OBJECTIVE: To examine concussion experiences and knowledge among top-level youth karate athletes. METHODS: This cross-sectional study collected data during the 12th World Karate Championships for cadets, juniors and under-21 athletes (held in Konya, Turkey, 2022). All 1414 registered athletes from 95 countries were invited to complete a 16-item paper-based questionnaire assessing demographic data, concussion history and concussion knowledge prior to the competing at the tournament. χ2 and Fisher's exact tests were used to analyse differences by sex, age group and continental karate federation. RESULTS: A total of 654 athletes (46.3% response rate), including 286 (43.7%) females and 368 (56.3%) males, participated in the study, with 29.9% reporting one or more concussions during participation in karate training or competition. Older age groups (under 21 years) reported significantly higher concussion rates than younger athletes (56.9% vs 31.1% juniors and 24.7% cadets; p<0.001). Concussion knowledge revealed considerable gaps, with only 24.5% of athletes correctly identifying a concussion and 68.9% believing loss of consciousness was required for a concussion diagnosis. Misconceptions varied significantly across geographical regions, with Asian and African athletes demonstrating the greatest need for targeted education. Female athletes demonstrated better concussion reporting attitudes than males (60.4% vs 48.9%, p=0.004). CONCLUSIONS: This study highlights the prevalence of concussions and significant knowledge gaps among top-level youth karate athletes, emphasising the need for tailored educational interventions to improve concussion recognition and management within the karate community.
- MeSH
- Martial Arts * injuries MeSH
- Brain Concussion * epidemiology MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Cross-Sectional Studies MeSH
- Surveys and Questionnaires MeSH
- Athletes * statistics & numerical data MeSH
- Athletic Injuries * epidemiology MeSH
- Health Knowledge, Attitudes, Practice * MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Soudní lékař se často setkává s diagnózou otřesu mozku, respektive lehkého mozkového poranění (mTBI). Dřívější koncept mozkové komoce (otřesu mozku) jako funkční a plně reverzibilní klinické jednotky je nutno považovat za překonaný, neboť otřes mozku může vést k prokazatelným strukturálním změnám mozku. Proto se doporučuje od používání pojmu „otřes mozku“ či „komoce“ co nejdříve upustit. Protože jsou ale tyto termíny v klinické praxi mnohde stále používány a neexistuje jednoznačné kritérium, jak odlišit komoci od mTBI, je pragmatické tyto pojmy považovat za synonyma, což platí i pro tento článek. Soudní lékař v souvislosti s mTBI řeší zpravidla tři otázky: diagnóza zranění, závažnost zranění a mechanizmus a způsob vzniku zranění. Měl by vždy zvážit, zda ke klinikem diagnostikovanému mTBI skutečně došlo, k tomu může využít konzultaci s neurologem. Pokud ano, jde vždy o poruchu zdraví, může ale jít i o těžké zranění. Ze statistiky ÚZIS vyplývá, že průměrná doba léčení je u otřesu mozku delší než dosud akceptované 2–3 týdny. Postkomoční syndrom je relativně častou komplikací otřesu mozku. Adresa pro korespondenci: doc. MUDr. František Vorel, CSc., Soudnělékařské oddělení Nemocnice České Budějovice, a.s. B. Němcové 54, 370 01 České Budějovice tel. 602 430 152, e-mail vorel.frantisek@nemcb.cz Delivered: March 1, 2024 Accepted: April 1, 2024
The forensic physician is often faced with the diagnosis of concussion or mild traumatic brain injury (mTBI). The earlier concept of cerebral concussion as a functional and fully reversible clinical entity must be considered obsolete, as concussion can lead to demonstrable structural changes in the brain. It is therefore recommended that the use of the term ‘concussion’ be abandoned as soon as possible. However, as these terms are still used in clinical practice in many places and there is no clear criterion to distinguish concussion from mTBI, it is pragmatic to consider these terms as synonyms. The forensic physician typically addresses three issues in the context of mTBI: the diagnosis of the injury, the severity of the injury, and the mechanism and mode of injury. He or she should always consider whether the clinician-diagnosed mTBI actually occurred, and may use consultation with a neurologist to do so. If so, it is always a medical disorder, but it may also be a severe injury. Statistics from the Institute of Health Information and Statistics (IHIS) show that the average period of incapacity for concussion is 39 days for people aged 20-65, which is longer than the previously accepted 2-3 weeks. The average period of incapacity for work for men and women is not statistically different. However, it increases with age, by almost one day for each year of age between 20 and 65 years. Post-concussion syndrome is a relatively common complication of concussion.
