Abstract
Subdural hematomas have been observed in several sports, from ball games like basketball to noncontact sports like race walking. Soccer-related brain injury is uncommon. Only few studies have shown the existence of a relationship between the practice of sport activities and a higher risk to develop chronic subdural hematoma (CSDH), especially in a young population. The best indirect example of this association is Argentina soccer legend Diego Maradona who was operated for CSDH a month before his death. In the presence of an arachnoid cysts, the practice of sport activities may expose young patients to minor head trauma and to an increased risk of developing CSDH. We performed a literature review of all the reported cases of patients with CSDH related to sport practice, from the year 1950 through March 1, 2020, and we finalized a total of 66 cases found across 52 studies. For each case, we analyzed age, sex, sport activity practiced, delay between sport and diagnosis, symptoms, brain imaging, treatment performed, the outcome, and evolution. There is no clear consensus regarding the return of athletes to the sport after CSDH. This study will be of interest to all neurosurgeons and other physicians who treat patients with sports-related CSDH.
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References
Adhiyaman V, Asghar M, Ganeshram K, Bhowmick B. Chronic subdural haematoma in the elderly. Postgrad Med J. 2002;78:71–5.
Alaraj AM, Chamoun RB, Dahdaleh NS, Haddad GF, Comair YG. Spontaneous subdural haematoma in anabolic steroids dependent weight lifters: reports of two cases and review of literature. Acta Neurochir. 2005;147:85–7.
Barnes B, Cooper L, Kirkendall D, McDermott T, Jordan B, Garrett W. Concussion history in elite male and female soccer players. Am J Sports Med. 1998;26:433–8.
Bey T, Ostick B. Second impact syndrome. West J Emerg Med. 2009;10:6–10.
Blereau RP, Haley TJ. Arachnoid cyst. Consultant. 2013;53:540–1.
Bo-abbass Y, Bolton CF. Roller coaster headache. N Engl J Med. 1995;332:1585.
Boden B, Kirkendall D, Garrett W. Concussion incidence in elite college soccer players. Am J Sports Med. 1998;26:238–41.
Byard R, Vink R. The second impact syndrome. Forensic Sci Med Pathol. 2009;5:36–8.
Cantu R. Second-impact syndrome. Clin Sports Med. 1998;17:37–44.
Cantu R. Athletic concussion: current understanding as of 2007. Neurosurgery. 2007;60:963–4.
Cantu R, Mueller F. Brain injury-related fatalities in American football, 1945–1999. Neurosurgery. 2003;52:846–52.
Cantu R, Gean A. Second-impact syndrome and a small subdural hematoma: an uncommon catastrophic result of repetitive head injury with a characteristic imaging appearance. J Neurotrauma. 2010;27:1557–64.
Carmont M, Mahattanakul W, Pigott T. Acquisition of a chronic subdural haematoma during training for competitive race walking. Br J Sports Med. 2002;36:306–7.
Chillala S, Read C, Evans PA. An unusual case of subdural haematoma presenting to the accident and emergency department. Emerg Med J. 2001;18:308–9.
Cress M, Kestle JRW, Holubkov R, Riva-Cambrin J. Risk factors for pediatric arachnoid cyst rupture/hemorrhage: a case control study. Neurosurgery. 2013;72:716–22.
Demetriades AK, McEvoy AW, Kitchen ND. Subdural haematoma associated with an arachnoid cyst after repetitive minor heading injury in ball games. Br J Sports Med. 2004;38:E8.
Denoronha R, Sharrack B, Hadjivassiliou M, Romanowski C. Subdural haematoma: a potentially serious consequence of spontaneous intracranial hypotension. J Neurol Neurosurg Psychiatry. 2003;74:752–5.
Domenicucci M, Russo N, Giugni E, Pierallini A. Relationship between supratentorial arachnoid cyst and chronic subdural hematoma: neuroradiological evidence and surgical treatment. J Neurosurg. 2009;110:1250–5.
Edmondson L, Upshaw J, Tuuri R. A 14-year-old male with a 10-week history of headaches. Pediatr Ann. 2014;43:220–3.
Ernestus R, Beldzinski P, Lanfermann H, Klug N. Chronic subdural hematoma: surgical treatment and outcome in 104 patients. Surg Neurol. 1997;48:220–5.
Fernandes CMB, Daya MR. A roller-coaster headache: case report. J Trauma. 1994;37:1007–10.
