Logan Shannon M., Bell Gerald W., Leonard James C.
University of Illinois, Champaign-Urbana, Urbana, IL.
J Athl Train. 2001 Dec;36(4):433-436.
To discuss the association between 2 unreported episodes of head trauma and an acute subdural hematoma in a high school football player; to address the role of the sport health care team in secondary schools when caring for an athlete with head trauma; and to recognize the importance of educating athletes and coaches about this condition. BACKGROUND: A previously healthy athlete experienced 2 unreported episodes of head trauma during a single game. The athlete was conscious and oriented to person, time, and place, but he vomited and complained of severe headache, nausea, and vertigo. During transfer, the athlete appeared to have a seizure. DIFFERENTIAL DIAGNOSIS: Subdural hematoma, epidural hematoma, intracerebral hemorrhage, second-impact syndrome, cervical spine injury, or epilepsy. TREATMENT: Computed tomography scan indicated fluid over the left frontal temporal fossa. Conservative treatment was begun, and the fluid resolved without incident. UNIQUENESS: A single episode of blunt trauma has been thought to cause an acute subdural hematoma. However, multiple concussions can also result in this condition. CONCLUSION: Single or multiple episodes of head trauma can lead to an acute subdural hematoma. This case study reflects the importance of proper education in the recognition and care of head trauma and return-to-play guidelines for athletes and coaches. A sport health care team in all secondary schools can provide the immediate and appropriate intervention for such injuries.
探讨一名高中橄榄球运动员未报告的两次头部创伤与急性硬膜下血肿之间的关联；阐述中学体育保健团队在照顾头部创伤运动员时的作用；并认识到对运动员和教练进行这种情况教育的重要性。背景：一名此前健康的运动员在一场比赛中经历了两次未报告的头部创伤。该运动员意识清醒，对人物、时间和地点定向正常，但他呕吐并抱怨严重头痛、恶心和眩晕。在转运过程中，该运动员似乎发生了癫痫发作。鉴别诊断：硬膜下血肿、硬膜外血肿、脑内出血、二次撞击综合征、颈椎损伤或癫痫。治疗：计算机断层扫描显示左额颞窝有积液。开始进行保守治疗，积液顺利消退。独特之处：单次钝性创伤曾被认为会导致急性硬膜下血肿。然而，多次脑震荡也可导致这种情况。结论：单次或多次头部创伤可导致急性硬膜下血肿。本案例研究反映了对运动员和教练进行头部创伤识别、护理及重返比赛指南的适当教育的重要性。所有中学的体育保健团队可为此类损伤提供及时且恰当的干预。
