Skip to Main Content
Skip Nav Destination
ASTM Selected Technical Papers
Head and Neck Injuries in Sports
By
EF Hoerner, M.D.
EF Hoerner, M.D.
1
Chairman
, Subcommittee F08.51 on Medical Aspects and Biomechanics,
ASTM
Search for other works by this author on:
ISBN-10:
0-8031-1886-4
ISBN:
978-0-8031-1886-7
No. of Pages:
872
Publisher:
ASTM International
Publication date:
1994

A review of a class of head injured patients who display a lucid interval before onset of coma which defines an important category of brain trauma. A hypothesis explaining the mechanism of this syndrome (T.A.D.D.) is developed on the basis of in-vitro testing of venous and arterial responses to tensile strains and the relevant clinico-pathologic data are reviewed. Venospasm is proposed as the cause of secondary ischemic hypoxia associated with a high incidence of acute subdural hematomas and brain swelling. Suggestions for further testing of this hypothesis and implications for preventive management are discussed.

1.
Ommaya
,
A.K.
and
Gennarelli
,
T.A.
, “
Cerebral Concussion and Traumatic Unconsciousness
.”
Brain
. Vol.
97
,
1974
, pp 633–654.
2.
Ommaya
,
A.K.
, “
Mechanisms of Cerebral Concussion, Contusions and Other Effects of Head Injury
.” Neurological Surgery. Ed.
Youmans
,
J.
Vol.
4
, pp 1877–1895.
W. B. Saunders
,
1982
.
3.
Strich
,
S.J.
, “
Shearing of Nerve Fibres as a Cause of Brain Damage Due to Head Injury. A Pathological Study of Twenty Cases
.”
Lancet
 0140-6736, Vol.
2
, pp 443–448.
4.
Strich
,
S.J.
, “
Cerebral Trauma
”, Greenfield's Neuropathology. Ed.
Blackwood
W.
and
Corsellis
J.A.N.
.
Year Book Publishers
, 3rd. Edition,
1976
.
5.
Oppenheimer
,
D.R.
, “
Microscopic Lesions in the Brain Following Head Injury
.”
Journal of Neurology, Neurosurgury and Psychiatry
, Vol.
31
,
1968
, pp 299 – 306.
6.
Graham
,
D.I.
,
Adams
,
J.H.
,
Gennarelli
,
T.
, “
Pathology of Brain Damage in Head Injury
”, Head Injury, 3rd Edition. Ed.
Cooper
,
P.R.
Williams & Wilkins
,
1993
.
7.
Gennarelli
,
T.A.
,
Thibault
,
L.E.
,
Adams
,
J.H.
, et al
, “
Diffuse Axonal Injury and Traumatic Coma in the Primate
.”
Annals of Neurology
, Vol.
12
,
1982
, pp 564–574.
8.
Reilly
,
P.L.
,
Graham
,
D.I.
,
Adams
,
J.H.
, et al
, “
Patients with Head Injury who Talk and Die
.”,
Lancet
,
30
08
1975
, pp 375 – 377.
9.
Lobato
,
R.D.
,
Rivas
,
J.J.
,
Gomez
,
P.A.
, et al
, “
Head Injured Patients Who Talk & Deteriorate into Coma: Analysis of 211 Cases Studied with Computerized Tomography
.
Journal of Neurosurgery
, Vol.
75
,
1991
, pp 256–261.
10.
Bruce
,
D.A.
,
Alavi
,
Al
,
Bilanink
,
L.
, et al
, “
Diffuse Cerebral Swelling Following Head Injuries in Children: The Syndrome of ‘Malignant Brain Edema’
”,
Journal of Neurosurgery
, Vol.
54
,
1983
, pp 285–288.
11.
Ommaya
,
A.K.
, “
Biomechanical Aspects of Head Injuries in Sports
.” Chapter 8. In Sports Neurology, Ed,
Jordan
,
B.D.
,
Tsairis
,
P.
&
Warren
,
R.F.
Aspen Publishers
,
Maryland
,
1989
.
12.
Gennarelli
,
T.A.
,
Spielman
,
G.A.
,
Langfitt
,
T.W.
, et al
, “
Influence of the Type of Intracranial Lesion on Outcome from Severe Head Injury
”,
Journal of Neurosurgery
, Vol.
56
,
1982
, pp 26–36.
13.
Adams
,
J.H.
,
Doyle
,
D.
,
Ford
,
I.
, et al
, “
Diffuse Axonal Injury in Head Injury: Definition, Diagnosis & Grading
”,
Histopathology
, Vol.
15
,
1989
, pp 49–59.
14.
Marshall
,
L.F.
,
Toole
,
B.M.
,
Bowers
,
S.A
, “
The National Traumatic Coma Data Bank, Part 2. Patients who Talk & Deteriorate: Implications for Treatment
”,
Journal of Neurosurgery
, Vol.
59
,
1983
, pp 285–288.
15.
