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Foundations of Sport-Related Brain Injuries pp 45–63Cite as

Concussion Mechanisms and Pathophysiology

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Abstract

Concussions are a frequent occurrence in athletic endeavors, its rate exceeding that occurring in the general population by 50 fold. The biomechanics and pathophysiology of concussion are still not well understood and may lead to potential significant sequelae from single or more commonly multiple concussions. Postconcussive symptoms, the second impact syndrome and the cumulative effects of concussions are all topics of interest in current concussion research in athletes and are leading to a more rational approach in determining policy aimed at returning athletes to their sport after a concussion. This chapter reviews current knowledge on the mechanisms, pathophysiology and sequelae of concussion in athletes.

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References

  • Buckley, W.E. (1988). Concussions in College Football: A Multivariate Analysis. American Journal of Sports Medicine, 16, 51–56.

    PubMed  CAS  Google Scholar 

  • Gerberich, S.G., Priest, J.D., Boen., J.R., et al. (1983). Concussion Incidences and Severity in Secondary School Varsity Football Players. American Journal of Public Health 73, 1370–1375.

    Article  PubMed  CAS  Google Scholar 

  • Macciochi, S.N., Barth, J.T., Alves, W., et al. (1996). Neuropsychological Recovery and Functioning after Mild Head Injury in Collegiate Athletes. Neurosurgery, 39, 510–514

    Article  Google Scholar 

  • Guskiewicz, K., Weaver, N., Padua, D., Garrett, W. (2000). Epidemiology of Concussion in Collegiate and High School Football Players. American Journal of Sports Medicine, 28, 643–650.

    PubMed  CAS  Google Scholar 

  • Powell, J, Barber-Foss, K. Traumatic Brain Injury in High School Athletes. JAMA 282:958–963, 1999.

    Article  PubMed  CAS  Google Scholar 

  • Pellman, E.J, Powell, J.W, Viano, D.C., et al. (2004). Concussion in Professional Football: Epidemiological Features of Game Injuries and Review of the Literature-Part 3. Neurosurgery, 54, 81–96.

    Article  PubMed  Google Scholar 

  • Shaw, N. (2002). The neurophysiology of concussion. Progress in Neurobiology, 67, 281–344.

    Article  PubMed  CAS  Google Scholar 

  • Wojtys, E., Hovda, D., Landry, G., Boland, A., Lovell, M., McCrea, M., Minkoff, J. (1999). Concussion in sports: Current Concepts. American Journal of Sport Medicine, 27(5), 676–687.

    CAS  Google Scholar 

  • Barth, J., Freeman, J., Broshek, D., Varney, R. (2001). Acceleration-decelaration sport-related concussion: The gravity of it all. Journal of Athletic Training, 36(3), 253–256.

    PubMed  Google Scholar 

  • Viano, D.C., Casson, I.R., Pellman, E.J. (2005). Concussion in Professional Football: Brain Responses by Finite Element Analysis-Part 9. Neurosurgery, 57, 891–916.

    Article  PubMed  Google Scholar 

  • Hovda, D.A. (1995). Metabolic dysfunction. In: Narayan R.K., Wilberger, J.E., Povlishock J.T. (Eds). Neurotrauma. pp.1459–1478. McGraw Hill, NY.

    Google Scholar 

  • Doberstein, C., Velarde, F., Babie, H., Vovda, D.A. (1992). Changes in local cerebral blood flow following concussive brain injury. Society for Neuroscience, Abstract 18, 175. Anaheim, CA.

    Google Scholar 

  • Giza, C., & Hovda, D. (2001). The neurometabolic cascade of concussion. Journal of Athletic Training, 36(3), 228–235.

    PubMed  Google Scholar 

  • Pfenninger, E.G., Reith, A., Breitig, D., et al. (1989). Early changes of intracranial pressure, perfusion pressure, and blood flow after acute head injury. Par 1. Journal of Neurosurgery, 70, 774–779.

    PubMed  CAS  Google Scholar 

  • Yamakashi, I., & McIntosh, T.K. (1989). Effects of traumatic brain injury on regional cerebral blood flow in rats as measured with radiolabeled microspheres. Journal of Cerebral Blood Flow Metabolism, 9, 117–124.

    Google Scholar 

  • Bergsneider, M., Hovda, D.A., Shalman, E., et al., (1997). Cerebral hyperglucolysis following severe traumatic brain injury in humans: A positron emission tomography study. Journal of Neurosurgery, 86, 241–251.

    PubMed  CAS  Google Scholar 

  • Ballanyi, K., Grafe, R., ten Bruggencate, G. (1987). Ion activities and potassium uptake mechanisms of glial cells in guinea-pig olfactory cortex slices. Journal of Physiology, 382, 159–174.

