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2014 ; 20
(6 Sports Neurology
): 1545-51
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An introduction to sports concussions
#MMPMID25470159
Giza CC
; Kutcher JS
Continuum (Minneap Minn)
2014[Dec]; 20
(6 Sports Neurology
): 1545-51
PMID25470159
show ga
PURPOSE OF REVIEW: Concussions are a major public health issue, and particularly
so in the setting of sports. Millions of athletes of all ages may face the risks
of concussion and repeat concussion. This article introduces the terminology,
epidemiology, and underlying pathophysiology associated with concussion, focused
on sports-related injuries. RECENT FINDINGS: Concussion is a clinical syndrome of
symptoms and signs occurring after biomechanical force is imparted to the brain.
Because of the subjective nature of symptom reporting, definitions of concussion
differ slightly in different guidelines. Concussion nomenclature also includes
mild traumatic brain injury, postconcussion symptoms, postconcussion syndrome,
chronic neurocognitive impairment, subconcussive injury, and chronic traumatic
encephalopathy. Between 1.6 and 3.8 million sports-related concussions are
estimated in the United States annually, particularly in youth athletes. Rates of
concussion are higher in sports such as football, rugby, ice hockey, and
wrestling in males, and soccer and basketball in females. The underlying
pathophysiology of concussion centers on membrane leakage, ionic flux,
indiscriminate glutamate release, and energy crisis. These initial events then
trigger ongoing metabolic impairment, vulnerability to second injury, altered
neural activation, and axonal dysfunction. While the linkage between acute
neurobiology and chronic deficits remains to be elucidated, activation of cell
death pathways, ongoing inflammation, persistent metabolic problems, and
accumulation of abnormal or toxic proteins have all been implicated. SUMMARY:
Concussion is a biomechanically induced syndrome of neural dysfunction. Millions
of concussions occur annually, many of them related to sports. Biologically, a
complex sequence of events occurs from initial ionic flux, glutamate release, and
axonal damage, resulting in vulnerability to second injury and possibly to
longer-term neurodegeneration.
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