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Concussions

‘A Concussion (or mild traumatic brain injury) is a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces secondary to direct or indirect forces to the head.  Disturbance of brain function is related to neurometabolic dysfunction, rather than structural brain injury, and is typically associated with normal structural imaging findings (CT/MRI).  Concussion may or may not involve a loss of consciousness.  Concussion results in a constellation of physical, cognitive, emotional, and sleep-related symptoms.  Recovery is a sequential process and symptoms may last from several minutes to days, weeks, months, or even longer in some cases.’  – Collins, Gioia et al; CDC Physicians Toolkit 2007

Vulnerability

  • Metabolic dysfunction until fully resolved may lead to neurologic vulnerability if even minor injury has been sustained.
  • Though long-term deficits and post-concussion syndrome have been observed from a single concussive event, it is believed that proper management of injury should lead to good prognosis without long-term deficits.
  • Conversely, returning an athlete to play prior to full recovery may increase the risk of long-term deficits or catastrophic neurologic injury and can increase the likelihood of another concussion.

    High school football players who suffered a concussion are 3 times more likely to suffer a repeat concussion in the same season when compared to nonconcussed teammates

    - Guskiewicz K, et al, Am J Spors Med 2000