Best Practice Case Studies-Case 145 Asset 1 Overview of Sports-Related Head Injuries

Pdf Summary

This review provides a brief “survival guide” for recognizing and managing common sports-related head injuries. It emphasizes that although most sports head injuries are not fatal, prompt identification and treatment are essential to prevent long-term disability or death. The article is aimed primarily at medical students, but also serves first responders, primary care clinicians, and athletic trainers.

The review covers four major injuries:

- <strong>Epidural hematoma (EDH):</strong> A rare but life-threatening bleed between the skull and dura, often linked to skull fracture and middle meningeal artery rupture. It may present with a “lucid interval.” Non-contrast CT is the diagnostic standard. Surgery is usually required when hematoma volume is large or neurologic status worsens, while smaller, stable lesions may be monitored closely with repeat imaging.

- <strong>Acute subdural hematoma (SDH):</strong> The most common and deadliest sports-related intracranial bleed, caused by tearing of bridging veins. CT shows a crescent-shaped hematoma. Surgical evaluation is recommended for larger hematomas, midline shift, declining GCS, or pupillary abnormalities. Early surgery is crucial because delays greatly worsen survival.

- <strong>Diffuse axonal injury (DAI):</strong> A severe injury caused by acceleration-deceleration or rotational forces that shear axons. MRI is more useful than CT for diagnosis. Treatment is mainly supportive, focusing on airway, circulation, and intracranial pressure management.

- <strong>Mild traumatic brain injury (mTBI)/concussion:</strong> The most common sports head injury. Symptoms include headache, dizziness, amnesia, confusion, and behavioral changes. Diagnosis is clinical, imaging is mainly to rule out bleeding, and management centers on rest, symptom control, observation, and gradual return to activity.

The article also discusses complications such as post-concussion syndrome and second-impact syndrome, and reviews graduated return-to-play protocols. It concludes that better education, early recognition, and more long-term research are needed.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 145

Topic Neurology

Keywords

sports-related head injuries

epidural hematoma

acute subdural hematoma

diffuse axonal injury

mild traumatic brain injury

concussion

intracranial hemorrhage

computed tomography

return-to-play protocol

4th Edition

post-concussion syndrome

4th Edition, Case 145

Neurology