Handball concussion case series in a Brazilian Team

Abstract

To analyze the history of self-reported head impacts, prevalence of post-concussion symptoms and performance in motor coordination tests in amateur handball athletes. Handball is a contact sport where athletes can suffer collisions through different mechanisms and there are few published data about brain concussion in handball, mainly in Brazilian athletes. Amateur male athletes aged between 18 and 35 years, with 4-6 hours of training per week and an average of 12.5 games in the last 6 months were evaluated regarding to the head impact history during handball games and practices. The athletes were also evaluated regarding of the most common kind of impact mechanism, loss of consciousness (LOC), reported cervical injury (pain and decreased range of motion), symptoms prevalence and their severity using the Post Concussion Symptom Scale (PCSS), time to execution of single-task tandem gait (TG) and performance in the Finger-to-Nose test (>4 seconds to perform five successive finger to nose repetitions was considered abnormal). Six athletes reported direct impacts on the head while playing handball. Falls, elbow to the head, trunk to the head and hit by the ball were the most reported mechanisms of head impact in handball athletes. Two athletes reported LOC and all of them denied cervical injury after trauma. Regarding the PCSS score, three athletes had a score between 6-21 and five athletes had a 22-84 score. The most reported symptoms were sleeping more than usual, drowsiness, fatigue, changes in behavior (nervousness, feeling more emotional and irritability), trouble falling asleep and dizziness. However, athletes shown a normal performance in the single task TG (14.6-17.2 seconds) compared to normative data and three athletes shown altered performance on the Finger-to-Nose test. Amateur handball athletes had significant scores of PCSS mainly related to sleep, emotional and possibly to the vestibular function.