Handbook of Neurological Sports Medicine: Concussion and Other Nervous System Injuries int he Athlete

Overview

Handbook of Neurological Sports Medicine: Concussion and Other Nervous System Injuries in the Athlete presents techniques for diagnosis and treatment of head-related injuries to enable medical professionals to provide the best care possible. Authored by a respected team of neurosurgeons, including highly regarded concussion researcher Julian Bailes, this evidence-based reference offers expert guidelines for managing these serious injuries.

A strong focus is placed on concussion ...

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Handbook of Neurological Sports Medicine: Concussion and Other Nervous System Injuries in the Athlete

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Overview

Handbook of Neurological Sports Medicine: Concussion and Other Nervous System Injuries in the Athlete presents techniques for diagnosis and treatment of head-related injuries to enable medical professionals to provide the best care possible. Authored by a respected team of neurosurgeons, including highly regarded concussion researcher Julian Bailes, this evidence-based reference offers expert guidelines for managing these serious injuries.

A strong focus is placed on concussion due to the risk involved with this common injury. The text outlines how to recognize, assess, and treat concussions, preparing practitioners to calmly respond to athletes who are exhibiting signs of this dangerous condition. It also reviews the biomechanics and pathophysiology at the core of concussions to better understand their clinical presentations.

Critical return-to-play guidelines and participation recommendations for patients with preexisting neurological conditions or structural lesions arm medical professionals with the principles needed for making appropriate decisions for athletes’ safety. The text explains the roles of pharmacological management, natural treatment approaches, rehabilitation strategies, and education. In addition, chapters provide coverage of postconcussion syndrome, subconcussion, and second-impact syndrome.

Handbook of Neurological Sports Medicine also takes a look at other traumatic injuries, including injuries to the cervical, thoracic, and lumbar spine, and the soft tissue and fascia within the spinal unit. It provides an overview of peripheral nervous system injuries to ensure medical professionals understand those serious and potentially career-ending issues, reviews facets of optimal response with suspected or proven spinal injury, and discusses the evaluation and management of athletes with non-concussion-related headaches and heat illness or heatstroke. The text includes additional features to address issues surrounding critical injuries:

• Guidance on developing an action plan for athletic events prepares first responders for emergency situations.

• A review of cases of interest provides examples of situations that can—and do—occur.

• Medicolegal considerations educate practitioners about negligence, standard of care, and proximate cause.

• More than 150 photos and illustrations offer visual support to further explain the injuries.

The evaluation and management of sport-related neurological injuries have matured at an unprecedented rate. Handbook of Neurological Sports Medicine is a critical resource for all who encounter and treat neurological injuries, providing the foundation for the clinical decisions that all athletic medical practitioners must make to give their patients the best treatment possible.

Continuing education credits and units may also be earned based on the subject matter in this book. Explore online CE course options in Human Kinetics’ Continuing Education store.

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Product Details

  • ISBN-13: 9781450441810
  • Publisher: Human Kinetics Publishers
  • Publication date: 9/1/2014
  • Pages: 416
  • Sales rank: 840,069
  • Product dimensions: 8.60 (w) x 11.00 (h) x 1.00 (d)

Meet the Author

Anthony L. Petraglia, MD, graduated from the University of Chicago in 2002 with a BA in neuroscience and earned his medical degree from the University of Rochester School of Medicine and Dentistry in 2007. He completed his residency in neurological surgery at the University of Rochester Medical Center in 2014. Petraglia was the first neurosurgery resident to complete a neurological sports medicine fellowship, and is currently an attending neurosurgeon at Unity Health System in Rochester, New York, where he is also the director of the concussion program.

Petraglia has presented nationally and internationally on neurological sports medicine, has published numerous manuscripts and book chapters on various aspects of neurological surgery, and performs editorial duties for several medical journals. His membership in professional organizations includes the Congress of Neurological Surgeons (CNS) and the American Association of Neurological Surgeons (AANS), and he has served as an assistant to the Sports Medicine Section of the AANS/CNS. He has worked as a physician with several collegiate and high school football teams, as a neurosurgical consultant for the Webster Youth Sports Council, and as a medical director for cyclocross racing.

Julian E. Bailes, Jr., MD, earned a BS from from Louisiana State University in 1978, and his MD from Louisiana State University School of Medicine in New Orleans in 1982. He completed a general surgery internship at Northwestern Memorial Hospital in 1983 and a neurological surgery residency at Northwestern University in Chicago in 1987, as well as a fellowship in cerebrovascular surgery at the Barrow Neurological Institute in Phoenix.

