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P-73 Essential aspects of traumatic encephalopathy in athletes
  1. Antonia Onaca1,
  2. Anca Ionescu2
  1. 1Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  2. 2National Institute of Sports Medicine, Bucharest, Romania

Abstract

Post-Traumatic Encephalopathy represents through its diversity and seriousness of consequences an important aspect of sport’s pathology.

Within the impact of head trauma we often meet intracranial pressure and hemodynamics change that occurs with vasoplegy in the initial exchanges with altered arteriole capillaries, diapedesis of red blood cells with tissue acidosis, which causes capillary pore opening situated at capillary junction. The impact causes micro bleeds in cloth being the incipient phase of brain contusion or realises the known type intracranial hematoma accumulations.

In the head injury there can be Vasogenic Cerebral Oedema that is caused by the impact and the blood-brain barrier breakdown occurs.

In Romanian Sports history we have N.P. 34 years old, Olympic boxing champion, with phenomena of progressive intracranial hypertension for 4 days, dies and anatomical pathology examination showing cerebral oedema cerebellar tonsils with important employment.

Clinical manifestations in head trauma are of particular importance because we have immediate signs after brain contusion represented by headache, dizziness, speech disorder, agitation, dilated pupil, memory loss, personality change and post-game signs represented by a consciousness loss, severe headache and coma (Glasgow scale).

The mechanism that we meet in head traumas is represented by the head impact that breaks the head’s emissary veins with subdural hematoma production.

Intracranial hematomas represented by the expansive process, making pressure cones, which is associated with symptoms of focal lesions.

Treatment Serious cases providing vital functions, stabilisation, emergency hospitalisation, continuous surveillance, compared to medium cases first aid, assess the athlete for the game, regular surveillance.

Late consequences are caused by repeated head trauma, followed by cognitive-motor disorders and form the arguments for rehabilitation treatment early instituted and continued in specialty health centres.

Diagnosis Complete somatic clinical examination, tracking consciousness, motor and sensory structures, cranial nerves and eyeball examination, back of the eye.Skull radiography;Cerebral Computed Tomography; MRI; Pet CT; Electroencephalogram.

Head Injury complications are Parkinson’s, epilepsy, pugilistic dementia, cognitive deficits and residual paralysis.

Prognosis For Minor contusions it’s needed a short period of recovery with periodic checks.For Major contusions recovery is long lasting, detailed with medical supervision. Final statement on the resumption of sporting activity, it is essential, because only in this way we can protect the athlete as well as to be sure it can perform on the field.

Prevention Protection equipment: like stronger hats, bicycle or motorcycle helmets, seat belts, helmets (hockey, baseball).

The key to prevention is to stop or limit any activity that can develop this pathology, a suitable training program.

Conclusions Post-traumatic encephalopathy that comes after a head injury, takes multiple forms of manifestation whose seriousness requires medical intervention. Neuropsychological and somatic recovery is a mandatory measure for the resumption of sports activities.

Abstract P-73 Figure 1

Posttraumatic front right hematoma intraparenchimatoase and skull fracture

Abstract P-73 Figure 2

Epidural hematoma

  • Clinical manifestations
  • Diagnosis
  • Head Injury
  • Post-Traumatic Encephalopathy.

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