Abstract des Autors

One of the most challenging problems faced by medical personnel responsible for the health care of athletes is the recognition and management of concussions. Concussions can be defined as any alteration in cerebral function caused by a direct or indirect (rotation) force transmitted to the head resulting in one or more of the following acute signs or symtoms: a brief loss of consciousness, lightheadedness, vertigo, cognitive and memory dysfunction, tinnitus, blurred vision, difficulty concentrating, amnesia, headache, nausea, vomiting, photophobia, or a balance disturbance. Delayed signs and symptoms may also include sleep irregularities, fatigue, personality changes, an inability to perform usual daily activities, depression, or lethargy. Although many concussions are mild, the range of injury is wide. Nevertheless, concussions are a form of traumatic brain injury. Returning an injured athlete to competition when the brain needs time to recover is an obvious concern. One of the reasons for concern is the second-impact syndrome, a rare but ominous consequence of an untimely blow to a vulnerable central nervous system. Also, the cumulative effects of repeated injuries, even mild injuries, over time remains a serious concern to those involved in sports medicine. In 1999, a complete understanding of the pathobiology of cerebral concussion is still lacking. This article focuses on the key elements of the initial evaluation of concussion and on recommendations for concussion work-up and return to play. Verf.-Referat