Division of Kinesiology and Health Promotion, California State University, Fullerton, CA 92834.
J Athl Train. 1998 Jul;33(3):264-8.
This case details the possible relationship between a reported mild concussion and an acute subdural hematoma in a football athlete. Concussion grading scales and return-to-play guidelines are also discussed.
An otherwise healthy athlete suffered a re- ported mild concussion, and continued symptoms led to the diagnosis of postconcussion syndrome. The patient returned to football 25 days after the injury and sustained a second head injury 10 days later. He became unconscious and presented with decerebrate posturing, a fixed and dilated left pupil, shallow breathing, right-sided paralysis, and bilateral Babinski signs.
Possible pathologies included subdural hematoma, epidural hematoma, cerebrovascular accident, cerebral edema, and intracerebral hemorrhage.
Computerized tomography indicated fluid overlying the left hemisphere and temporal fossa. Two burr holes released acute and clotted subdural blood. After 19 days, the patient was discharged without neurologic deficit.
Traditionally, acute subdural hematomas are thought to result from single traumatic incidents. However, individuals may be more susceptible to such pathology after recent head trauma.
Recent mild head injury may increase the risk for catastrophic pathology. This case emphasizes the importance of using concussion grading scales and adhering to return-to-play guidelines, as well as the use of additional diagnostic techniques after mild head Injury.
本病例详细介绍了一名足球运动员报告的轻度脑震荡与急性硬膜下血肿之间可能存在的关系。同时还讨论了脑震荡分级量表和重返赛场指南。
一名原本健康的运动员报告遭受了轻度脑震荡，持续的症状导致了脑震荡后综合征的诊断。该患者在受伤后 25 天重返足球赛场，10 天后再次遭受头部损伤，随后陷入昏迷，出现去脑强直姿势、左侧瞳孔固定且散大、呼吸浅弱、右侧瘫痪和双侧巴氏征阳性。
可能的病理包括硬膜下血肿、硬膜外血肿、脑血管意外、脑水肿和颅内出血。
计算机断层扫描显示左半球和颞窝上方有液体。两个骨孔释放出急性和凝结的硬膜下血液。19 天后，患者出院时无神经功能缺损。
传统上，急性硬膜下血肿被认为是单一创伤事件的结果。然而，在最近头部受伤后，个体可能更容易受到这种病理的影响。
最近的轻度头部损伤可能会增加灾难性病理的风险。本病例强调了使用脑震荡分级量表和遵守重返赛场指南的重要性，以及在轻度头部损伤后使用额外诊断技术的重要性。