    PubMed  CAS  Google Scholar 

  • Ip, E.Y., Zanier, E.R., Moore, A.H., Lee, S.M., Hovda, D.A. (2003). Metabolic, neurochemical, and histologic responses to vibrissa motor cortex stimulation after traumatic brain injury. Journal of Cerebral Blood Flow Metabolism, 23(8), 900–910.

    Article  PubMed  Google Scholar 

  • Bergsneider, M., Hovda, D.A., Lee, S.M., et al., (2000). Dissociation of cerebral glucose metabolism and level of consciousness during the period of metabolic depression following human traumatic brain injury. Journal of Neurotrauma, 17, 389–401.

    PubMed  CAS  Google Scholar 

  • Vespa, P., Bergsneider, M., Hattori, N., Wu, H.M., Huang, S.C., Martin, N.A., Glenn, T.C., McArthur, D.L., Hovda, D.A. (2005). Metabolic crisis without brain ischemia is common after traumatic brain injury: a combined microdialysis and positron emission tomography study. Journal of Cerebral Blood Flow Metabolism, 25(6), 663–774.

    Article  CAS  Google Scholar 

  • Soustiel, J.F., Glenn, T.C., Shik, V., Bascardin, J., Mahamid, E., Zaaroor, M. (2005). Monitoring of cerebral blood flow and metabolism in traumatic brain injury. Neurotrauma, 22(9), 955–965.

    Article  Google Scholar 

  • Viant, M.R., Lyeth, B.C., Miller, M.G., Berman, R.F. (2005). An NMR metabolomic investigation of early metabolic disturbances following traumatic brain injury in a mammalian model. NMR Biomedicine, 18(8), 507–571.

    Article  CAS  Google Scholar 

  • Parkin M, Hopwood S, Jones DA, Hashemi P, Landolt H, Fabricius M, Lauritzen M, Boutelle MG, Strong AJ. (2005). Dynamic changes in brain glucose and lactate in pericontusional areas of the human cerebral cortex, monitored with rapid sampling online microdialysis: relationship with depolarisation-like events. Journal of Cerebral Blood Flow Metabolism, 25(3), 402–413.

    Article  PubMed  CAS  Google Scholar 

  • Wu, H.M., Huang, S.C., Hattori, N., Glenn, T.C., Vespa, P.M., Hovda, D.A., Bergsneider, M. (2004a). Subcortical white matter metabolic changes remote from focal hemorrhagic lesions suggest diffuse injury after human traumatic brain injury. Neurosurgery, 55(6), 1306–1315.

    Article  PubMed  Google Scholar 

  • Wu, H.M., Huang, S.C., Hattori, N., Glenn, T.C., Vespa, P.M., Yu, C.L., Hovda, D.A., Phelps, M.E., Bergsneider, M. (2004b). Selective metabolic reduction in gray matter acutely following human traumatic brain injury. Journal of Neurotrauma, 21(2), 149–61.

    Article  PubMed  Google Scholar 

  • Hattori, N., Huang, S.C., Wu, H.M., Yeh, E., Glenn, T.C., Vespa, P.M., McArthur, D., Phelps, M.E., Hovda, D.A., Bergsneider, M. (2003). Alteration of glucose utilization correlates with glasgow coma scale after traumatic brain injury. Journal of Nuclear Medicine, 44(11), 1709–1716.

    PubMed  Google Scholar 

  • Takahashi, et al. 1981. H. Takahashi, H., S. Manaka, S., & S. Keiji, S. (1981). Changes in extracellular potassium concentration in cortex and brainstem during the acute phase of experimental closed head injury. Journal of Neurosurgery, 55, 708–717.

    PubMed  CAS  Google Scholar 

  • Katayama, Y., Becker., D., Tamura, T., Hovda, D. (1990). Massive Increases in Extracellular Potassium and the Indiscriminate Release of Glutamate Following Concussive Brain Injury. Journal of Neurosurgery, 73, 889–900.

    Article  PubMed  CAS  Google Scholar 

  • Nilsson et al., 1993. P. Nilsson, P., L. Hillered, L., Y. Olsson, Y., M. Sheardown, M., A.J. Hansen, A.J. (1993). Regional changes of interstitial K+ and Ca2+ levels following cortical compression contusion trauma in rats. Journal of Cerebral Blood Flow Metabolism, 13, 183–192.

    PubMed  CAS  Google Scholar 

  • Samii, A., Badie, H., Fu, K., Lusher, R.R., Hovda, D.A. (1999). Effect of an N-type calcium channel antagonist (SNX 1111 Ziconotide) on calcium-45 accumulation following fluid perfusion injury. Journal of Neurotrauma, 16, 879–892.

    PubMed  CAS  Google Scholar 

  • Maxwell, W.L, McCreath, B.J., Graham, D.I. Gennarelli, T.A., (1995). Cytochemical evidence for redistribution of membrane pump calcium-ATPase and ecto-Ca-ATPase activity, and calcium influx in myelinated nerve fibres of theoptic nerve after stretch injury. Journal of Neurocytology, 24, 925–942.

