Alani I Jack, Helena T Digney, Carter A Bell, Scott N Grossman, Jacob I McPherson, Ghazala T Saleem, Mohammad N Haider, John J Leddy, Barry S Willer, Laura J Balcer, Steven L Galetta, Neil A Busis, Daniel M Torres
BACKGROUND AND OBJECTIVES: We determined inter-modality (in-person vs telemedicine examination) and inter-rater agreement for telemedicine assessments (2 different examiners) using the Telemedicine Buffalo Concussion Physical Examination (Tele-BCPE), a standardized concussion examination designed for remote use. METHODS: Patients referred for an initial evaluation for concussion were invited to participate. Participants had a brief initial assessment by the treating neurologist...
October 2024: Neurology. Clinical Practice
Haidar M Al-Khazali, Rune H Christensen, David W Dodick, Basit Ali Chaudhry, Anna G Melchior, Rami Burstein, Håkan Ashina
BACKGROUND: Large conductance  calcium-activated potassium (BKCa ) channels have been implicated in the neurobiological underpinnings of migraine. Considering the clinical similarities between migraine and persistent post-traumatic headache (PPTH), we aimed to examine whether MaxiPost (a BKCa channel opener) could induce migraine-like headache in persons with PPTH. METHODS: This is a randomized double-blind, placebo-controlled, two-way crossover study from September 2023 to December 2023...
June 18, 2024: Journal of Headache and Pain
Kerry Glendon, Glen Blenkinsop, Antonio Belli, Matthew Pain
OBJECTIVES: Explore if implementing an individualised Sub-Symptom Heart Rate Threshold (SSHeRT) rehabilitation program within 48 hours versus physical rest for 14 days affects recovery following SRC in university-aged student-athletes. DESIGN: Prospective, observational cohort study. METHODS: Two UK university-aged student-athlete rugby union cohorts were compared (Physical Rest Group (PRG), n = 140, July 2019-March 2020 and Controlled Early-Exercise Group (CEG), n = 167, July 2021-April 2023)...
May 31, 2024: Journal of Science and Medicine in Sport
Michael P Jorgensen, Parissa Safai, Lynda Mainwaring
INTRODUCTION: Initially developed by New Zealand Rugby in 2014, the Blue Card initiative in rugby enables match officials to remove athletes from play if they are suspected to have sustained a concussion. Considerable attention has been paid by sport and health advocates to the possibilities and limitations of this initiative in safeguarding athlete health. However, little if any attention has been paid to the well-being of those responsible for administering the Blue Card (i.e., match officials)...
2024: Frontiers in sports and active living
Bhanu Sharma, Eric Koelink, Carol DeMatteo, Michael D Noseworthy, Brian W Timmons
BACKGROUND: Recent scientific evidence has challenged the traditional "rest-is-best" approach for concussion management. It is now thought that "exercise-is-medicine" for concussion, owing to dozens of studies which demonstrate that sub-maximal, graded aerobic exercise can reduce symptom burden and time to symptom resolution. However, the primary neuropathology of concussion is altered functional brain activity. To date, no studies have examined the effects of sub-maximal aerobic exercise on resting state functional brain activity in pediatric concussion...
June 17, 2024: BMC Sports Science, Medicine and Rehabilitation
Yangjian Cao, Yiping Liu, Liqun Tang, Zhenyu Jiang, Zejia Liu, Licheng Zhou, Bao Yang
BACKGROUND: Accidental impact on a player's head by a powerful soccer ball may lead to brain injuries and concussions during games. It is crucial to assess these injuries promptly and accurately on the field. However, it is challenging for referees, coaches, and even players themselves to accurately recognize potential injuries and concussions following such impacts. Therefore, it is necessary to establish a list of minimum ball velocity thresholds that can result in concussions at different impact locations on the head...
June 11, 2024: Injury
Sushan Nakarmi, Yaohui Wang, Alice Lux Fawzi, Christian Franck, Rika Wright Carlsen
INTRODUCTION: Assessing the survivability of, and potential injury to, a ship's crew from underwater blast is crucial to understanding the operating capability of a military vessel following blast exposure. One form of injury that can occur and affect a crew member's ability to perform tasks is traumatic brain injury (TBI). To evaluate the risk of TBI from underwater blasts, injury metrics based on linear head acceleration have traditionally been used. Although these metrics are popular given their ease of use, they do not provide a direct measure of the tissue-level biomechanical responses that have been shown to cause neuronal injury...
June 15, 2024: Military Medicine
Olivier Brown, Zhuo Fang, Andra Smith, Katherine Healey, Roger Zemek, Andree-Anne Ledoux
PURPOSE: This study investigated the association between psychological resilience and resting-state network functional connectivity of three major brain networks in pediatric concussion. METHODS: This was a substudy of a randomized controlled trial, recruiting children with concussion and orthopedic injury. Participants completed the Connor-Davidson Resilience 10 Scale and underwent magnetic resonance imaging at 72 hours and 4-weeks post-injury. We explored associations between resilience and connectivity with the default-mode (DMN), central executive (CEN), and salience (SN) networks at both timepoints and also any change that occurred over time...