Fogelholm R, Heiskanen O, Waltimo O. Chronic subdural hematoma in adults. Influence of patient’s age on symptoms, signs, and thickness of hematoma. J Neurosurg. 1975;42:43–6.
Fukutake T, Mine S, Yamakami I. Roller coaster headache and subdural hematoma. Neurology. 2000;54:264.
Gerberich SG, Priest JD, Boen JR, Straub CP, Maxwell RE. Concussion incidences and severity in secondary school varsity football players. Am J Public Health. 1983;73:1370–5.
Gregori F, Colistra D, Mancarella C, Chiarella V, Marotta N, Domenicucci M. Arachnoid cyst in young soccer players complicated by chronic subdural hematoma: personal experience and review of the literature. Acta Neurol Belg. 2020;120:235–46.
Hamada H, Hayashi N, Umemura K. Middle cranial fossa arachnoid cyst presenting with subdural effusion and endoscopic detection of tear of the cyst. Neurol Med Chir (Tokyo). 2010;50:512–4.
Hara H, Inoue T, Matsuo K. Unusual computed tomographic findings in a case of arachnoid cyst in the middle cranial fossa. Surg Neurol. 1984;22:79–82.
Hilleshein E, Souza L, Lautert L, Paz A, Catalan VM, Teixeira M, et al. Capacidade para o trabalho de enfermeiros de umhospitaluniversitário. Rev Gaúcha Enf. 2011;32:509–15.
Hou K, Li CG, Zhang Y, Zhu BX. The surgical treatment of three young chronic subdural hematoma patients with different causes. J Korean Neurosurg Soc. 2014;55:218–21.
Işik SH, Yildiz Ö, Ceylan Y. Chronic subdural hematoma caused by soccer ball trauma associated with arachnoid cyst in childhood: case report. Neurol Sci Neurophysiol. 2011;28:398–401.
Jacome DE, Yanez GF. Subdural haematoma upon straining. J Neurol Neurosurg Psychiatry. 1989;52:134.
Jones N, Blumbergs P, North J. Acute subdural haematomas: aetiology, pathology and outcome. Aust N Z J Surg. 1986;56:907–13.
Kaste M, Waltimo O, Heiskanen O. Chronic bilateral subdural haematoma in adults. Acta Neurochir (Wien). 1979;48:231–6.
Kawanishi A, Nakayama M, Kadota K. Heading injury precipitating subdural hematoma associated with arachnoid cysts: two case reports. Neurol Med Chir (Tokyo). 1999;39:231–3.
Keller T, Holland M. Chronic subdural haematoma: an unusual injury from playing basketball. Br J Sports Med. 1998;32:338–9.
Kersey RD. Acute subdural hematoma after a reported mild concussion: a case report. J Athl Train. 1998;33:264–8.
Kertmen H, Gürer B, Yilmaz ER, Sekerci Z. Chronic subdural hematoma associated with an arachnoid cyst in a juvenile taekwondo athlete: a case report and review of the literature. Pediatr Neurosurg. 2012;48:55–8.
Lacour F, Trevor R, Carey M. Arachnoid cyst and associated subdural hematoma. Observations on conventional roentgenographic and computerized tomographic diagnosis. Arch Neurol. 1978;35:84–9.
Lindsay KW, McLatchie G, Jennett B. Serious head injury in sport. BMJ. 1980;281:789–91.
Logan S, Bell G, Leonard J. Acute subdural hematoma in a high school football player after 2 unreported episodes of head trauma: a case report. J Athl Train. 2001;36:433–6.
MacDonald JR, MacDougall JD, Interisano SA, Smith KM, McCartney N, Moroz JS, et al. Hypotension following mild bouts of resistance exercise and submaximal dynamic exercise. Eur J Appl Physiol Occup Physiol. 1999;79:148–54.
Maeda M, Kawamura Y, Handa Y. Value of MR imaging in middle fossa arachnoid cyst with intracystic and subdural hematoma. Eur J Radiol. 1993;17:145–7.
Maher CO, Garton HJ, Al-Holou WN, Trobe JD, Muraszko KM, Jackson EM. Management of subdural hygromas associated with arachnoid cysts. J Neurosurg Pediatr. 2013;12:434–43.
Matser E, Kessels A, Lefak M, Jordan B, Troost J. Neuropsychological impairment in amateur soccer players. JAMA. 1999;282:971–3.
