Differentiating Concussion From Intracranial Pathology in Athletes

Abstract

Clinical Scenario: A cerebral concussion is a traumatically induced transient disturbance of brain function characterized by a complex pathophysiologic process and is classified as a subset of mild traumatic brain injury. The occurrence of intracranial lesions after sport-related head injury is relatively uncommon, but the possibility of serious intracranial injury (ICI) should be included in the differential diagnosis. ICIs are potentially life threatening and necessitate urgent medical management; therefore, prompt recognition and evaluation are critical to proper medical management. One of the primary objectives of the initial evaluation is to determine if the concussed athlete has an acute traumatic ICI. Athletic trainers must be able promptly recognize clinical signs and symptoms that will enable them to accurately differentiate between a concussion (ie, a closed head injury not associated with significant ICI) and an ICI. The identification of predictors of intracranial lesions is, however, relatively broad. Clinical ScenarioA cerebral concussion is a traumatically induced transient disturbance of brain function characterized by a complex pathophysiologic process and is classified as a subset of mild traumatic brain injury. 1 The occurrence of intracranial lesions after sport-related head injury is relatively uncommon, 2 but the possibility of serious intracranial injury (ICI) should be included in the differential diagnosis. ICIs are potentially life threatening and necessitate urgent medical management; therefore, prompt recognition and evaluation are critical to proper medical management. One of the primary objective of the initial evaluation is to determine if the concussed athlete has an acute traumatic ICI. 3 Athletic trainers must be able promptly recognize clinical signs and symptoms that will enable them to accurately differentiate between a concussion (ie, a closed head injury not associated with significant ICI) and an ICI. The identification of predictors of intracranial lesions is, however, relatively broad. 4 Focused Clinical QuestionWhich clinical examination findings (ie, clinical signs and symptoms) indicate possible intracranial pathology in individuals with acute closed head injuries?

Concussion Reporting Intentions Among Division I Football Players: Consideration of Individual-Level and Team-Level Predictors

“…Development of methods to improve athlete self-efficacy and attitudes about reporting concussion symptoms should continue. R esearch on sport-related concussions has grown exponentially over the past several years in an effort to better understand the etiology, 1,2 pathology, 3,4 methods to improve diagnosis, [5][6][7] and rehabilitation outcomes [8][9][10][11] for these injured student-athletes. These investigations are needed due to the high prevalence of sport-related concussions in athletics.…”