June 14, 2024: Brain Connectivity
Gregory Roe, Sarah Whitehead, Lindsay Starling, David Allan, Matt Cross, Éanna Falvey, Simon Kemp, Cameron Owen, Clint Readhead, Danielle Salmon, Sean Scantlebury, Keith Stokes, Greg Tierney, James Tooby, Ross Tucker, Ben Jones
Instrumented mouthguards (iMGs) are a novel technology being used within rugby to quantify head acceleration events. Understanding practitioners' perceptions of the barriers and facilitators to their use is important to support implementation and adoption. This study assessed men's and women's rugby union and league iMG managers' perceptions of staff and player interest in the technology, data and barriers to use. Forty-six iMG managers (men's rugby union and league n = 20 and n = 9 and women's rugby union and league n = 7 and n = 10) completed an 18-question survey...
June 2024: European Journal of Sport Science
Safira Dharsee, Christianne Laliberté Durish, Ken Tang, Brian L Brooks, Melanie Noel, Ashley L Ware, Miriam Helen Beauchamp, William Craig, Quynh Doan, Stephen B Freedman, Bradley G Goodyear, Jocelyn Gravel, Roger Zemek, Keith Owen Yeates
Protective factors, including psychological resilience, cognitive reserve, and brain reserve, may be positively associated with recovery after pediatric mild traumatic brain injury (mTBI) but have yet to be studied concurrently. We sought to examine these factors as moderators of post-concussive symptoms (PCS) in pediatric mTBI compared to mild orthopedic injury (OI). Participants included 967 children (633 mTBI, 334 OI) aged 8-16.99 years, recruited from 5 Canadian pediatric emergency departments as part of a prospective longitudinal cohort study...
June 14, 2024: Journal of Neurotrauma
Zhanglu Fang, Guanghong Shen, Chengjian Lou, Benson O A Botchway, Qinglin Lu, Qining Yang, Nashwa Amin
Concussions sustained while playing sports are a prominent cause of mild traumatic brain injury (mTBI), which is prevalent among teenagers. The early and intermediate stages of mild traumatic brain injury (mTBI) can be characterized by inflammation, neurodegeneration, and brain tissue edema, which can lead to permanent brain damage. The present study investigated the therapeutic effects of triptolide in mTBI and brain damage recovery. After building mTBI model in male rat, triptolide administrated daily for 1 week in the treated group...
December 2024: IBRO neuroscience reports
Alyssa F Pybus, Sara Bitarafan, Rowan O Brothers, Alivia Rohrer, Arushi Khaitan, Felix Rivera Moctezuma, Kareena Udeshi, Brae Davies, Sydney Triplett, Martin N Griffin, Eric B Dammer, Srikant Rangaraju, Erin M Buckley, Levi B Wood
Repetitive mild traumatic brain injuries (rmTBI) sustained within a window of vulnerability can result in long term cognitive deficits, depression, and eventual neurodegeneration associated with tau pathology, amyloid beta (Aβ) plaques, gliosis, and neuronal and functional loss. However, a comprehensive study relating acute changes in immune signaling and glial reactivity to neuronal changes and pathological markers after single and repetitive mTBIs is currently lacking. In the current study, we addressed the question of how repeated injuries affect the brain neuroimmune response in the acute phase of injury (< 24 h) by exposing the 3xTg-AD mouse model of tau and Aβ pathology to successive (1x-5x) once-daily weight drop closed-head injuries and quantifying immune markers, pathological markers, and transcriptional profiles at 30 min, 4 h, and 24 h after each injury...
June 13, 2024: Journal of Neuroinflammation
Abdullah Khan
CASE PRESENTATION: We present the case of a six-year-old child with autism who presented with persistent vomiting in the setting of a closed head injury (CHI). Computed tomography of the head was normal, but due to persistent vomiting a radiograph of the abdomen was done, which showed multiple, rare-earth magnets in the abdomen. There was no history of witnessed ingestion. These magnets had caused enteroenteric fistula formation leading to persistent vomiting. DISCUSSION: In the setting of CHI, vomiting can be a sign of concussion or intracranial hemorrhage...
May 2024: Clinical Practice and Cases in Emergency Medicine
Gregory Roe, Thomas Sawczuk, Cameron Owen, James Tooby, Lindsay Starling, Mark S Gilthorpe, Éanna Falvey, Sharief Hendricks, Karen Rasmussen, Clint Readhead, Danielle Salmon, Keith Stokes, Ross Tucker, Ben Jones
OBJECTIVES: Describe head acceleration events (HAEs) experienced by professional male rugby union players during tackle, ball-carry, and ruck events using instrumented mouthguards (iMGs). DESIGN: Prospective observational cohort. METHODS: Players competing in the 2023 Currie Cup (141 players) and Super Rugby (66 players) seasons wore iMGs. The iMG-recorded peak linear acceleration (PLA) and peak angular acceleration (PAA) were used as in vivo HAE approximations and linked to contact-event data captured using video analysis...