Maughan R, Whiting P, Davidson R. Estimation of plasma volume changes during marathon running. Br J Sports Med. 1985;19:138–41.
McNeil SL, Austin Spruill W, Langley RL. Multiple subdural hematomas associated with breakdancing. Ann Emerg Med. 1987;16:114–6.
Miele VJ, Carson L, Carr A. Acute on chronic subdural hematoma in a female boxer: a case report. Med Sci Sports Exerc. 2004;36:1852–5.
Miele VJ, Bailes JE, Cantu RC, Rabb CH. Subdural hematomas in boxing: the spectrum of consequences. Neurosurg Focus. 2006;21:E10.
Mokri B. The Monro-Kellie hypothesis: applications in CSF volume depletion. Neurology. 2001;56:1746–8.
Mori T, Katayama Y, Kawamata T. Acute hemispheric swelling associated with thin subdural hematomas: pathophysiology of repetitive head injury in sports. Acta Neurochir Suppl. 2006;96:40–3.
Ochi M, Morikawa M, Ogino A. Supratentorial arachnoid cyst and associated subdural hematoma: neuroradiologic studies. Eur Radiol. 1996;6:640–4.
Oliver LC. Primary arachnoid cysts: report of two cases. BMJ. 1958;1:1147–9.
Page A, Paxton RM, Mohan D. A reappraisal of the relationship between arachnoid cysts of the middle fossa and chronic subdural haematoma. J Neurol Neurosurg Psychiatry. 1987;50:1001–7.
Park HR, Lee KS, Bae HG. Chronic subdural hematoma after eccentric exercise using a vibrating belt machine. J Korean Neurosurg Soc. 2013;54:265–7.
Parkkari J, Kujala M, Kannus P. Is it possible to prevent sports injuries? Sports Med. 2001;31:985–95.
Pascoe HM, Phal PM, King JA. Progressive post traumatic tearing of an arachnoid cyst membrane resulting in intracystic and subdural haemorrhage. J Clin Neurosci. 2015;22:897–9.
Pillai P, Menon SK, Manjooran RP, Kariyattil R, Pillai AB, Panikar D. Temporal fossa arachnoid cyst presenting with bilateral subdural hematoma following trauma: two case reports. J Med Case Rep. 2009;3:53.
Pothe H. Chronic subdural haematoma in prize fighters (In German). Beitr Neurochir. 1964;8:232–7.
Powell J, Barber-Foss K. Traumatic brain injury in high school athletes. JAMA. 1999;282:958–63.
Prabhu VC, Bailes JE. Chronic subdural hematoma complicating arachnoid cyst secondary to soccer-related head injury: case report. Neurosurgery. 2002;50:195–7.
Pretorius PM, McAuley DJ. Something old, something new? Br J Radiol. 2005;78:1063–4.
Raghupathi R, Mehr M, Heflaer M, Margulies S. Traumatic axonal injury is exacerbated following repetitive closed head injury in the neonatal pig. J Neurotrauma. 2004;21:307–16.
Rashid S, Watson C, Agarwal R. Episodic headache and arachnoid cyst related subdural hematoma. Headache. 2016;56:1354–5.
Robles LA, Hernandez V. Subdural and intracystic hematomas in an arachnoid cyst secondary to a boxing injury. Inj Extra. 2006;37:375–8.
Rogers MA, Klug GL, Siu KH. Middle fossa arachnoid cysts in association with subdural hematomas. A review and recommendations for management. Br J Neurosurg. 1990;4:497–502.
Roldan-Valadez E, Facha MT, Martinez-Lopez M, Herrera-Mora P. Subdural hematoma in a teenager related to roller-coaster ride. Eur J Paediatr Neurol. 2006;10:194–6.
Ross R, Oschner M. Acute intracranial boxing related injuries in US Marine Corps recruits: report of two cases. Mil Med. 1999;164:68–70.
Santarius T, Hutchinson P. Chronic subdural haematoma: time to rationalize treatment. Br J Neurosurg. 2004;18:328–32.
Seelig J, Becker D, Miller D, Greenberg R, Ward J, Choi S. Traumatic acute subdural hematoma: major mortality reduction in comatose patients treated within four hours. N Engl J Med. 1981;304:1511–8.
Senturk S, Guzel A, Bilici A, Takmaz I, Guzel E, Aluclu MU, et al. CT and MR imaging of chronic subdural hematomas: a comparative study. Swiss Med Wkly. 2010;140:335–40.
