Clinics in sports medicine
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Most concussion symptoms resolve within the first week after injury. Athletes with persistent symptoms may manifest subtle behavioral and cognitive changes. The astute clinician uses various information to determine when these symptoms have cleared before allowing the athlete to return to athletic competition.
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Concussions and head injuries may never be completely eliminated from sports. However, with better data comes an improved understanding of the types of actions and activities that typically result in concussions. With this knowledge can come improved techniques and rule changes to minimize the rate and severity of concussions in sports. This article identifies the factors that affect concussion rate.
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The occurrence and management of sports concussion provokes more debate and concern than virtually all other sports injuries combined. In the past 3 decades, clinicians have gone from mostly anecdotal strategies to an international consensus-based approach and the early evolution of evidence-based practice. ⋯ Legislators have proposed regulatory measures that restrict medical management of concussion in ways that apply to no other medical condition. This paper examines some of the key areas that are likely to be the focus of research in the next few years.
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Chronic traumatic encephalopathy (CTE) is a form of neurodegeneration believed to result from repeated head injuries. Originally termed dementia pugilistica because of its association with boxing, the neuropathology of CTE was first described by Corsellis in 1973 in a case series of 15 retired boxers. ⋯ In association with these pathologic changes, disordered memory and executive functioning, behavioral and personality disturbances (eg, apathy, depression, irritability, impulsiveness, suicidality), parkinsonism, and, occasionally, motor neuron disease are seen in affected individuals. No formal clinical or pathologic diagnostic criteria for CTE currently exist, but the distinctive neuropathologic profile of the disorder lends promise for future research into its prevention, diagnosis, and treatment.
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Concussion or mild traumatic brain injury (mTBI) is a condition that affects hundreds of thousands of patients worldwide. Understanding the pathophysiology of this disorder can help manage its acute and chronic repercussions. Immediately following mTBI, there are several metabolic, hemodynamic, structural, and electric changes that alter normal cerebral function. ⋯ Translational studies such as functional magnetic resonance imaging, magnetic resonance spectroscopy and diffusion tensor imaging prove to be effective clinical tools for both prognostic and treatment parameters. Understanding the neurobiology of concussion will lead to development and validation of physiological biomarkers of this common injury. These biomarkers (eg, laboratory tests, imaging, electrophysiology) will then allow for improved detection, better functional assessment and evidence-based return to play recommendations.