June 2024: Scandinavian Journal of Medicine & Science in Sports
Stephen F Braden, Brit Long, Julie Rizzo, Michael D April, Bradley A Dengler, Steven Gremel Schauer
BACKGROUND: Traumatic brain injury (TBI) is often underreported or undetected in prehospital civilian and military settings. This study evaluated the incidence of TBI within the Prehospital Trauma Registry (PHTR) system. METHODS: We reviewed PHTR and the linked Department of Defense Trauma Registry (DoDTR) records of casualties from January 2003 through May 2019 for diagnostic data and surgical reports. RESULTS: A total of 709 casualties met inclusion criteria...
June 12, 2024: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Claire V Buddenbaum, Grace O Recht, Adriana K Rodriguez, Sharlene D Newman, Keisuke Kawata
INTRODUCTION: Repetitive head impacts (RHI) have been suggested to increase the risk of developing a neurodegenerative disease, and many of these individuals develop a preceding mental health diagnosis. Given the lack of studies among amateur athletes, this study aimed to examine mental health outcomes in middle-aged amateur athletes who have been exposed to RHI through contact sport participation. METHODS: This is a single site, cohort study involving former amateur athletes aged between 30 and 60 with at least 10 years of organized contact or non-contact sport participation...
2024: Frontiers in Psychiatry
Kimberly G Harmon, Bridget M Whelan, Douglas F Aukerman, Calvin E Hwang, Sourav K Poddar, Anna DeLeo, Heather A Elkington, Gabrielle Garruppo, Marissa Holliday, Jared M Bruce
IMPORTANCE: The Sports Concussion Assessment Tool-5 (SCAT5) has been recommended for concussion evaluation and utilizes both a subjective reported symptom grading scale and objective measures of concussion including a cognitive evaluation: the Standardized Assessment of Concussion (SAC). The SAC includes testing for orientation, immediate memory, concentration, and delayed recall; a 10-word list is used to assess immediate memory and delayed recall. OBJECTIVE: To determine the diagnostic accuracy of components of the SCAT5 and to provide a framework for clinical interpretation...
June 3, 2024: JAMA Network Open
Allyssa K Memmini, Lauren N Bos, Kelleen Maluski, Alexis Ellsworth-Kopkowski, Paola Savvidou, Kristen H Schuyten
INTRODUCTION: Contemporary concussion literature has yet to establish appropriate clinical management guidelines to address the unique needs of performing arts populations, especially at the collegiate level. Therefore, the purpose of this investigation was to collate current evidence regarding post-concussion return to performance management among university-aged performing artists to generate broad clinical implications. METHODS: The research team was comprised of two faculty members in the performing arts, one concussion researcher, and athletic trainer, two university librarians, and one physical therapy graduate student with expertise in post-concussion management among performing arts patients...
June 10, 2024: Journal of Dance Medicine & Science
Aaron J Zynda, Megan C Loftin, Alyssa Pollard-McGrandy, Tracey Covassin, Ransome Eke, Jessica Wallace
BACKGROUND: Concussion is a type of traumatic brain injury (TBI) that can be sustained through sport-related and non-sport-related (e.g., motor vehicle accidents, falls, assaults) mechanisms of injury (MOI). Variations in concussion incidence and MOI may be present throughout the four geographic regions (Midwest, Northeast, South, West) of the United States. However, there is limited evidence exploring concussion cause and diagnosis patterns based on geographic region and MOI. These factors have implications for better understanding the burden of concussion and necessary efforts that can translate to the mitigation of safety concerns...
June 2024: Journal of Safety Research
Mary U Simons, Michael A McCrea, Steven Broglio, Thomas W McAllister, Lindsay D Nelson, Holly Benjamin, Alison Brooks, Thomas Buckley, Kenneth Cameron, Jay Clugston, John DiFiori, Chris D'Lauro, James Eckner, Luis Alejandro Feigenbaum, Christopher Giza, Joseph Hazzard, Thomas Kaminski, Louise Kelly, Anthony Kontos, Christina Master, Jason Mihalik, Christopher Miles, Nicholas Port, Margot Putukian, Adam Susmarski
BACKGROUND: A sport-related concussion (SRC) is a common injury that affects multiple clinical domains such as cognition, balance, and nonspecific neurobehavioral symptoms. Although multidimensional clinical assessments of concussion are widely accepted, there remain limited empirical data on the nature and clinical utility of distinct clinical profiles identified by multimodal assessments. PURPOSE: Our objectives were to (1) identify distinct clinical profiles discernible from acute postinjury scores on the Sport Concussion Assessment Tool (SCAT), composed of a symptom checklist, a cognitive assessment (Standardized Assessment of Concussion), and a balance assessment (Balance Error Scoring System), and (2) evaluate the clinical utility of the identified profiles by examining their association with injury characteristics, neuropsychological outcomes, and clinical management-related outcomes...
June 10, 2024: American Journal of Sports Medicine
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