Korean J Neurotrauma.  2016 Apr;12(1):1-5. 10.13004/kjnt.2016.12.1.1.

A Review of Sport-Related Head Injuries

• Mizobuchi
• Nagahiro S

• KMID: 2163007
• DOI: http://doi.org/10.13004/kjnt.2016.12.1.1

Abstract

We review current topics in sport-related head injuries including acute subdural hematoma (ASDH), traumatic cerebrovascular disease, cerebral concussion, and chronic traumatic encephalopathy (CTE). Sports-related ASDH is a leading cause of death and severe morbidity in popular contact sports like American football and Japanese judo. Rotational acceleration can cause either cerebral concussion or ASDH due to rupture of a parasagittal bridging vein. Although rare, approximately 80% of patients with cerebral infarction due to sport participation are diagnosed with ischemia or infarction due to arterial dissection. Computed tomography angiography, magnetic resonance angiography, and ultrasound are useful for diagnosing arterial dissection; ultrasound is particularly useful for detecting dissection of the common and internal carotid arteries. Repeated sports head injuries increase the risks of future concussion, cerebral swelling, ASDH, and CTE. To avoid fatal consequences of CTE, it is essential to understand the criteria for safe post-concussion sports participation. Once diagnosed with a concussion, an athlete should not be allowed to return to play on the same day and should not resume sports before the concussion symptoms have completely resolved. Information about the risks and management of head injuries in different sports should be widely disseminated in educational institutions and by sport organization public relations campaigns.

Keyword

Brain injuries; Hematoma, subdural, acute; Cerebrovascular disorders; Brain concussion; Brain injury, chronic

MeSH Terms

Acceleration
Angiography
Asian Continental Ancestry Group
Athletes
Brain Concussion
Brain Injuries
Brain Injury, Chronic
Carotid Artery, Internal
Cause of Death
Cerebral Infarction
Cerebrovascular Disorders
Craniocerebral Trauma*
Football
Head*
Hematoma, Subdural, Acute
Humans
Infarction
Ischemia
Magnetic Resonance Angiography
Martial Arts
Public Relations
Rupture
Sports
Ultrasonography
Veins

Figure

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  FIGURE 1 Rotational acceleration injury and damage to the bridging vein with the neck as a pivot point during judo. When the head strikes the mat, rotational acceleration is increased in brain (arrows), putting tensile strain between the bridging vein and dura mater, leading to rupture.

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  FIGURE 2 A 30-year-old man was admitted to the hospital with mild headache and amnesia. He had been thrown by a judo competitor and received a blow to the back of the head 4 hours before presentation. Computed tomography (A) and fluid-attenuated inversion recovery magnetic resonance imaging scans (B) on admission revealed a thin subdural hematoma in the interhemispheric fissure (arrows).

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  FIGURE 3 A college-level judo athlete presented with a persistent headache after practice. Fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) revealed a thin subdural hematoma on the right convexity (A, arrow). He was treated conservatively. Four months later, his symptoms remitted, and FLAIR MRI showed no evidence of a subdural hematoma (B). He returned to judo practice 6 months after his initial injury but suffered fatal acute subdural hematoma during judo practice.

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