Department of Neurosurgery, Beaumont Hospital, Dublin 9, Ireland; Department of Physiology & Medical Physics, Royal College of Surgeons, Ireland.
Department of Neurosurgery, Beaumont Hospital, Dublin 9, Ireland.
J Clin Neurosci. 2020 Nov;81:416-420. doi: 10.1016/j.jocn.2020.10.015. Epub 2020 Oct 24.
While the concerns regarding the long-term cognitive effects of repeated sports related head injury have become a major source of debate, it is not uncommon for these patients to require neurosurgical interventions in the acute setting. The aim of this study was to provide a unique insight into the acute nature and neurosurgical management of sports and exercise related traumatic brain injury.
We retrospectively analysed electronic records of all referrals made between July 2016 and December 2018 to the National Neurosurgical Centre at Beaumont Hospital to identify instances of sport and exercise related traumatic brain injuries (TBI). A sub-group analysis was carried out on patients transferred to the tertiary centre requiring neurosurgical/neuro-critical care.
Over the 30-month period, 194 patients (mean age: 36) were referred withsports and exercise related TBI, of which 56 were transferred to our unit (26 adults, 30 paediatrics). The most frequently encountered sporting activities were cycling, gaelic football, horse riding and rugby. Injuries included cerebral contusions, subdural haematomas, extradural haematomas and skull fractures. Neurosurgical intervention via intracranial pressure monitoring (ICP), decompressive craniectomy and elevation of depressed skull fracture was required in 28 out of 194 patients (14.4%). 85.7% (n = 48) of patients had a discharge Glasgow Coma Scale (GCS) of 15. 4 patients had a tracheostomy in place at discharge and there were 4 mortalities.
Sports and exercise activities, ranging from contact team sports to individual activities, are a common cause of traumatic brain injury and maybe associated with a significant morbidity and mortality.
尽管人们对重复的与运动相关的头部损伤的长期认知影响表示担忧，但这些患者在急性情况下需要神经外科干预的情况并不少见。本研究的目的是提供对运动和锻炼相关创伤性脑损伤的急性性质和神经外科管理的独特见解。
我们回顾性分析了 2016 年 7 月至 2018 年 12 月期间提交给 Beaumont 医院国家神经外科中心的所有转诊病例，以确定与运动和锻炼相关的创伤性脑损伤（TBI）病例。对需要神经外科/神经重症监护的转诊至三级中心的患者进行了亚组分析。
在 30 个月的时间里，有 194 名患者（平均年龄 36 岁）因与运动和锻炼相关的 TBI 被转诊，其中 56 名被转至我们的单位（26 名成人，30 名儿科）。最常见的运动活动包括骑自行车、盖尔式足球、骑马和橄榄球。受伤包括脑挫伤、硬膜下血肿、硬膜外血肿和颅骨骨折。194 名患者中有 28 名（14.4%）需要通过颅内压监测（ICP）、去骨瓣减压和抬高凹陷性颅骨骨折进行神经外科干预。48 名（85.7%）患者出院时格拉斯哥昏迷量表（GCS）评分为 15。4 名患者出院时存在气管切开，4 名患者死亡。
从接触团队运动到个人运动等运动和锻炼活动是创伤性脑损伤的常见原因，可能与较高的发病率和死亡率相关。
