4.3 Review

Overview of Traumatic Brain Injury in American Football Athletes

Journal

CLINICAL JOURNAL OF SPORT MEDICINE
Volume 32, Issue 3, Pages 236-247

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/JSM.0000000000000918

Keywords

concussion; traumatic brain injuries; sports injuries; football; subdural hematoma; epidural hematoma

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This review summarizes the epidemiology, clinical presentation, pathophysiology, and treatment of traumatic brain injury in collision athletes, particularly those participating in American football. The literature review yielded 147 references, with limited information on the epidemiology and management of severe traumatic brain injuries. Return-to-play decisions should be based on individual patient symptoms and recovery.
Objective: The aim of this review is to provide a summary of the epidemiology, clinical presentation, pathophysiology, and treatment of traumatic brain injury in collision athletes, particularly those participating in American football. Data Sources: A literature search was conducted using the PubMed/MEDLINE and Google Scholar databases for publications between 1990 and 2019. The following search phrases were used: concussion, professional athletes, collision athletes, mild traumatic brain injury, severe traumatic brain injury, management of concussion, management of severe traumatic brain injury, and chronic traumatic encephalopathy. Publications that did not present epidemiology, clinical presentation, pathophysiology, radiological evaluation, or management were omitted. Classic articles as per senior author recommendations were retrieved through reference review. Results: The results of the literature review yielded 147 references: 21 articles discussing epidemiology, 16 discussing clinical presentation, 34 discussing etiology and pathophysiology, 10 discussing radiological evaluation, 34 articles for on-field management, and 32 articles for medical and surgical management. Conclusion: Traumatic brain injuries are frequent in professional collision athletes, and more severe injuries can have devastating and lasting consequences. Although sport-related concussions are well studied in professional American football, there is limited literature on the epidemiology and management of severe traumatic brain injuries. This article reviews the epidemiology, as well as the current practices in sideline evaluation, acute management, and surgical treatment of concussions and severe traumatic brain injury in professional collision athletes. Return-to-play decisions should be based on individual patient symptoms and recovery.

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