A sports-related traumatic brain injury is a serious accident which may lead to significant morbidity or mortality. Traumatic brain injury (TBI) in sports are usually a result of physical contact with another person or stationary object, These sports may include boxing, gridiron football, field/ice hockey, lacrosse, martial arts, rugby, soccer, wrestling, auto racing, cycling, equestrian, rollerblading, skateboarding, skiing or snowboarding. The most common TBIs in sports are cerebral contusions, second-impact syndrome concussions, chronic traumatic encephalopathy, and hematomas.
Epidemiology Sport TBI has been shown to be an important issue of global public health importance. A systematic review in 2020 showed that the incidence rate of TBI due to sports in hospitalized settings was between 3.5 to 31.5 per 100,000 persons, while a community-based analysis had a much higher incidence rate of 170 per 100,000 persons, which shows significant underestimation in the data from hospitals only. The majority of documented injuries are mild TBI, such as concussions. Men and adolescents have been shown to be at high risk of developing such conditions. Incidence rates across studies are not comparable due to varying definitions.
Concussions
Definition A concussion is defined as a stunning, damaging, or shattering effect from a hard blow; especially: a jarring injury of the brain resulting in disturbance of cerebral function. Concussions are also sometimes referred to as mTBI (Mild Traumatic Brain Injury). Concussions are injuries to the head which cause a temporary lapse in the normal operation of brain function. Concussions have many symptoms which could be displayed in a physical, psychological or emotional manner. Concussions symptoms can sometimes be hard to determine because they present in a subtle manner. A symposium was held in 2008 in Zurich, Switzerland, where a definition for concussions was developed. A concussion is now defined as "a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces." There are five major features in conjunction with the definition:
Concussion may be caused either by a direct blow to the head, face, or neck or elsewhere on the body with an "implosive" 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 neuropathological changes, but the acute clinical symptoms largely reflect a functional disturbance rather than a structural injury. Concussion results in a graded set of clinical symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive symptoms typically follows a sequential course; however, in a small percentage of cases, post-concussive symptoms may be prolonged. No abnormality on standard structural neuroimaging studies is seen in concussion.
Signs and symptoms in sports Signs and symptoms of concussions can be hard to determine because they may not present strongly and because they may not present for several hours after the incident has occurred. There are 4 categories that symptoms of a concussion can be classified within: physical, cognitive, emotional and sleep disturbance. The most common symptom is a headache as well as the feeling of being "fog like". Other, more subtle symptoms that can accompany headaches are emotional changes, irritability, slowed reaction times and drowsiness. Accompanying symptoms can include sensitivity to light, and noise, fatigue, dizziness, nausea and vomiting. The loss of consciousness is another identifiable characteristic of concussions but it is not a required symptom to diagnose it. The loss of consciousness occurs in only 10% of concussions, so it cannot be a reliable sign of a concussion. Other distinguishing characteristics of concussions are retrograde amnesia (loss of memory just prior to injury) and posttraumatic amnesia (impaired recall of time between the injury or resumption of consciousness and the point at which new memories are stored and retrieved).
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