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.
Post-traumatic seizure
Neuroimaging is used to guide treatment. Often, MRI is performed in any patient with PTS, but the less sensitive but more easily accessed CT scan may also be used.
Shortly after TBI, people are given anticonvulsant medication, because seizures that occur early after trauma can increase brain damage through hypoxia, excessive release of excitatory neurotransmitters, increased metabolic demands, and increased pressure within the intracranial space. Medications used to prevent seizures include valproate, phenytoin, and phenobarbital. It is recommended that treatment with anti-seizure medication be initiated as soon as possible after TBI. Prevention of early seizures differs from that of late seizures, because the aim of the former is to prevent damage caused by the seizures, whereas the aim of the latter is to prevent epileptogenesis. Strong evidence from clinical trials suggests that antiepileptic drugs given within a day of injury prevent seizures within the first week of injury, but not after. For example, a 2003 review of medical literature found phenytoin to be preventative of early, but probably not late PTS. In children, anticonvulsants may be ineffective for both early and late seizures. For unknown reasons, prophylactic use of antiepileptic drugs over a long period is associated with an increased risk for seizures. For these reasons, antiepileptic drugs are widely recommended for a short time after head trauma to prevent immediate and early, but not late, seizures. No treatment is widely accepted to prevent the development of epilepsy. However, medications may be given to repress more seizures if late seizures do occur.