Minor Traumatic Brain Injury (mTBI) in Ice Hockey and Other Contact Sports

Abstract

Minor Traumatic Brain Injury (mTBI) is caused by the inertial effect of a mechanical impact to the head with sudden rotational acceleration forces. MTBI produces, in the less severe cases, only transient disturbances of ionic homeostasis with temporary disturbances of brain function. Depending on the severity of the trauma, animal and human studies have demonstrated focal intraaxonal alterations in neurofilamentous/cytoskeletal network and impairment of axoplasmic transport, which may lead to progressive axonal swelling, detachment or even cell death over a period of hours or days, the so-called process of delayed axotomy. Disturbances of ionic homeostasis, acute metabolic changes and cerebral blood flow alterations compromise the ability of neurons to function and render brain cells vulnerable. These processes may predispose brain cells to a vulnerable state for an undetermined period; therefore, it is recommended that any confused player with or without amnesia should be taken off the ice and not be permitted to play again for at least 72 h.