- MeSH
- Brain Concussion * diagnosis etiology MeSH
- Humans MeSH
- Post-Concussion Syndrome diagnosis pathology MeSH
- Sick Leave statistics & numerical data MeSH
- Severity of Illness Index MeSH
- Brain Injuries, Traumatic * diagnosis etiology MeSH
- Research MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
This study investigates the risk of head injuries, specifically concussions, from falling objects in workplace accidents. A case study focuses on a construction worker who sustained a head injury despite wearing a protective helmet. Utilizing finite element (FE) analysis, the helmet-head system was modeled to assess impact forces and head accelerations. The helmet, made of High-Density Polyethylene with a 6-point suspension system, was tested against falling objects of 332 g and 665 g. Simulations, conducted from heights of 5 to 25 m, revealed that objects weighing as little as 332 g could cause severe concussions from a 10-meter fall. These findings demonstrate that helmets, while mitigating some impact, absorb significantly less energy than the kinetic energy of falling objects. The analyses carried out confirmed the worker's statement that his injury was caused by a foreign object falling on his head, which was protected by a helmet.
- MeSH
- Finite Element Analysis MeSH
- Biomechanical Phenomena MeSH
- Brain Concussion * prevention & control MeSH
- Humans MeSH
- Accidents, Occupational * prevention & control MeSH
- Head Protective Devices * MeSH
- Accidental Falls * prevention & control MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
AIMS: Mild Traumatic Brain Injury (mTBI) is the most common type of craniocerebral injury. Proper management appears to be a key factor in preventing post-concussion syndrome. The aim of this prospective study was to evaluate the effect and safety of selected training protocol in patients after mTBI. METHODS: This was a prospective study that included 25 patients with mTBI and 25 matched healthy controls. Assessments were performed in two sessions and included a post-concussion symptoms questionnaire, battery of neurocognitive tests, and magnetic resonance with tractography. Participants were divided into two groups: a passive subgroup with no specific recommendations and an active subgroup with simple physical and cognitive training. RESULTS: The training program with slightly higher initial physical and cognitive loads was well tolerated and was harmless according to the noninferiority test. The tractography showed overall temporal posttraumatic changes in the brain. The predictive model was able to distinguish between patients and controls in the first (AUC=0.807) and second (AUC=0.652) sessions. In general, tractography had an overall predictive dominance of measures. CONCLUSION: The results from our study objectively point to the safety of our chosen training protocol, simultaneously with the signs of slight benefits in specific cognitive domains. The study also showed the capability of machine learning and predictive models in mTBI patient recognition.
- MeSH
- Adult MeSH
- Brain Concussion * MeSH
- Middle Aged MeSH
- Humans MeSH
- Magnetic Resonance Imaging MeSH
- Young Adult MeSH
- Neuropsychological Tests MeSH
- Post-Concussion Syndrome * MeSH
- Prospective Studies MeSH
- Case-Control Studies MeSH
- Diffusion Tensor Imaging MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
... Bramlett -- 61 Concussion in Sports and Performance, 907 -- Jeffrey S. ...
Eighth edition 2 svazky : ilustrace, tabulky ; 28 cm
- Conspectus
- Patologie. Klinická medicína
- Učební osnovy. Vyučovací předměty. Učebnice
- NML Fields
- neurologie
- NML Publication type
- kolektivní monografie
- učebnice vysokých škol
INTRODUCTION: Loss of consciousness (LOC) is used as a diagnostic feature of mild traumatic brain injury (MTBI). However, only 10% of concussions result in LOC. There are only a limited number of in-vivo studies dealing with unconsciousness and structural and functional integrity of the brainstem in patients with MTBI. The aim of our pilot study was to assess the sensitivity of proton magnetic resonance spectroscopy (1H-MRS) to detect metabolic changes in the brainstem in patients after MTBI with unconscioussness. METHODS: Twenty-four patients (12 with LOC, and 12 without LOC) within 3 days of MTBI and 19 healthy controls were examined. All subjects underwent single-voxel 1H-MRS examination of the upper brainstem. Spectra were evaluated using LCModel software. Ratios of total N-acetylaspartate (tNAA), total choline-containing compounds (tCho) and glutamate plus glutamine (Glx) to total creatine (tCre) were used for calculations. RESULTS: We found a significant decrease in tNAA/tCre and tCho/tCre ratios in the patient group with LOC when compared with the control group of healthy volunteers (P=0.002 and P=0.041, respectively), and a significant decrease in the tNAA/tCre ratio in the LOC group when compared with patients without LOC (P=0.04). Other metabolite ratios in the brainstem did not show any significant group differences. CONCLUSION: Our findings indicate that decrease of tNAA/tCre ratio in the upper brainstem using single-voxel 1H-MRS may provide a potential biomarker for MTBI associated with LOC.
