Sports-related traumatic brain injury
Rules exist within each sport to help prevent cerebral contusions and traumatic brain injuries. However, individual athletes are the best prevention against their own injuries. In a game, athletes notice when they have the symptoms of a cerebral contusion and should take themselves out of the game. It may be hard for medical personnel or coaches to notice when a player has a traumatic brain injury, so it is in the player’s best interest to be removed from play. In hockey, traumatic brain injuries constitute 10%-15% of all head injuries. With the high percent of injuries being traumatic, extensive design improvements have been made to helmets. These improvements reduce the risk of cerebral contusions by providing more padding around the skull and a chin strap that keeps the helmet snug. In baseball, major improvements to helmets have been made to protect batters from the impact a baseball can have when hitting their head. Helmets, before this major improvement, were designed to withstand a velocity of 70 mph from a pitch or foul ball. Since the company Rawlings’ new design, helmets can withstand a velocity of 100 mph and have further padding around the softer parts on the side of the skull.
Primary and secondary brain injury
In TBI, primary injuries result immediately from the initial trauma. Primary injury occurs at the moment of trauma and includes contusion, damage to blood vessels, and axonal shearing, in which the axons of neurons are stretched and torn. The blood brain barrier and meninges may be damaged in the primary injury, and neurons may die. Cells are killed in a nonspecific manner in primary injury. Tissues have a deformation threshold: if they are deformed past this threshold they are injured. Different regions in the brain may be more sensitive to mechanical loading due to differences in their properties that result from differences in their makeup; for example, myelinated tissues may have different properties than other tissues. Thus some tissues may experience more force and be more injured in the primary injury. The primary injury leads to the secondary injury.