Sports-Related Concussions.

Sports-Related Concussions Bailes JE, Lovell MR, Maroon JC, eds. St Louis, MO, 63146, Quality Medical Publishing Inc, 1999, paperback, 261 pp, illus, $75.

This book was inspired by a national conference held on the topic of diagnosis and treatment of central nervous system injuries in the athlete. According to the editors, up to 40% of athletic injuries involve the head or spine. The text provides state-of-the-art coverage of the evaluation and treatment of sports-related concussions in the athlete. It is intended for individuals working in the fields of neurosurgery, neuropsychology, and athletic training.

The text is edited by 2 physicians and 1 neuropsychologist with contributions from 27 authors who are primarily physicians and neuropsychologists. It contains 18 chapters divided into 4 parts. Part I, appropriately titled "Foundations," contains 4 chapters. Chapter 1 provides classification and management guidelines for concussions. Several tables are added to clarify subject matter in this short chapter. Chapter 2, "Neurobiology of Concussion," describes cerebral metabolic response to concussive brain injury. Images from positron-emission tomography scans are included to illustrate the metabolic changes following injury. The third and fourth chapters focus on the long-term effect of traumatic brain injury and discuss topics such as chronic traumatic brain injury and Alzheimer disease.

Part II contains 5 chapters that focus on the incidence, prevention, and management of head injuries. The first 3 chapters cover topics such as recreational sports, helmet design, and injury patterns in high school sports. The chapter on helmet design is especially interesting because it provides detailed information on engineering and material considerations and helmet testing. The final 2 chapters in this part are written by the team neurosurgeon for the Pittsburgh Steelers, who covers the clinical diagnosis and management of head and cervical spine injuries. These 2 chapters contain images from neurodiagnostic scans and provide information that is clinically useful for the physical therapist.

Part III contains 8 chapters on evaluation and testing in neuropsychology. This third part includes chapters on 'ethical issues, the reliability and validity of serial assessment, and computerized testing. Three chapters are devoted to the neuropsychological evaluation of the high school, collegiate, and professional athlete. The chapter on professional athletes includes introductory work completed by the medical team of the Pittsburgh Steelers and describes a specific battery of tests that provide information on functional status.

The closing part of this text is the dialogue from an experts' roundtable that focuses on previous head traumas experienced by the athletes. The moderator is former football player Lynn Swann, who is joined by 4 other retired football players and 3 NFL physicians.

Overall, the text is easy to read, even though it follows no consistent format. Only a couple of chapters are heavily referenced. This text is appropriate for the sports physical therapist who works with athletes on and off the field. The general physical therapist or student would find this text useful only for research and reference.

Janice K Loudon, PhD, PT, SCS, ATC University of Kansas Medical Center Kansas City, Kan

Dr Loudon is Assistant Professor in the Department of Physical Therapy Education. Her research interests are the study of biomechanics and prevention of injuries in sports.