Ľahké mozgové poranenie (ĽMP) patrí medzi najčastejšie diagnózy, s ktorými sa stretáva neurológ vo svojej praxi. Napriek dôležitým poznatkom získaným za posledné desaťročia zostáva v rámci tejto klinickej jednotky stále mnoho otázok. Článok obsahuje prehľad terminológie ochorenia, zásady diagnostického postupu so zameraním na indikačné kritériá zobrazovacích vyšetrení u dospelých pacientov aj detí a princípy liečby v iniciálnom poúrazovom období.
Mild traumatic brain injury (MTBI) is among the most common diagnoses encountered by a neurologist in the clinical practice. Despite several important findings in recent decades, there are still many question marks. The article provides an overview of disease terminology, the principles of diagnosis with a focus on the indication criteria for imaging in adult patients and children and the principles of treatment in the initial post-traumatic period.
- MeSH
- Brain Concussion therapy MeSH
- Craniocerebral Trauma therapy MeSH
- Humans MeSH
- Disease Management MeSH
- Brain Injuries * therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Traumatické poranenie mozgu utrpí ročne viac než 50 miliónov ľudí. S rastúcim rozvojom proteomiky a iných výskumných techník boli ubikvitín C-terminálna hydroláza-L1 (UCH-L1) a gliový fibrilárny acidický proteín (GFAP) nedávno uvedené ako nové potenciálne markery poranenia mozgu. Hladina biomarkerov v krvi má potenciál predpovedať absenciu intrakraniálneho poranenia a tým redukovať potrebu CT vyšetrenia mozgu. Uvedené biomarkery krvi majú potenciál dokumentovať, či k otrasu mozgu došlo, najmä ak je anamnéza nejasná. Z týchto dôvodov by mali byť realizované multimarkerové analýzy, ktoré by preukázali poškodenie glie a neurónov.
More than 50 million people sustain a traumatic brain injury each year. Recently as a result of increased development of proteomics analysis and other discovery techniques, investigators have reported ubiquitin C-terminal hydrolase-L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) as novel potential markers for brain injury. Blood-based brain biomarkers hold the potential to predict absence of intracranial injury and thus reduce unnecessary head CT scanning. Blood-based brain biomarkers also hold the potential to document whether a concussion occurred, especially when the history is unclear. For this reason, multi-markers analysis that presents glial and neuronal cell body damage should be performed.
V současné době není příliš pochybností o tom, že mozkové poranění jakékoli tíže může zanechávat trvalé změny v nervové tkáni a mozkové funkce v různém stupni trvale poškozovat. Mnoho nevyřešených otázek ale zůstává nad vztahem mezi mozkovým poraněním a vývojem chronicky progresivní neurodegenerace. S opakovaným lehkým poraněním mozku bývá nejvíce spojována chronická traumatická encefalopatie. Jedná se ale o neuropatologicky definovanou jednotku, jejíž neurobiologický i klinický význam spolehlivě ukáže až budoucnost. Na základě epidemiologických studií lze přesto konstatovat, že anamnéza mozkového poranění souvisí v dalším průběhu života se zvýšeným rizikem klinické diagnózy různých neurodegenerativních onemocnění. Zdá se přitom, že TBI výrazněji nevyčnívá nad ostatní ovlivnitelné rizikové faktory. Tento přehled si klade za cíl popsat současný stav na tomto poli neurověd.
There now is little doubt that traumatic brain injuries of any severity can leave permanent changes in neural tissue and lead to long-term brain damage. However, many questions remain over the relationship between brain injury and the development of a chronic progressive neurodegenerative process. Chronic traumatic encephalopathy is most commonly associated with repeated mild brain injury, but this is a neuropathologically defined concept whose neurobiological and clinical significance remains to be elucidated. Nevertheless, epidemiological studies suggest that a history of brain injury is associated with an increased risk of clinical diagnosis of various neurodegenerative diseases later in life. At the same time, TBI does not seem to stand out significantly above other modifiable risk factors. This review aims to describe the current state of this field of neuroscience.
- MeSH
- Chronic Traumatic Encephalopathy pathology MeSH
- Humans MeSH
- Neurodegenerative Diseases * etiology MeSH
- Brain Injuries, Traumatic * complications MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
