Steamrolled: Sports-Related Concussions

  • Michael Sharland
  • Thomas A. Hammeke


Stephen played inside linebacker for his high school junior varsity football team. His teammates called him the Steamroller because he knocked other players flat. During the final scrimmage prior to the regular season, Stephen sustained a concussion during play. He was not rendered unconscious but was immediately dizzy and later had nausea. He was removed from play and allowed only limited practice for the week. His symptoms resolved, and he returned to play in early September, 2 weeks following his injury. He did not have a clear concussion in this return game but did strike his head on the ground on several occasions while diving for the ball. His symptoms returned and he felt markedly fatigued; consequently, he was again removed from play. His parents were concerned because this was not Stephen 's first concussion, nor even his second. In fact, according to their count, Stephen had sustained four concussions since childhood (Table 5.1).

Stephen 's primary care physician saw him for follow-up care and released him to return to play in mid-September. But his parents elected to withhold him from play until they obtained a second opinion from a pediatric neurologist. The neurologist saw Stephen in late October, 8 weeks following his injury, and at that time Stephen 's parents noted that his grades had suffered. Magnetic resonance imaging (MRI) of the brain was ordered and interpreted as normal. Additionally, Stephen 's neurological exam was normal. The neurologist referred Stephen to the Mild traumatic brain injury (TBI) Clinic at a regional academic medical center, where Stephen was seen in November.


Traumatic Brain Injury Grade Point Average Mild Traumatic Brain Injury Neuropsychological Performance Posttraumatic Amnesia 
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Resources for Clinicians

  1. Barr, W. B., & McCrea, M. (2001). Sensitivity and specificity of standardized neurocognitive testing immediately following sports concussion. Journal of the International Neuropsycho-logical Society: JINS, 7(6), 693–702.CrossRefGoogle Scholar
  2. Echemend´ia, R. J. (2006). Sports neuropsychology: Assessment and management of traumatic brain injury. New York: Guilford Press.Google Scholar
  3. McKeever, C. K., & Schatz, P. (2003). Current issues in the identification, assessment, and management of concussions in sports-related injuries. Applied Neuropsychology, 10(1), 4–11.CrossRefPubMedGoogle Scholar

Resources for Families

  1. Centers for Disease Control and Prevention National Center for Injury Prevention and Control. TBI — traumatic brain injury home page,
  2. United States Department of Health and Human Services Centers for Disease Control and Prevention. Heads up: Concussion in high school sports,

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Michael Sharland
    • 1
  • Thomas A. Hammeke
    • 1
  1. 1.Department of NeurologyMedical College of WisconsinMilwaukee

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