A “scattered” SCAT in a football goalkeeper: a case report

  • Saskia Bosch Institute of Sport and Exercise Medicine, Division of Orthopaedics, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa; FIFA Medical Centre of Excellence, Stellenbosch University, South Africa; Campus Health Service, Stellenbosch University, South Africa; Catholic University of Leuven, Department of Physical Medicine and Rehabilitation, Leuven, Belgium https://orcid.org/0000-0002-6728-0663
  • Pierre Viviers Institute of Sport and Exercise Medicine, Division of Orthopaedics, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa; IOC Research Centre, Cape Town, South Africa; FIFA Medical Centre of Excellence, Stellenbosch University, South Africa; Campus Health Service, Stellenbosch University, South Africa https://orcid.org/0000-0001-6682-3438
  • Wayne Derman Institute of Sport and Exercise Medicine, Division of Orthopaedics, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa; IOC Research Centre, Cape Town, South Africa; FIFA Medical Centre of Excellence, Stellenbosch University, South Africa https://orcid.org/0000-0002-8879-177X
  • Richard de Villiers Winelands Radiology, Institute of Orthopaedics and Rheumatology, Stellenbosch, South Africa https://orcid.org/0000-0001-6114-126X

Abstract

Background: In an acute field-side setting, it is often challenging to differentiate benign sports-related concussion (SRC) from potential, more sinister, intracranial pathology. Moreover, recovery in the ensuing days and weeks is often complex as the resolution of classical signs and symptoms does not always follow a standard pattern.

Aim: To highlight the value of a structured and repeated thorough clinical assessment approach toward SRC, particularly as atypical and unexpected sequences in patient recovery patterns may require further specialist referral and intervention.

Findings: A football goalkeeper sustained a concussion in which symptoms failed to resolve as expected. Deterioration in his clinical condition led to an eventual diagnosis of Chiari malformation (type I), which required surgical intervention.Implications: Non-typical recovery patterns of concussion may be indicative of increased severity when considered retrospectively. However, clinicians should not discount the possibility of underlying conditions.

Keywords: concussion, soccer, sports-related head injury

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Published
2020-03-05
Section
Case Study