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A Case of Repeated Concussions with Subdural Hematomas in a High School Football Player

John M. Wilson, Jessica Ginsberg, Laszlo Nagy

(Department of Pediatrics, Texas Tech University Health Sciences Center School of Medicine, Amarillo, USA)

Med Sci Case Rep 2017; 4:41-44

DOI: 10.12659/MSCR.904540


BACKGROUND: Catastrophic brain injuries among high school football players can be devastating, resulting in subdural hemorrhages. This is particularly true among individuals with repeated brain injuries.
CASE REPORT: A 14-year-old male presented with a helmet-to-helmet collision and a loss of consciousness. According to the Clinical Academy of Neurology concussion grading system, this patient had a grade 3 concussion. He had a subdural bleed with a 6-mm midline shift that did not require surgery. Two years later, the same patient presented with a second helmet-to-helmet collision. He suffered a grade 2 concussion with a subdural bleed and an 8–9-mm midline shift that required a craniotomy and evacuation. Intraoperatively, the dura was thicker and more vascular than normal, possibly reflecting consequences of the previous subdural hematoma.
CONCLUSIONS: With a 2-year interval between concussions, the patient exceeded the average time for cognitive and symptom recovery. However, his second head injury resulted in a lower-grade concussion but a more severe subdural hemorrhage. The scientific community must decide if former bridging vein injury represents a higher risk for subsequent head injuries. There is an established timeline for short-term recovery from concussions both cognitively and symptomatically; however, there must be a greater focus on the long-term recovery of the brain and its vessels.

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
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