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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

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

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

Concussions in sports


Colorado Medical Society


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