tailieunhanh - Ebook Handbook of neurological sports medicine: Part 2

(BQ) Part 2 book “Handbook of neurological sports medicine” has contents: Severe head injury and second impact syndrome, neurological considerations in return to sport participation, the role of pharmacologic therapy and rehabilitation in concussion, peripheral nerve injuries in athletes, and other contents. | chapter 11 The Emerging Role of Subconcussion C linical care of the athlete with concussion has traditionally centered on the recognition of signs and symptoms associated with a concussive event. As discussed previously, grading scales have been largely replaced by the recognition and characterization of concussion symptoms and their duration for determination of severity. Additionally, appropriate management centers on a symptom-free waiting period of physical and cognitive rest to allow the athlete to, usually, subsequently return to play. However, emerging research now suggests that head impacts may commonly occur during contact or collision sports in which symptoms may not develop and there are no outward or visible signs of neurological dysfunction—a phenomenon termed subconcussion. While these impacts are often not recognized or identified as a concussion at the clinical level, their importance cannot be overstated. The concept of minimal or “subconcussive” injuries thus requires examination and consideration regarding the role they may play in accruing sufficient anatomical or physiological damage or both. Emerging evidence is drawn from laboratory data in animal models of mild traumatic brain injury, biophysics data, advanced neuroimaging studies, and forensic analyses of brains of former athletes who did not have a diagnosis of concussion during their playing career. Thus, subconcussion is a previously underrecognized phenomenon that needs to be further explored and also contemporaneously appreciated for its ability to cause important current and future detrimental neurological effects, such that the effects of these injuries are potentially expressed later in life.[3] A Working Definition Subconcussion is a cranial impact that does not result in known or diagnosed concussion on clinical grounds. It may also occur with rapid acceleration-deceleration to the body or torso, particularly when the brain is free to move within the cranium, creating a .

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