The Experts below are selected from a list of 7029 Experts worldwide ranked by ideXlab platform
Roger Härtl - One of the best experts on this subject based on the ideXlab platform.
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Cerebral concussion in athletes: evaluation and neuropsychological testing
Neurosurgery, 2000Co-Authors: Joseph C. Maroon, Mark R. Lovell, John Norwig, Kenneth Podell, John W. Powell, Roger HärtlAbstract:OBJECTIVE: To conduct a topic review of studies related to cerebral concussion in athletes, as an aid to improving decision-making and outcomes. METHODS: We review the literature to provide an historical perspective on the incidence and definition of and the management guidelines for mild traumatic brain injury in sports. In addition, metabolic changes resulting from cerebral concussion and the Second-Impact Syndrome are reviewed, to provide additional principles for decision-making. Neuropsychological testing, as it applies to athletes, is discussed in detail, to delineate baseline assessments, the characteristics of the neuropsychological evaluation, the neuropsychological tests used, and the methods for in-season identification of cerebral concussion. Future directions in the management of concussions are presented. RESULTS: The incidence of cerebral concussions has been reduced from approximately 19 per 100 participants in football per season to approximately 4 per 100, i.e., 40,000 to 50,000 concussions per year in football alone. The most commonly used definitions of concussion are those proposed by Cantu and the American Academy of Neurology. Each has associated management guidelines. Concussion or loss of consciousness occurs when the extracellular potassium concentration increases beyond the upper normal limit of approximately 4 to 5 mmol/L, to levels of 20 to 50 mmol/L, inhibiting the action potential and leading to loss of consciousness. This phenomenon helps to explain the delayed effects of symptoms after trauma. CONCLUSION: Neuropsychological testing seems to be an effective way to obtain useful data on the short-term and long-term effects of mild traumatic brain injury. Moreover, knowledge of the various definitions and management strategies, as well as the utility of neuropsychological testing, is essential for those involved in decision-making with athletes with mild traumatic brain injuries. Language: en
Christopher Randolph - One of the best experts on this subject based on the ideXlab platform.
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implementation of neuropsychological testing models for the high school collegiate and professional sport settings
Journal of Athletic Training, 2001Co-Authors: Christopher RandolphAbstract:OBJECTIVE: To review models for the use of neuropsychological testing in the management of sport-related concussion at various levels of competition. BACKGROUND: As we come to understand the natural history of sport-related concussive brain injury, it is increasingly evident that significant neurologic risks are associated with this type of injury. These risks include (1) acute intracranial pathology, (2) catastrophic brain swelling from Second-Impact Syndrome, and (3) the potential risk for markedly prolonged recovery or permanent cognitive dysfunction associated with multiple concussions. DESCRIPTION: Neuropsychological testing has proved to be a useful tool in the medical management of sport-related concussion. In this paper, I describe a systematic model for the implementation of neuropsychological assessment of athletes at various levels of competition. CLINICAL ADVANTAGES: The systematic model was designed to incorporate state-of-the-art techniques for the detection and tracking of neurocognitive deficits associated with concussion into recently formulated guidelines for the medical management of sport-related concussion. Current applications of the model are discussed, as well as ongoing studies designed to elaborate the empirical underpinnings of the model and refine clinical decision making in this area.
Joseph C. Maroon - One of the best experts on this subject based on the ideXlab platform.
