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Head and Neck Injuries in Football Athletes

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					Head and Neck Injuries
  in Football Players

   Joel Gonzales, M. D.
            Today’s Topics
•   Concussions
•   Burner Syndrome
•   Transient Quadriparesis
•   Permanent Spinal Cord Injuries
             Concussions
• Player’s initial state of condition does NOT
  reliably indicate severity of injury
              Concussions
• Evaluate:
  – Facial expression
  – Orientation to time, person, place
  – Amnesia?
  – Gait
         Grade 1 Concussion
•   Player dazed / confused
•   May have unsteady gait
•   Mildest form
•   No loss of consciousness
       Grade 1 Concussion
• No Amnesia
• Symptoms last only 10-15 minutes
  – Player lucid
  – Gait steady
  – Eyes clear
       Grade 1 Concussion
• TREATMENT: allow return to play under
  close supervision
• No return to play if dizzy, have headache, or
  overly emotional
      Grade 2 Concussions
• Same symptoms as Grade 1
• Post-traumatic amnesia
  (cannot recall events since injury)
      Grade 2 Concussions
• NO RETURN to play on day of injury
• Must see neurosurgeon
• No return to play until headache, irritability,
  and inability to concentrate resolve
      Grade 3 Concussion
• Have Retrograde Amnesia
  (cannot recall events PRIOR to injury)
• No return to play
• Need hospital observation
      Grade 4 Concussion
• Loss of consciousness for seconds to minutes
• Emerge confused
• Have post-traumatic and retrograde amnesia
         Grade 4 Concussion
•   Place player on stretcher
•   Protect cervical spine
•   Hospital for observation
•   Never allow player with l.o.c. to return to
    play that day
       Grade 5 Concussion
• Loss of consciousness
• Cardiorespiratory arrest
• CPR and transport to hospital immediately
      Summary on Concussions
•   Grade 1 - No amnesia - return to play
•   Grade 2 - Post-injury amnesia - see neurosurgeon
•   Grade 3 - Retrograde amnesia - hospital
•   Grade 4,5 - loss of consciousness - hospital
       Burner Syndrome
• Common injury - 50% of NCAA players
  over 4 yr career
• Player makes contact with head and
  shoulder while tackling
• Intense burning pain about shoulder
          Burner Syndrome
•   Complain of burning numbness
•   Pain may radiate into arm or hand
•   “Dead arm” or numbness / tingling
•   Recovery time = usually minutes
        Burner Syndrome
• 5-10% of injuries more serious
• Neurologic deficit may last several hours
• Weakness in deltoids / biceps
         Burner Syndrome
• Athletes may return to play only if:
  – complete recovery of biceps / deltoid strength
  – complete resolution of symptoms
     • Watch player closely
     • Equip with more cushioned pads / custom rubber
       neck roll
        Burner Syndrome
• Some players more susceptible to repeat injury
• Equip with more cushioned pads and custom
  rubber neck roll
• Neck strengthening regimen
   Transient Quadriparesis
• Numbness and weakness from neck down
• Persistent numbness or weakness in arms,
  legs, trunk
• Need immediate spine x-rays / MRI
   Transient Quadriparesis
• No return to play
• Referral to neurosurgeon
• Must rule out cervical fracture or disc problem
Permanent Spinal Cord Injuries
 • 99 permanent spinal cord injuries in H.S.
   and college football 1971-1975
 • 1976 - “NO SPEARING RULE”
 • 1977-1987 = 105 permanent cord inj.
 • 50% reduction rate after rule started
Permanent Spinal Cord Injuries
 • 86 H.S. player / 14college / 5 semi-pro
 • Most occur during games
 • Defensive backs most vulnerable
Prevention of Spinal Cord Injury
 • Teach proper tackling (no spearing)
 • Proper conditioning / neck strengthening
 • Enforce “no spearing” rule during practice
Prevention of Spinal Cord Injury
 • Make certain equipment fits properly
 • Physician should be at all games

				
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posted:10/23/2011
language:English
pages:35