Moderate to Severe Traumatic Brain Injury in Sports

Author(s):  
Robert C. Cantu ◽  
Robert V. Cantu

Traumatic brain injury in sports encompasses a spectrum including injuries such as concussion, skull fracture, intracranial hemorrhage, malignant brain edema syndrome, and axonal shear. Knowledge of these injuries and their signs and symptoms is important for medical personnel covering a sporting contest or practice. The authors discuss each of these injuries, how they typically occur, and what the initial treatment entails.

2021 ◽  
Vol 27 (S1) ◽  
pp. i42-i48
Author(s):  
Barbara A Gabella ◽  
Jeanne E Hathaway ◽  
Beth Hume ◽  
Jewell Johnson ◽  
Julia F Costich ◽  
...  

BackgroundIn 2016, the CDC in the USA proposed codes from the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for identifying traumatic brain injury (TBI). This study estimated positive predictive value (PPV) of TBI for some of these codes.MethodsFour study sites used emergency department or trauma records from 2015 to 2018 to identify two random samples within each site selected by ICD-10-CM TBI codes for (1) intracranial injury (S06) or (2) skull fracture only (S02.0, S02.1-, S02.8-, S02.91) with no other TBI codes. Using common protocols, reviewers abstracted TBI signs and symptoms and head imaging results that were then used to assign certainty of TBI (none, low, medium, high) to each sampled record. PPVs were estimated as a percentage of records with medium-certainty or high-certainty for TBI and reported with 95% confidence interval (CI).ResultsPPVs for intracranial injury codes ranged from 82% to 92% across the four samples. PPVs for skull fracture codes were 57% and 61% in the two university/trauma hospitals in each of two states with clinical reviewers, and 82% and 85% in the two states with professional coders reviewing statewide or nearly statewide samples. Margins of error for the 95% CI for all PPVs were under 5%.DiscussionICD-10-CM codes for traumatic intracranial injury demonstrated high PPVs for capturing true TBI in different healthcare settings. The algorithm for TBI certainty may need refinement, because it yielded moderate-to-high PPVs for records with skull fracture codes that lacked intracranial injury codes.


Author(s):  
Tomas Vedin ◽  
Henrik Bergenfeldt ◽  
Emanuel Holmström ◽  
Jakob Lundager-Forberg ◽  
Marcus Edelhamre

Abstract Purpose The aim of this planned study is to evaluate the ability of a cranial microwave scanner in conjunction with nine brain biomarkers (Aβ40, Aβ42, GFAP, H-FABP, S100B, NF-L, NSE, UCH-L1 and IL-10) to detect and rule out traumatic intracranial hemorrhage in an emergency department setting. Traumatic brain injury is a world-wide topic of interest for researchers and clinicians. It affects 2% of the population per annum and presents challenges for physicians as patients’ initial signs and symptoms do not always correlate with the extent of brain injury. The gold standard for diagnosis of intracranial hemorrhage is head computerized tomography (CT) with the drawbacks of high cost and radiation exposure. A fast, secure way of diagnosing without these drawbacks has potential to make care more effective and reduce cost. Methods Study will be prospective and enroll adult, consenting patients with head trauma who seek emergency department care. Only patients where the treating physician prescribes a head-CT will be included. The microwave scan and blood sampling will be performed in close temporal proximity to the CT scan. Results will be analyzed with sensitivity, specificity and receiver operator characteristics analysis to provide the best combination of a number of biomarkers and the microwave scan. Conclusion This study will explore the diagnostic accuracy of a head microwave scanner in combination with biomarkers in ruling out intracranial hemorrhage in traumatic brain injury patients presenting to the emergency department. Potentially, this combined diagnostic approach could achieve both high sensitivity and high specificity, thereby reducing the need of CT-head scans when managing these patients. Clinicaltrials.gov identifier: NCT04666766. Registered December 11, 2020.


2019 ◽  
Vol 64 (4) ◽  
pp. 435-444
Author(s):  
Tessa Hart ◽  
Jessica M. Ketchum ◽  
Therese M. O'Neil-Pirozzi ◽  
Thomas A. Novack ◽  
Doug Johnson-Greene ◽  
...  

2017 ◽  
Vol 62 (4) ◽  
pp. 600-608 ◽  
Author(s):  
Sean M. Barnes ◽  
Lindsey L. Monteith ◽  
Georgia R. Gerard ◽  
Adam S. Hoffberg ◽  
Beeta Y. Homaifar ◽  
...  

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