Concussão Cerebral no Judo – Programa de Retorno ao Treino e Competição

Cerebral concussion consists in a complex traumatic brain injury with functional repercussion, which occurs after a direct or indirect brain trauma, without abnormalities identified in imaging studies. The increasing prevalence of this injury in judo, its clinical severity and the general unawareness of the best therapeutic behavior were the necessary stimulus to conduct a specific orientation program for the sport. These procedures will allow a safe return to train and competition ensuring the athlete’s physical and cognitive integrity.

Specifi c features of connective tissuing metabolism of children with closed craniocerebral injury

The author of this paper, in order to diagnose the imbalance of connective tissue metabolism, has analyzed the results of laboratory tests of blood and urine according to biochemical parameters of the patients with closed craniocerebral injury (CCI) with diff erent severity and has established their clinical and diagnostic value. 100 children who had closed craniocerebral trauma were examined. There were 79 boys (79 %) and 21 girls (21 %), aged from 3 to 17 years among them. Distribution of children into groups was conducted according to the clinical forms of craniocerebral trauma: Group I — closed craniocerebral trauma, cerebral concussion — 50 children (50 %), average age (14,6 ± 2,5) years; Group II — closed craniocerebral trauma with cerebral contusion of moderate severity — 20 children (20 %), average age (13.5 ± 4.5 years); Group III —closed craniocerebral trauma with severe cerebral contusion — 30 children (30 %), average age (14.5 ± 3.5 years). Chondroitin sulfates were determined in the blood serum of patients — according to the М. Németh-Csóka method in the modifi cation of L. I. Slutskyi, fraction of glycosaminoglycans (GAG). The content of oxyproline was determined in the urine — by the reaction with chloramine-B, uronic acids — by the reaction with carbazole. In case of mild CCI (cerebral concussion), the indicators of biochemical studies of the blood and urine remained within the normal range, while with the increase in the severity of the injury, we observed an increase in chondroitin sulfate, and a decrease in the level of general GAG, its II and III fractions, and an increase in oxyproline in the urine, indicating the dysgenesia of the connective tissue metabolism and which may be the basis for the unfavorable course of closed craniocerebral injury of children during the rehabilitation period. Detection of changes in the connective tissue metabolism allows additionally predict the course of the disease in the period of rehabilitation and the possibility of recovery of children after CCI. Key words: children, craniocerebral injury, connective tissue dysgenesia, mucopolysaccharides, oxyproline.

Difference in the ascending reticular activating system injury between mild traumatic brain injury and cerebral concussion

Introduction We investigated differences in the ascending reticular activating system (ARAS) injuries between patients with mild traumatic brain injury (mTBI) and cerebral concussion by using diffusion tensor tractography (DTT). Methods Thirty-one patients with mTBI, 29 patients with concussion, and 30 control subjects were recruited. We used DTT to reconstruct the lower ventral and dorsal ARAS, and the upper ARAS. The fractional anisotropy (FA) value and the fiber number (FN) of the lower ventral and dorsal ARAS, and the upper ARAS were determined. Results Significant differences were observed in the FA values of the lower ventral and dorsal ARAS on both sides between the mTBI and control groups and between the concussion and control groups (p < 0.05). The FN value was significantly different in the lower ventral ARAS on both sides between the concussion and control groups and between the mTBI and concussion groups (p < 0.05). Conclusion Both the mTBI and concussion patients suffered injuries in the lower ventral and dorsal ARAS, with the concussion patients exhibiting more severe injury in the ventral ARAS than that in the mTBI patients. These results suggest that the terms mTBI and concussion should be used differentially, even though they have used interchangeably for a long time.