury by medical assessment. The CC requires no specific management beyond immediate onfield first aid measures such as protection of the airway. Antiepileptic therapy is not indicated and prolonged absence from sport is unwarranted. These episodes, although dramatic, are relatively straightforward to manage and all team physicians and those involved in athlete care need to be aware of this condition.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |