Sports-related concussion and strangulation

Authors: Atzmon Tsur1, Avi Ohry2



1 Meuhedet Mutual Service, Northern District, Haneviim Tower, Haifa, Israel

2 Reuth Rehabilitation Center, Yad Eliyahu, Tel-Aviv, Israel



Background. Brain concussion is an immediate transient alteration of the neurological functions due to direct or indirect traumatic head injury followed by a post-concussion syndrome of variable duration. Concussion is included in the group of mild head injuries and is manifested in the form of immediate and transient changes in the central nervous system function caused by the brain’s impact against the skull’s bony wall. Strangulation is a strong compression around the neck. The damage is caused when pressure is applied to the front of the neck, preventing air and sometimes blood from passing to the brain. These phenomena can lead to short-term loss of consciousness

Methods. A bibliographic survey was done.

Results. In high-level sports, concussion is common and recurrent, especially in high-speed contact or collision sports such as boxing, rugby, American football, ice hockey, soccer and others. When concussion occurs, the athlete requires a recovery period during which he/she is unable to continue sports practice. Former elite athletes, who have suffered from repetitive concussion reported mental alterations such as headaches, anxiety, depression and sleep disturbances. The most common means used to assess the severity of sports concussion is the 5th version of the Sport Concussion Assessment Tool (SCAT5) which incorporates several tests. Strangulation usually occurs in mattress sports such as judo and wrestling. The management of concussion and strangulation by the medical staff must follow existing guidelines, beginning in the sports arena or ground immediately after occurrence, and continuing until the athlete is allowed to return to play.

Conclusions. 1) Concussion obliges medical staff to assess the athlete’s level of consciousness immediately after the trauma and involves an incapacity to continue sport practice with a variable period of recovery. 2) Air choking, blood choking and vagal phenomenon probably explains most cases of loss of consciousness after strangulation


Keywords: concussion, strangulation, athlete, clinical signs, neurological examination.


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