Gerberich
,
S.G.
,
Priest
,
J.D.
,
Boen
,
J.R.
, “
Conscussions, Incidence and Severity in Secondary School Varsity Football Players
”,
American Journal of Public Health
 0090-0036, Vol.
73
,
1983
, pp 1370.
16.
Barth
,
J.T.
,
Alves
,
W.M.
,
Ryan
,
T.V.
, et al
, “
Mild Head Injury in Sports: Neuropsychological Sequelae and Recovery of Function
.”
17.
Levin
,
H.S.
,
Eisenberg
,
H.M.
,
Benton
,
A.L.
(eds), Mild Head Injury,
Oxford University Press
,
New York
,
1989
.
18.
Dacey
,
R.G.
,
Alves
,
W.M.
,
Jane
,
J.A.
, et al
, “
Neurosurgical Complications after Apparently Minor Head Injury: Assessment of Risk in a Series of 610 Patients
”,
Journal of Neurosurgery
,
1986
, pp 203 – 210.
19.
Schnieder
,
R.C.
, “
Head and Neck Injuries in Football: Mechanisms, Treatment and Prevention
”,
Williams & Wilkins
,
Baltimore, MD
,
1973
.
20.
Mendelow
,
A.D.
,
Teasdale
,
G.
,
Jennet
,
B.
, et al
, “
Risk of Intracranial Hematoma in Head Injured Adults
”,
British Medical Journal
, Vol.
287
,
1983
, pp 1173 – 1176.
21.
Mendelow
,
A.D.
,
Campbell
,
D.A.
,
Jeffrey
,
R.R.
, et al
, “
Admission after Mild Head Injury: Benefits and Costs
”,
British Medical Journal
, Vol.
285
,
1982
, pp 1530–1532.
22.
Saunders
,
R.L
, &
Harbaugh
,
R.E.
, “
The Second Impact in Catastrophic Contact Sports Head Trauma
”,
JAMA
, Vol.
252
(
4
),
1984
, pp 538 – 539.
23.
McQuillen
,
J.B.
,
McQuillen
,
E.N.
,
Morrow
,
P.
, “
Trauma, Sport & Malignant Cerebral Edema
”,
American Journal of Forensic Medical Pathology
, Vol.
9
(
1
),
1988
, pp 12 – 15.
24.
Kelley
,
J.P.
,
Nichold
,
J.S.
,
Filley
,
M.
, et al
, “
Concussion in Sports. Guidelines for the Prevention of Catastrophic Outcome
”,
JAMA
, Vol.
266
(
20
),
1991
, pp 2867 – 2869.
25.
Mueller
,
F.O.
,
Schindler
,
R.D.
, “
Annual Survey of Football Injury Research, 1931 – 1990
”,
American Football Coaches Association
.
26.
Mcpherson
,
P.
,
Graham
,
D.I.
, “
Arterial Spasm and Slowing of the Cerebral Circulation in the Ischemia of Head Injury
”,
Journal of Neurology, Neurosurgery & Pshiciatry
, Vol.
36
,
1973
, pp 1069 – 1072.
27.
Margulies
,
S.S.
,
Tibault
,
L.E.
,
Gennarelli
,
T.A.
, “
Physical Model Simulations of Brain Injury in the Primate
”,
Journal of Biomechanics
, Vol.
23
(
8
),
1990
, pp 823–836.
28.
Boock
,
J.R.
,
Thibault
,
L.E.
, “
An Experimental and Analytical Approach to the Development of a Range of Neruovascular Trauma Indicies
”, Procedings of IRCOBI,
Lyon, France
,
1990
.
29.
Lowenhielm
,
P.
, “
Dynamic Properties of Parasaggital Bridging Veins
”,
Z. Rechsmedizin
, Vol.
74
,
1974
, pp 55 – 62.
30.
Wilberger
,
J.E.
,
Harris
,
M.
,
Diamond
,
D.L.
Acute Subdural Hematoma: Morbidity, Mortality and Operative Timing
”,
Journal of Neurosurgery
, Vol.
74
,
1991
, pp 212–218.
31.
Fishman
,
R.A.
,
Dillon
,
W.P.
, “
Durai Enhancement and Cerebral Displacement Secondary to Intracranial Hypotension
”,
Neurology
, Vol.
43
,
1993
, pp 609–611.
32.
Kellie
,
G.
, “
An Account of the Appearances Observed in the Dissection of 2 or 3 Individuals Presumed to have Perished in the Storm of the 3rd and Whose Bodies were Recovered in the Vicinity of Leith with Some Reflections on the Pathology of the Brain
”,
Trans. Edinburgh Medical Chirological Society
, Vol.
1
,
1824
, pp 84–169.
33.
Ommaya
,
A.K.
,
O'Tuama
,
L.A.
,
Lorenzo
,
A.V.
, “
CSF Dynamics, Hydrocephalus and Leaks
”, in Principles of Nuclear Medicine, 2nd Ed.
Wagner
,
H.N.
(Ed.),
1993
.
This content is only available via PDF.
You do not currently have access to this chapter.
Close Modal

or Create an Account

Close Modal
Close Modal