Concusions & Head Injuries

Question 1

What is the most common mechanism of neck injury in football?

Answer 1

Spear tacklers spine

Question 2

What is a Torg-Palov ratio?

Answer 2

Ratio of spinal canal to vertebral body width; less than 0.8 is concerning for neck injury (normal is 1.0)

Question 3

What are contraindications to return to play for neck injuries?

Answer 3

1) transient quadriplegia with severe stenosis
2) spear tackler’s spine
3) cervical neuropraxia with ligamentous instability
4) odontoid hypoplasia and os odontoideum
are absolute contraindications to play
5) Klippel-Feil anomalies- mass fusion of the cervical and thoracic vertebrae is an absolute contraindication to play

Question 4

What is a useful tool in the guiding of treatment and return to play for concussion injuries?

Answer 4

ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing battery)

Question 5

What concussive sequlae would be a contraindication to return to play without further treatment?

Answer 5

1) LOC
2) prior Grade 1 concussion in same season
3) symptoms > 15 minutes
4) positive exertional stress test
5) amnesia
6) postconcussion syndrome