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Short-term and long-term outcome of athletic closed head injuries

2003; Elsevier BV; Volume: 22; Issue: 3 Linguagem: Inglês

10.1016/s0278-5919(02)00103-5

1556-228X

Frank M. Webbe, Jeffrey T. Barth,

Traumatic Brain Injury and Neurovascular Disturbances

Only gradually has a research literature evolved that differentiates short- versus long-term effects and outcomes in athletic head injuries. The good news of early studies was that symptom number was small and most symptoms resolved for most athletes within 5 to 10 days postinjury [ [1] Barth J.T Alves W.M Ryan T.V et al. Mild head injuries in sports: neuropsychological sequelae and recovery of function. in: Levin H Eisenberg H Benton A Mild head injury. Oxford University Press, New York1989: 257-277 Google Scholar ]. Continued study has revealed that a small percentage of athletes recover more slowly, and an even smaller subset appears to manifest permanent symptoms [ 2 Bernstein D.M Recovery from mild head injury. Brain Inj. 1999; 13: 151-172 Crossref PubMed Scopus (101) Google Scholar , 3 Jagoda A Riggio S Mild traumatic brain injury and the postconcussive syndrome. Emerg Med Clin North Am. 2000; 18: 355-363 Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar , 4 Macciocchi S.N Barth J.T Alves W et al. Neuropsychological functioning and recovery after mild head injury in college athletes. Neurosurgery. 1996; 39: 510-514 PubMed Google Scholar , 5 Macciocchi S.N Barth J.T Litlefield L.M Outcome after mild head injury. Clin Sports Med. 1998; 17: 27-36 Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar ]. The somatic symptoms that predominate both short- and long term are headache and confusion. Neuropsychological assessment measures have demonstrated their worth in detecting nonsomatic residuals of injury, primarily diffuse frontal and temporal lobe manifestations, including impaired attention, decision-making, memory, and speed of processing. Determining what factors may predict early versus delayed resolution of mild sport-related head injury symptoms remains the challenge. This article reviews the basic mechanisms of sport-related closed head injury, primary risk factors for differential outcome, and findings of neurocognitive deficit that characterize the immediate, short, and long-term aftermath of athletic head injury, and points toward known or theoretically sound mechanisms that might be candidates for clarifying differences.