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Concussions in Sports. Enrique Saguil, MD. Concussion:. To shake violently. A temporary disturbance of brain function without a structural change in the brain. Also known as:. Minor traumatic brain injury* Bell ringer Footballers migraine Boxers blow

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Concussions in Sports

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Concussions in sports

Concussions in Sports

Enrique Saguil, MD



To shake violently.

A temporary disturbance of brain

function without a structural change

in the brain.

Also known as

Also known as:

Minor traumatic brain injury*

Bell ringer

Footballers migraine

Boxers blow

Wrestling headache

Headband headache

Mild traumatic brain injury concussion

Mild traumatic brain injury:concussion

Traumatic brain injury:

Cerebral contusion

Intracranial hemorrhage

Epidural hematoma

Subdural hematoma

Intracerebral hematoma

Diffuse axonal injury

Coup contra coup

Coup Contra Coup

Force of impact

Force of Impact

Ommaya: experimented with monkey brains on axial vs rotational forces

findings were that rotation and not translation were responsible for coup-contra-coup, EEG slowing, and change in blood flow to brain

Brain changes

Brain changes

With the linear and translational forcers combined with rotation= axonal injury and shearing occurs

This leads to change in membrane permeability, swelling to nerve (axon) and metabolic change


Sports to beware of

Sports to beware of:








Touch/flag football


Field hockey

Ice hockey





Cdc statistics

CDC statistics

5.3 million americans have disability –TBI

1.4 milliion sustain injury from TBI

1.1 are treated and released from ER

75% of TBI’s each year are concussions or mild TBI

(Appx 1.6-3.8 million/yr are from sports or rec considered mild and not treated)

Wearing a helmet helps

Wearing a helmet helps

  • Riding a bike, motorcycle, snowmobile, scooter, or all-terrain vehicle;

  • Playing a contact sport, such as football, ice hockey, or boxing;

  • Using in-line skates or riding a skateboard;

  • Batting and running bases in baseball or softball;

  • Riding a horse; or

  • Skiing or snowboarding

Wearing a seat belt helps

Wearing a seat belt helps

  • Wearing a seat belt every time you drive or ride in a motor vehicle

  • Children should start using a booster seat when they outgrow their child safety seats (usually when they weigh about 40 pounds). They should continue to ride in a booster seat until the lap/shoulder belts in the car fit properly, typically when they are 4’9” tall.12

Post concussive syndrome

Post concussive syndrome

  • Persistent headaches

  • Inability to concentrate

  • Irritability


Punch drunk encephalopathy dementia pugilistica

Punch-drunk encephalopathy (dementia pugilistica)


Slowness in thinking

Dysarthric speech

Post concussive headache

Post concussive headache

  • Localized where scarring and entrapment of sensory nerve evident

  • Headache-migraine-cluster-tension

    that develops after trauma

Sudden impact syndrome

Sudden Impact Syndrome

Thought secondary to loss of autoregulation causing vascular engorgement of brain tissue

Primed from the first injury where brain is noted to have membrane permeability, edema to nerve and metabolic change unresolved

Malignant Brain Edema



  • Emotionalresponse

  • Pain-headache

  • Memory (person place play)

  • Motor

  • Coordination

  • Exertional response

  • Re-evaluation

Diagnostic testing

Diagnostic testing:

  • Neurological eval

  • CT

  • MRI

  • EEG

  • Neuropsychiatric testing

Univeral guidelines

Univeral guidelines


Concussions in sports


Colorado Medical Society


Return to sports

Return to sports


Concussions in sports


  • Antiinflammatory diet

  • Tylenol (with or without narcotics)

  • Muscle relaxers

  • Arnica, Capsicum

  • Tumeric, ginger, willow bark, boswelia

  • Massage

  • Insure sleep pattern

  • Avoid tobacco, etoh, caffeine, stimulants

Wear a helmet

Wear a Helmet!

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