Shell D, Carico G, Patton R. Can subdural hematoma result from repeated minor head trauma? Phys Sportsmed. 1993;21:74–84.
Strahle J, Selzer B, Geh N. Sports participation with arachnoid cysts. J Neurosurg Pediatr. 2016;17:410–7.
Svien HJ, Gelety JE. On the surgical management of encapsulated subdural hematoma. A comparison of the results of membranectomy and simple evacuation. J Neurosurg. 1964;21:172–7.
Takizawa K, Sorimachi T, Honda Y, Ishizaka H, Baba T, Osada T. Chronic subdural hematomas associated with arachnoid cysts: significance in young patients with chronic subdural hematomas. Neurol Med Chir (Tokyo). 2015;55:727–34.
Torg JS, Vegso JJ, Sennelt B. The national football head and neck injury registry: 14-year report on cervical quadriplegia, 1971 through 1984. JAMA. 1985;254:3439–43.
Tsitsopoulos PP, Pantazis GC, Syrmou EC, Tsitsopoulos PD. Intracranial arachnoid cyst associated with traumatic intracystic hemorrhage and subdural haematoma. Hippokratia. 2008;12:53–5.
Tsuzuki N, Katoh H, Ohtani N. Chronic subdural hematoma complicating arachnoid cyst secondary to soccer-related head injury: case report. Neurosurgery. 2003;53:242–3.
Türkoğlu E, Serbes G, Sanli M, Sari O, Sekerci Z. Chronic subdural hematoma in capoeira sport. Turk Neurosurg. 2008;18:39–41.
Tyson G, Strachan WE, Newman P, Winn HR, Butler A, Jane J. The role of craniectomy in the treatment of chronic subdural hematomas. J Neurosurg. 1980;52:776–81.
Ulmer S, Engellandt K, Stiller U, Nabavi A, Jansen O, Mehdorn MH. Chronic subdural hemorrhage into a giant arachnoidal cyst (Galassi classification type III). J Comput Assist Tomogr. 2002;26:647–53.
Varma TRK, Sedzimir CB, Miles JB. Post-traumatic complications of arachnoid cysts and temporal lobe agenesis. J Neurol Neurosurg Psychiatry. 1981;44:29–34.
Wakai S, Hashimoto K, Watanabe N, Lnoh S, Ochiai C, Nagai M. Efficacy of closed-system drainage in treating chronic subdural hematoma: a prospective comparative study. Neurosurgery. 1990;26:7713.
Weinberg PE, Flom RA. Intracranial subarachnoid cysts. Radiology. 1973;106:329–33.
Wetjen N, Pichelmann M, Atkinson J. Second impact syndrome: concussion and second injury brain complications. J Am Coll Surg. 2010;211:553–7.
Yaldiz C, Kacira T, Ceylan D, Asil K. Chronic subdural hemorrhage associated with an arachnoid cyst after sports injury in childhood. Neurosurg Q. 2016;26:361–4.
Yokoyama K, Tonami N, Kimura M. Scintigraphic demonstration of intracranial communication between arachnoid cyst and associated subdural hematoma. Clin Nucl Med. 1989;14:350–3.
Zeng T, Shi S, Lin Y. Chronic subdural hematoma associated with sylvian arachnoid cyst in juvenile athletes: report of two cases and literature review. Chin J Traumatol. 2011;14:174–7.
Zhang H, Zhang JM, Chen G. Chronic subdural hematoma associated with arachnoid cyst: report of two cases. Chin Med J (Engl). 2007;120:2339–40.
Zhao KJ, Zhang RY, Sun QF, Wang XQ, Gu XY, Qiang Q, et al. Comparisons of 2/3Sh estimation technique to computer-assisted planimetric analysis in epidural, subdural and intracerebral hematomas. Neurol Res. 2010;32:910–7.
Zheng S-P, Li G, You C. Chronic subdural hematoma associated with arachnoid cysts in young people. Neurosurg Q. 2013;23:258–61.
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Baallal, H., Belfquih, H., Akhaddar, A. (2021). Chronic Subdural Hematoma Related to Sport Head Injury. In: Turgut, M., Akhaddar, A., Hall, W.A., Turgut, A.T. (eds) Subdural Hematoma. Springer, Cham. https://doi.org/10.1007/978-3-030-79371-5_25
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