    Article  PubMed  CAS  Google Scholar 

  • Saunders, R.L., Harbaugh, R.E. (1984). The second impact in catastrophic contact sports head trauma. JAMA: 252, 538–539.

    Article  PubMed  CAS  Google Scholar 

  • Cantu, R.C. (1992). Second Impact Syndrome: Immediate Management. Physician and Sports Medicine, 20, 55–66.

    Google Scholar 

  • Cantu, R.C., & Voy, R. (1995). Second Impact Syndrome: A Risk in any Sport. Physician and Sports Medicine 23(6), 91–96.

    Google Scholar 

  • Junger, E.C., Newell., D.W., Grant., G.A., et al. (1997). Cerebral Autoregulation Following Minor Head Injury. Journal of Neurosurgery, 86, 425–432.

    Article  PubMed  CAS  Google Scholar 

  • Martland, H.S. (192). Punch Drunk. JAMA 91, 1103–1107.

    Google Scholar 

  • Casson, I.R., Siegel, O., Sharm, R., et al. (1984). Brain Damage in Modern Boxers. JAMA 251, 2663–2667.

    Article  PubMed  CAS  Google Scholar 

  • Casson, I.R., Sharon., R., Campbell., E.A., et al. (1982). Neurological and CT Evaluation of Knocked-Out Boxers. Journal of Neurology, Neurosurgery, 45, 170–174.

    CAS  Google Scholar 

  • Corsellis, J.A.N., Bruton, C.J., Freeman-Brown, D. (1973). The Aftermath of Boxing. Psychological Medicine, 3, 270–273.

    Article  PubMed  CAS  Google Scholar 

  • Jordan, B.D., Relkin., N.R., Ravdin, L.D., et al. (1997). Apolipoprotein E e4 Associated with Chronic Traumatic Brain Injury in Boxing. JAMA 278, 136–140.

    Article  PubMed  CAS  Google Scholar 

  • Matser, J.T., Kessels, A.G., Jordan, B.D., et al. (1998). Chronic Traumatic Brain Injury in Professional Soccer Players. Neurology, 51, 791–796.

    PubMed  CAS  Google Scholar 

  • Sortland, O., Tysvaer., A.T. (1989). Brain Damage in Former Association Soccer Players. An Evaluation by Cerebral Computed Tomography. Neuroradiology, 31, 44–48.

    PubMed  CAS  Google Scholar 

  • Tysvaer, A.T., Lochen, E.A. (1991). Soccer Injuries to the Brain: A neuropsychological study of Former Soccer Players. American Journal of Sports Medicine, 19, 56–60.

    PubMed  CAS  Google Scholar 

  • Guskiewicz, K.M., McCrea, M., Marshall, S, W, et al. (2003). Cumulative Effects Associated with Recurrent Concussion in Collegiate Football Players: The NCAA Concussion Study. JAMA 19, 2604–2605.

    Google Scholar 

  • Iverson, G.L., Gaetz, ML, Lovell, M.R, Collins, M.W. (2004). Cumulative Effects of Concussion in Amateur Athletes. Brain Injury, 18, 433–443.

    Article  PubMed  Google Scholar 

  • Wilberger, J.E., Maroon, J.C. (1989). Head Injury in Athletes. Clinical Sports Medicine, 8, 1–9.

    Google Scholar 

  • Bailes, J., & Hudson, V. (2001). Classification of sport-related head trauma: a spectrum of mild to severe injury. Journal of Athletic Training, 36(3), 236–243.

    PubMed  Google Scholar 

  • Yuan, Y., Prough, D., Smith, T., DeWitt, D. (1998). The Effects of Traumatic Brain Injury on Regional l0.Cerebral Blood Flow in Rats. Journal of Neurotrauma 5, 289–301.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Vice Dean Drexel University College of Medicine, Allegheny General Hospital, Pittsburgh, PA

    Jack Wilberger (Chairman)

  2. Department of Neurosurgery, Allegheny General Hospital, Pittsburgh, PA

    Juan Ortega

  3. Department of Kinesiology, The Pennsylvania State University, University Park, PA

    Semyon Slobounov

Authors
  1. Jack Wilberger
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  2. Juan Ortega
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  3. Semyon Slobounov
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Editor information

Editors and Affiliations

  1. Penn State University, USA

    Semyon Slobounov  & Wayne Sebastianelli  & 

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© 2006 Springer Science+Business Media, Inc.

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Wilberger, J., Ortega, J., Slobounov, S. (2006). Concussion Mechanisms and Pathophysiology. In: Slobounov, S., Sebastianelli, W. (eds) Foundations of Sport-Related Brain Injuries. Springer, Boston, MA . https://doi.org/10.1007/0-387-32565-4_3

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  • DOI: https://doi.org/10.1007/0-387-32565-4_3

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-387-32564-4

  • Online ISBN: 978-0-387-32565-1

  • eBook Packages: MedicineMedicine (R0)

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