Bailes was director of cerebrovascular surgery at Allegheny General Hospital in Pittsburgh from 1988 until 1997 and later at Celebration Health Hospital in Orlando, where he also was the director of emergency medical services at both the city and county levels. In 2000, Bailes assumed the position of professor and chair in the department of neurosurgery at West Virginia University School of Medicine in Morgantown. He most recently assumed the position of chair of the department of neurosurgery at NorthShore University Health System in Chicago and is co-director of the Neurological Institute.

Bailes is a past chair of the Sports Medicine Section for the American Association of Neurological Surgeons. He has more than 100 publications concerning various aspects of neurological surgery, including three books on neurological sports medicine, and performs editorial duties for numerous medical journals. He is an internationally recognized expert on neurological athletic injuries and has been a team physician at either the National Football League (NFL) or collegiate level for more than 20 years. Since 1992, he has been the neurological consultant to the NFL Players’ Association (NFLPA), which has sponsored his research on the effects of head injuries on professional athletes. He is the director of the NFLPA’s Second Opinion Network. He is the medical director of the Center for Study of Retired Athletes, which is affiliated with the NFLPA and the University of North Carolina, and is the medical director of Pop Warner Football, the nation’s largest youth football association.

Arthur L. Day, MD, graduated from Louisiana State University Medical School in 1972.

He completed his surgical internship in Birmingham, Alabama, and subsequently completed his residency in neurological surgery and fellowship in brain tumor immunology at the University of Florida College of Medicine in Gainesville, Florida.

Day practiced at the University of Florida for 25 years, ultimately rising to the positions of professor, co-chair, and program director of the department of neurological surgery at the University of Florida. In 2002, he moved to Boston to assume a position as a professor of surgery at Harvard Medical School with a clinical practice at Brigham and Women’s Hospital. While there, he served as the associate chair and residency program director of the department of neurological surgery at Brigham and Women’s and Children’s Hospital in Boston. Subsequently, he was the chair of the department and also the director of the Cerebrovascular Center and the Neurologic Sports Injury Center at Brigham and Women’s Hospital. He co-founded and directed an annual meeting at Fenway Park addressing the latest knowledge and treatments of athletic-related neurological injuries. He currently is professor, vice chair, residency program director, and director of clinical education in the department of neurosurgery at the University of Texas Medical School at Houston.

Day has held leadership positions in many medical professional societies and has received numerous awards and honors. He has published almost 170 journal articles and book chapters and has co-edited a book about neurological sports injuries. He is an internationally recognized expert in neurological sports medicine. For the past 30 years, he has served as a consulting physician for multiple NCAA and National Football League (NFL) teams.

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Table of Contents

Part 1: General Concepts

Chapter 1. Athletes and Neurological Injuries: A View From 10,000 Feet

A Stroll Through History

The Present

Spectrum of Neurological Injury in Sports

Concluding Thoughts

References

Chapter 2. Medicolegal Considerations in Neurological Sports Medicine

With Increased Awareness Comes Increased Scrutiny

The King of Concussions

Negligence

Duty and Breach

Violation of a Statutory Duty

Standard of Care Defined by Experts

Standard of Care Established Through Literature, Rules, Protocols and Textbooks

Good Samaritan Laws

Proximate Cause

Assumption of the Risk

Theories of Negligence

Cases of Interest

NFL and NCAA Concussion Litigation Concluding Thoughts

References

Chapter 3. Having a Game Plan

Developing an Emergency Action Plan

Caring for Athletic Injuries Responsibilities of Host and Visiting Medical Staff

Concluding Thoughts

References

Part 2: Sport-Related Head Injuries

Chapter 4. Biomechanics, Pathophysiology, and Classification of Concussion

Biomechanics and Basic Concepts

Lessons Learned From Football

Lessons Learned From Other Sports

Pathophysiology of Concussion

Classification of Concussion and Grading Systems

Concluding Thoughts

References

Chapter 5. In the Trenches: Acute Evaluation and Management of Concussion

Presentation

Acute Evaluation

Concluding Thoughts

References

Chapter 6. Neuroimaging and Neurophysiological Studies in the Head-Injured Athlete

Standard Neuroimaging

Advanced Structural Techniques

Advanced Functional Techniques

Neurophysiological Techniques

Concluding Thoughts

References

Chapter 7. Neuropsychological Assessment in Concussion

Use of Symptom Checklists

Value of Neuropsychological Assessment of Concussion

Issues With Computerized Assessments

Other Considerations

Other Issues Addressed by Neuropsychologists in the Assessment of Concussed Patients

