Barbara Buccilli, Yasser F Almealawi, Kimiya Shahabi, Dimitrie-Ionuț Atasiei, Khaled Elsousi, Marium Khan, Sarah Alshamery, Albert Alan, Martin Weinand
{"title":"治疗运动相关创伤性脑损伤的神经外科技术进展。","authors":"Barbara Buccilli, Yasser F Almealawi, Kimiya Shahabi, Dimitrie-Ionuț Atasiei, Khaled Elsousi, Marium Khan, Sarah Alshamery, Albert Alan, Martin Weinand","doi":"10.1016/j.amjsurg.2025.116664","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Sports-related Traumatic Brain Injury (TBI) is a public health concern, often requiringneurosurgical intervention. Outcomes vary widely across sports, yet remain underreported.</p><p><strong>Methods: </strong>We conducted a PRISMA-guided systematic review and meta-analysis of sports-related TBI in athletes, focusing on injury mechanisms, neurosurgical interventions, and clinical outcomes, including return-to-play. PubMed, Embase, and MEDLINE were searched; studies reporting injury mechanisms, neuroimaging or hemorrhage types, neurosurgical procedures, and outcomes were included. Two reviewers independently screened and extracted data, and proportions were pooled using random-effects models.</p><p><strong>Results: </strong>A total of 42,112 patients were included (62.0 % male; mean age 20.1 years). Skiing/snowboarding, football, and cycling were the leading sports associated with TBI. Across all sports, the mean GCS was 13.5, and average return to practice occurred at 5.4 months. Helmet use was confirmed in only 17 % of patients and 8.8 % of cyclists. Among cyclists, 27 % had ICH at presentation, with subdural hematoma being the most common type (32.1 %). Mechanisms of injury varied by sport, with falls dominating in cycling, horse riding, skiing, and skateboarding. Meta-analysis showed concussions were the most common injury (pooled proportion 0.11), followed by contusions (0.05). Hemorrhages included SDH (0.17), EDH (0.05), and SAH (0.04). Skull fractures occurred in 18 % of cases. Neurosurgical intervention was required in 21 % of patients, most commonly craniotomy (7 %). Mortality was low (<3 %), and favorable outcomes were frequent (93 %). Return to play was high overall (96 %) but only 23 % within 1 month. Helmet use was low overall (17 %) and varied substantially across different sports and study settings.</p><p><strong>Conclusions: </strong>Outcomes and surgical needs vary by sport. Targeted prevention and individualized carestrategies are essential.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"116664"},"PeriodicalIF":2.7000,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Advancements in neurosurgical techniques for managing sports-related traumatic brain injuries.\",\"authors\":\"Barbara Buccilli, Yasser F Almealawi, Kimiya Shahabi, Dimitrie-Ionuț Atasiei, Khaled Elsousi, Marium Khan, Sarah Alshamery, Albert Alan, Martin Weinand\",\"doi\":\"10.1016/j.amjsurg.2025.116664\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Sports-related Traumatic Brain Injury (TBI) is a public health concern, often requiringneurosurgical intervention. Outcomes vary widely across sports, yet remain underreported.</p><p><strong>Methods: </strong>We conducted a PRISMA-guided systematic review and meta-analysis of sports-related TBI in athletes, focusing on injury mechanisms, neurosurgical interventions, and clinical outcomes, including return-to-play. PubMed, Embase, and MEDLINE were searched; studies reporting injury mechanisms, neuroimaging or hemorrhage types, neurosurgical procedures, and outcomes were included. Two reviewers independently screened and extracted data, and proportions were pooled using random-effects models.</p><p><strong>Results: </strong>A total of 42,112 patients were included (62.0 % male; mean age 20.1 years). Skiing/snowboarding, football, and cycling were the leading sports associated with TBI. Across all sports, the mean GCS was 13.5, and average return to practice occurred at 5.4 months. Helmet use was confirmed in only 17 % of patients and 8.8 % of cyclists. Among cyclists, 27 % had ICH at presentation, with subdural hematoma being the most common type (32.1 %). Mechanisms of injury varied by sport, with falls dominating in cycling, horse riding, skiing, and skateboarding. Meta-analysis showed concussions were the most common injury (pooled proportion 0.11), followed by contusions (0.05). Hemorrhages included SDH (0.17), EDH (0.05), and SAH (0.04). Skull fractures occurred in 18 % of cases. Neurosurgical intervention was required in 21 % of patients, most commonly craniotomy (7 %). Mortality was low (<3 %), and favorable outcomes were frequent (93 %). Return to play was high overall (96 %) but only 23 % within 1 month. Helmet use was low overall (17 %) and varied substantially across different sports and study settings.</p><p><strong>Conclusions: </strong>Outcomes and surgical needs vary by sport. Targeted prevention and individualized carestrategies are essential.</p>\",\"PeriodicalId\":7771,\"journal\":{\"name\":\"American journal of surgery\",\"volume\":\"250 \",\"pages\":\"116664\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-10-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.amjsurg.2025.116664\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amjsurg.2025.116664","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
Advancements in neurosurgical techniques for managing sports-related traumatic brain injuries.
Background: Sports-related Traumatic Brain Injury (TBI) is a public health concern, often requiringneurosurgical intervention. Outcomes vary widely across sports, yet remain underreported.
Methods: We conducted a PRISMA-guided systematic review and meta-analysis of sports-related TBI in athletes, focusing on injury mechanisms, neurosurgical interventions, and clinical outcomes, including return-to-play. PubMed, Embase, and MEDLINE were searched; studies reporting injury mechanisms, neuroimaging or hemorrhage types, neurosurgical procedures, and outcomes were included. Two reviewers independently screened and extracted data, and proportions were pooled using random-effects models.
Results: A total of 42,112 patients were included (62.0 % male; mean age 20.1 years). Skiing/snowboarding, football, and cycling were the leading sports associated with TBI. Across all sports, the mean GCS was 13.5, and average return to practice occurred at 5.4 months. Helmet use was confirmed in only 17 % of patients and 8.8 % of cyclists. Among cyclists, 27 % had ICH at presentation, with subdural hematoma being the most common type (32.1 %). Mechanisms of injury varied by sport, with falls dominating in cycling, horse riding, skiing, and skateboarding. Meta-analysis showed concussions were the most common injury (pooled proportion 0.11), followed by contusions (0.05). Hemorrhages included SDH (0.17), EDH (0.05), and SAH (0.04). Skull fractures occurred in 18 % of cases. Neurosurgical intervention was required in 21 % of patients, most commonly craniotomy (7 %). Mortality was low (<3 %), and favorable outcomes were frequent (93 %). Return to play was high overall (96 %) but only 23 % within 1 month. Helmet use was low overall (17 %) and varied substantially across different sports and study settings.
Conclusions: Outcomes and surgical needs vary by sport. Targeted prevention and individualized carestrategies are essential.
期刊介绍：
The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.
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