Head Injuries

Details of Injury

The mechanism of injury may give an indication of the type of injury. Head injuries may result in loss of consciousness, amnesia, or vomiting. Additional symptoms may include headache, nausea, or difficulty concentrating. Athletes may seem [Page 633]dazed, irritable, or moody or may have difficulty answering questions.

Table 1 Indications for Immediate Transfer to Hospital of an Athlete with a Head Injury

Source: Reprinted from Hunte G. Sporting emergencies. In: Brukner P, Khan K, eds. Clinical Sports Medicine. 2nd ed. Roseville, New South Wales, Australia: McGraw-Hill; 2001:713–725. With permission from McGraw-Hill Australia.

Note: GCS = Glasgow Coma Scale.

The athlete's orientation, memory, and concentration may be affected. Orientation can be assessed by asking questions about the game, such as the opposing team, the score, and the position played. Memory can be evaluated by asking questions about events prior to the injury, such as when the last game was played, how the team got to the venue, or what the athlete did prior to the game. Immediate and delayed memory can be assessed by asking the athlete to recall a list of five words immediately and at the end of the assessment. Concentration and mental processing speed can be evaluated by asking the athlete to recite the months of the year backward or to do serial sevens. The athlete's ability to do the test may be affected by the injury, resulting in slow responses or mistakes.

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