This book is the partial product of a conference on concussion in athletics held at the Pennsylvania State University, April 29-30, 2004. For a number of reasons it seemed timely to hold such a conference as well as to condense our current understanding of mechanisms, predispositions, and latest developments in evaluation and managements of sport-related concussions in a single book format. Despite dramatic advances in medicine, traumatic brain injury, commonly know as concussion, is still one of the most puzzling and least understood injuries facing the sport medicine world today. There still no universal agreement assigning the level of severity the sport-related concussions nor there is any treatment besides the passage of time. Medicines' inability to fully understanding concussion, has led us to question when it is truly safe to return an athlete to full sport participation so threat for risk of re-injury is minimized. The need for a multidisciplinary approach to understanding the spo- related concussions stem from recent evidence that there are long-lasting residual behavioral, psycho-social and neural disabilities that are often overlooked using current research methods. The notion of transient and rapid symptoms resolution is misleading since symptoms resolution is frequently not indicative of injury resolution. There are no two traumatic brain injuries alike in mechanism, symptomology, or symptoms resolution. Most grading scales are based on loss of consciousness, and post-traumatic amnesia, both of which occur infrequently in sport-related mild traumatic brain injuries.
Mild traumatic brain injury continues to plague athletes of all sports. The clinical scenario at times does not reflect the injury or mechanisms and, as such, the pathophysiology, pathomechanics and pathopsychology of a concussion continue to be the major areas for further research. A lack of understanding of these pathologies has led to controversial recommendations for return to play, as well as an underestimation of true brain injury severity.
A major take-home point from this book should be the assumption that symptom resolution does not necessarily mean injury resolution. As can be seen by research focusing on global metabolic cascades and neural activity of the brain, long-standing dysfunctional pathways continue to exist for extended periods of time even after a minor concussion. Until we completely understand the consequences of short-term perturbations and long-term residual brain dysfunctions, concussions must be treated with respect and given a higher priority for continued research activity.
Increasing public awareness concerning the dangers of this often underestimated injury will hopefully increase funding for research, allowing investigators around the world to achieve a complete understanding of these pathological processes. Foundations of Sport-Related Brain Injuries is organized into five parts:
- Mechanisms of Concussion: From Brain to Behavior
- Evaluation of Sport-Related Concussions
- Neuroimaging of Traumatic Brain Injury
- Empirical Findings of Concussion along Life-Span
- Clinical Coverage of Sport-Related Concussions
This reference book provides the cumulative effort of world-known experts in the field to summarize current insights and controversies about concussions in athletics. Therefore, this book is an ideal resource for clinical practitioners, coaches, researchers and students interested in kinesiology, psychology, exercise, neuroscience, and sport medicine.