Concluding Thoughts

References

Chapter 8. Role of Balance Testing and Other Adjunct Measures in Concussion

Balance Assessment in Concussion

Emerging Technology and Future Directions for Adjunct Measures of Assessment in Concussion

Concluding Thoughts

References

Chapter 9. Postconcussion Syndrome

What’s in a Definition

Scope of the Problem

A Neuroanatomical Substrate for Prolonged SymptomsPsychogenesis of PCS and PPCS

A Modern Conceptual Framework for PCS and PPCS

Concluding Thoughts

References

Chapter 10. Neuropathology of Chronic Traumatic Encephalopathy

Definition of Chronic Traumatic Encephalopathy

Posttraumatic Encephalopathy Versus Chronic Traumatic Encephalopathy

Gross Morphology and Histomorphology of Chronic Traumatic Encephalopathy

Concluding Thoughts

References

Chapter 11. The Emerging Role of Subconcussion

A Working Definition

Laboratory Evidence of Subconcussive Effects

Clinical Evidence of Subconcussion

Concluding Thoughts

References

Chapter 12. Severe Head Injury and Second Impact Syndrome

Cerebral Contusions and Intraparenchymal Hemorrhage Traumatic Subarachnoid Hemorrhage

Subdural Hematoma

Skull Fractures

Epidural Hematoma

Diffuse Axonal Injury

Arterial Dissection and Stroke

Fatalities

Other Posttraumatic Sequelae

Second Impact Syndrome

Concluding Thoughts

References

Chapter 13. Neurological Considerations in Return to Sport Participation

History of Return to Play

Symptom Complex and Identification

Return to Play and Brain Abnormalities

Addressing and Resolving Return to Play Issues

Concluding Thoughts

References

Chapter 14. The Role of Pharmacological Therapy and Rehabilitation in Concussion

The Decision to Treat Pharmacologically

Somatic Symptoms

Sleep Disturbance Symptoms

Emotional Symptoms

Cognitive Symptoms

The Role of Rehabilitation in Concussion Management

Concluding Thoughts

References

Chapter 15. The Research Behind Natural Neuroprotective Approaches to Concussion

Eicosapentaenoic Acid and Docosahexaenoic Acid

Curcumin

Resveratrol

Creatine

Green Tea

Caffeine

Vitamins E and C

Vitamin D

Scutellaria baicalensis

Examples of Other Neuroprotective Nutraceuticals

Another Natural Approach: Hyperbaric Oxygen Therapy

Concluding Thoughts

Concluding Thoughts

References

Part 3: Sport-Related Injuries of the Spine and Peripheral Nervous System

Chapter 16. Cervical, Thoracic, and Lumbar Spine Injuries: Types, Causal Mechanisms, and Clinical Features

Background and Epidemiology

Normal Anatomy

Types of Tissue Injuries and Neurologic Syndromes

Common Cervical Injuries and Conditions

Common Thoracic Injuries

Common Lumbar Injuries

Concluding Thoughts

References

Chapter 17. Management of Spine Injuries, Including Rehabilitation, Surgical Considerations, and Return to Play

On-the-Field Assessment

Radiological Assessment

Treatment and Rehabilitation

Surgical Considerations

Cervical Spine Injuries and Their Management and Treatment

Cervical Spine Injury: Return to Play

Thoracic and Lumbar Spine Injuries and Their Management

Concluding Thoughts

Chapter 18. Peripheral Nerve Injuries in Athletes

Epidemiology

Pathogenesis

Clinical Evaluation

Additional Testing

Management Rationale

Surgical Options: Primary Nerve Surgery

Surgical Options: Secondary Surgery (Soft Tissue or Bony Reconstruction)

Postoperative Management and Return to Play

Legal Implications

Concluding Thoughts

References

Part 4: Other Sport-Related Neurological Issues

Chapter 19. Headaches in Athletics

Clinical Approach and Assessment

Commonly Recognized Headache Syndromes Coincidental to Sporting Activity

Prolonged Sporting Activity as a Trigger for Commonly Recognized Headache Syndromes

Primary Exertional Headache

Headaches Attributed to Head or Neck Trauma

Headaches Attributed to Sport-Specific Mechanisms

Concluding Thoughts

References

Chapter 20. Heat Illness in Sports

Background

Contributory Factors in Heat Illness

Prevention

The Spectrum of Heat Illness and Management

Return to Play

Concluding Thoughts

References

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