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Cerebral concussion in athletes: evaluation and neuropsychological testing
Neurosurgery, 2000Co-Authors: Joseph C. Maroon, Mark R. Lovell, John Norwig, Kenneth Podell, John W. Powell, Roger HärtlAbstract:OBJECTIVE: To conduct a topic review of studies related to cerebral concussion in athletes, as an aid to improving decision-making and outcomes. METHODS: We review the literature to provide an historical perspective on the incidence and definition of and the management guidelines for mild traumatic brain injury in sports. In addition, metabolic changes resulting from cerebral concussion and the Second-Impact Syndrome are reviewed, to provide additional principles for decision-making. Neuropsychological testing, as it applies to athletes, is discussed in detail, to delineate baseline assessments, the characteristics of the neuropsychological evaluation, the neuropsychological tests used, and the methods for in-season identification of cerebral concussion. Future directions in the management of concussions are presented. RESULTS: The incidence of cerebral concussions has been reduced from approximately 19 per 100 participants in football per season to approximately 4 per 100, i.e., 40,000 to 50,000 concussions per year in football alone. The most commonly used definitions of concussion are those proposed by Cantu and the American Academy of Neurology. Each has associated management guidelines. Concussion or loss of consciousness occurs when the extracellular potassium concentration increases beyond the upper normal limit of approximately 4 to 5 mmol/L, to levels of 20 to 50 mmol/L, inhibiting the action potential and leading to loss of consciousness. This phenomenon helps to explain the delayed effects of symptoms after trauma. CONCLUSION: Neuropsychological testing seems to be an effective way to obtain useful data on the short-term and long-term effects of mild traumatic brain injury. Moreover, knowledge of the various definitions and management strategies, as well as the utility of neuropsychological testing, is essential for those involved in decision-making with athletes with mild traumatic brain injuries. Language: en
Scott L Zuckerman - One of the best experts on this subject based on the ideXlab platform.
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sport related structural brain injury 3 cases of subdural hemorrhage in american high school football
World Neurosurgery, 2017Co-Authors: Aaron M Yengokahn, Ryan M Gardner, Andrew W Kuhn, Gary S Solomon, Christopher M Bonfield, Scott L ZuckermanAbstract:Background The risk of sport-related concussion (SRC) has emerged as a major public health concern. In rare instances, sport-related head injuries can be even more severe, such as subdural hemorrhage, epidural hemorrhage, or malignant cerebral edema. Unlike SRCs, sport-related structural brain injury (SRSBI) is rare, may require neurosurgical intervention, and can lead to permanent neurologic deficit or death. Data characterizing SRSBI are limited, and many have recognized the need to better understand these catastrophic brain injuries. The goal of the current series is to describe, in detail, the presentation, management, and outcomes of examples of these rare injuries. Case Description During the fall of 2015, three high school football players presented with acute subdural hemorrhages following in-game collisions and were treated at our institution within a span of 2 months. For the 2 athletes who required surgical intervention, a previous SRC was sustained within 4 weeks before the catastrophic event. One year after injury, 2 players have returned to school, though with persistent deficits. One patient remains nonverbal and wheelchair bound. None of the athletes has returned to sports. Conclusions Acute subdural hemorrhage resultant from an in-game football collision is rare. The temporal proximity of the reported SRSBIs to recent SRCs emphasizes the importance of return-to-play protocols and raises questions regarding the possibility of Second Impact Syndrome. Although epidemiologic conclusions cannot be drawn from this small sample, these cases provide a unique opportunity to demonstrate the presentation, management, and long-term outcomes of SRSBI in American high school football.
Alisa D Gean - One of the best experts on this subject based on the ideXlab platform.
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Second Impact Syndrome and a small subdural hematoma an uncommon catastrophic result of repetitive head injury with a characteristic imaging appearance
Journal of Neurotrauma, 2010Co-Authors: Robert Cantu, Alisa D GeanAbstract:There have been a handful of previously published cases of athletes who were still symptomatic from a prior head injury, and then suffered a Second injury in which a thin, acute subdural hematoma (SDH) with unilateral hemisphere vascular engorgement was demonstrated on CT scan. In those cases, the cause of the brain swelling/dysautoregulation was ascribed to the presence of the acute SDH rather than to the acceleration/deceleration forces that caused the SDH. We believe that the brain swelling is due to “Second-Impact dysautoregulation,” rather than due to the effect of the SDH on the underlying hemisphere. To support our hypothesis, we present 10 additional cases of acute hemispheric swelling in association with small SDHs in athletes who received a Second head injury while still symptomatic from a previous head injury. The clinical history and the unique neuroimaging features of this entity on CT are described and illustrated in detail. The CT findings included an engorged cerebral hemisphere with initial preservation of grey-white matter differentiation, and abnormal mass effect and midline shift that appeared disproportionately greater than the size of the SDH. In addition, the imaging similarities between our patients and those with non-accidental head trauma (shaken-baby Syndrome) will be discussed.