Acute Subdural Hematoma in a High School Football Player After 2 Unreported Episodes of Head Trauma: A Case Report.

OBJECTIVE: To discuss the association between 2 unreported episodes of head trauma and an acute subdural hematoma in a high school football player; to address the role of the sport health care team in secondary schools when caring for an athlete with head trauma; and to recognize the importance of educating athletes and coaches about this condition. BACKGROUND: A previously healthy athlete experienced 2 unreported episodes of head trauma during a single game. The athlete was conscious and oriented to person, time, and place, but he vomited and complained of severe headache, nausea, and vertigo. During transfer, the athlete appeared to have a seizure. DIFFERENTIAL DIAGNOSIS: Subdural hematoma, epidural hematoma, intracerebral hemorrhage, second-impact syndrome, cervical spine injury, or epilepsy. TREATMENT: Computed tomography scan indicated fluid over the left frontal temporal fossa. Conservative treatment was begun, and the fluid resolved without incident. UNIQUENESS: A single episode of blunt trauma has been thought to cause an acute subdural hematoma. However, multiple concussions can also result in this condition. CONCLUSION: Single or multiple episodes of head trauma can lead to an acute subdural hematoma. This case study reflects the importance of proper education in the recognition and care of head trauma and return-to-play guidelines for athletes and coaches. A sport health care team in all secondary schools can provide the immediate and appropriate intervention for such injuries.