It’s that time of the year again. Football has started up, baseball is winding down, and stories about professional sports injuries are appearing in the news.

Two recent sports injuries grabbed our attention because each called for the player to undergo a CT scan. The first involved Baltimore Orioles’ second baseman, Robert Andino. During the ninth inning of a recent game, Andino was hit in the back of his helmet by a 94-MPH fastball. The player was rushed to a local hospital for a CT scan, which was negative. However, Andino had to have a concussion test before being cleared to play again.

The second injury involved Dallas Cowboys’ player, Jason Witten, who was hit hard in the side during a preseason opener resulting in a lacerated spleen. Before Witten was allowed to play in another game, he was scheduled to have a CT scan.

We asked ZPR’s Chief Medical Officer, Dr. Elizabeth Maltin, why the scans were ordered and what they were looking for.

Regarding the Orioles’ Andino, “The CT scan of the head was ordered to see whether there was any bleeding around or within the brain,” said Maltin. “Even though the results were negative, the player may still suffer a concussion, which is a clinical rather than an imaging diagnosis,” she continued. “That’s why he was scheduled for a ‘concussion test,’ which is a clinical neurologic and cognitive exam that is based on the patient’s symptoms, the physician’s observations and the mental functioning of the patient. There is a phenomenon known as ‘second impact syndrome’ which refers to increased risk of traumatic brain injury (TBI) after a concussion. Players sent back to play before fully recovering from the original injury are at a greatly increased risk of TBI if they sustain a second hit to the head. This can potentially be fatal.”

Maltin pointed out that the American Academy of Neurology (AAN) has adopted recommendations for “The Management of Concussion in Sports” that are designed to prevent second impact syndrome and reduce the frequency of other cumulative brain injuries related to sports.

And what about Dallas Cowboys’ tight end, Jason Witten, and his lacerated spleen? “Again, they are looking for bleeding,” said Maltin. “The spleen is a highly vascular organ and lacerations can improve or get worse. Most isolated splenic injuries can be managed conservatively (non-surgically), which means watch and wait. The patient is observed for any sign of internal bleeding which would indicate a worsening of the splenic injury. Repeat CT scans are important in evaluating the athlete prior to returning to contact sports. An injured spleen requires five weeks of healing to be as strong as an uninjured spleen. The surgical literature supports repeat CT scanning at eight weeks post injury to ensure complete resolution of the injury.”

ZPR is pleased to report that both players were cleared for play and are back in the game. In the future, we’ll be looking at other sports injuries in the news and helping to explain them. If you have any questions, we’d be happy to answer them. Email us at