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Concussion prevention and management

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128 papers 500 to 1000 followers
By Faye Kehler Family Physician and GP Anesthetist since 1987 interested in all aspects of Medicine
David R Howell, Louis R Osternig, Li-Shan Chou
BACKGROUND: Age has been described as a factor that affects recovery after concussion. The recommended management protocol is to treat adolescents in a more cautious manner than adults. However, few studies have prospectively and longitudinally assessed the way these age groups perform on motor tasks after concussion. PURPOSE: To examine dual-task gait balance control deficits after concussion in a group of adolescents and young adults in reference to matched control subjects within 72 hours of injury and throughout 2 months after injury...
March 2015: American Journal of Sports Medicine
James L Farnsworth, Lucas Dargo, Brian G Ragan, Minsoo Kang
No abstract text is available yet for this article.
May 2016: Medicine and Science in Sports and Exercise
John-Ross Rizzo, Todd E Hudson, Weiwei Dai, Ninad Desai, Arash Yousefi, Dhaval Palsana, Ivan Selesnick, Laura J Balcer, Steven L Galetta, Janet C Rucker
OBJECTIVE: Concussion is a major public health problem and considerable efforts are focused on sideline-based diagnostic testing to guide return-to-play decision-making and clinical care. The King-Devick (K-D) test, a sensitive sideline performance measure for concussion detection, reveals slowed reading times in acutely concussed subjects, as compared to healthy controls; however, the normal behavior of eye movements during the task and deficits underlying the slowing have not been defined...
March 15, 2016: Journal of the Neurological Sciences
Pashtun Shahim, Yelverton Tegner, Niklas Marklund, Kina Höglund, Erik Portelius, David L Brody, Kaj Blennow, Henrik Zetterberg
OBJECTIVE: To determine whether postconcussion syndrome (PCS) due to repetitive concussive traumatic brain injury (rcTBI) is associated with CSF biomarker evidence of astroglial activation, amyloid deposition, and blood-brain barrier (BBB) impairment. METHODS: A total of 47 participants (28 professional athletes with PCS and 19 controls) were assessed with lumbar puncture (median 1.5 years, range 0.25-12 years after last concussion), standard MRI of the brain, and Rivermead Post-Concussion Symptoms Questionnaire (RPQ)...
April 11, 2017: Neurology
Laura Purcell, Jamie Kissick, John Rizos
No abstract text is available yet for this article.
August 6, 2013: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Anne M Grool, Mary Aglipay, Franco Momoli, William P Meehan, Stephen B Freedman, Keith Owen Yeates, Jocelyn Gravel, Isabelle Gagnon, Kathy Boutis, Willem Meeuwisse, Nick Barrowman, Andrée-Anne Ledoux, Martin H Osmond, Roger Zemek
Importance: Although concussion treatment guidelines advocate rest in the immediate postinjury period until symptoms resolve, no clear evidence has determined that avoiding physical activity expedites recovery. Objective: To investigate the association between participation in physical activity within 7 days postinjury and incidence of persistent postconcussive symptoms (PPCS). Design, Setting, and Participants: Prospective, multicenter cohort study (August 2013-June 2015) of 3063 children and adolescents aged 5...
December 20, 2016: JAMA: the Journal of the American Medical Association
Rachel E Ventura, Laura J Balcer, Steven L Galetta
Concussion may lead to subtle changes in brain function, and tests involving the visual system probe higher cortical functioning and increase our sensitivity in detecting these changes. Concussions are acutely and sometimes more persistently associated with abnormalities in balance, cognition, and vision. The visual system involves roughly half of the brain's circuits, including many regions susceptible to head impacts. After a concussion, the neuro-ophthalmologic exam commonly detects abnormalities in convergence, accommodation, the vestibulo-ocular reflex, ocular muscle balance, saccades, and pursuit...
October 2015: Seminars in Neurology
John-Ross Rizzo, Todd E Hudson, Weiwei Dai, Joel Birkemeier, Rosa M Pasculli, Ivan Selesnick, Laura J Balcer, Steven L Galetta, Janet C Rucker
OBJECTIVE: The King-Devick (KD) test, which is based on rapid number naming speed, is a performance measure that adds vision and eye movement assessments to sideline concussion testing. We performed a laboratory-based study to characterize ocular motor behavior during the KD test in a patient cohort with chronic concussion to identify features associated with prolonged KD reading times. METHODS: Twenty-five patients with a concussion history (mean age: 31) were compared to control participants with no concussion history ( n = 42, mean age: 32)...
October 2016: Annals of Clinical and Translational Neurology
Jon Patricios, Gordon Ward Fuller, Richard Ellenbogen, Stanley Herring, Jeffrey S Kutcher, Mike Loosemore, Michael Makdissi, Michael McCrea, Margot Putukian, Kathryn J Schneider
BACKGROUND: Sideline detection is the first and most significant step in recognising a potential concussion and removing an athlete from harm. This systematic review aims to evaluate the critical elements aiding sideline recognition of potential concussions including screening tools, technologies and integrated assessment protocols. DATA SOURCES: Bibliographic databases, grey literature repositories and relevant websites were searched from 1 January 2000 to 30 September 2016...
March 7, 2017: British Journal of Sports Medicine
Jason M Matuszak, Jennifer McVige, Jacob McPherson, Barry Willer, John Leddy
CONTEXT: With heightened awareness of concussion, there is a need to assess and manage the concussed patient in a consistent manner. Unfortunately, concussion physical examination has not been standardized or supported by evidence. Important questions remain about the physical examination. EVIDENCE ACQUISITION: Review of ClinicalKey, Cochrane, MEDLINE, and PubMed prior to July 2015 was performed using search terms, including concussion, mTBI, physical examination, mental status, cranial nerves, reflexes, cervical, vestibular, and oculomotor...
May 2016: Sports Health
Tej D Azad, Amy Li, Arjun V Pendharkar, Anand Veeravagu, Gerald A Grant
BACKGROUND: Few neurologic diseases have captured the nation's attention more completely than chronic traumatic encephalopathy (CTE), which has been discovered in the autopsies of professional athletes, most notably professional football players. The tragic case of Junior Seau, a Hall of Fame, National Football League linebacker, has been the most high-profile confirmed case of CTE. Here we describe Seau's case, which concludes an autopsy conducted at the National Institutes of Health that confirmed the diagnosis...
February 2016: World Neurosurgery
Lauriane Auvergne, Andrey V Bortsov, Jacob C Ulirsch, David A Peak, Jeffrey S Jones, Robert A Swor, Robert M Domeier, David C Lee, Niels K Rathlev, Phyllis L Hendry, Samuel A McLean
OBJECTIVES: To determine the influence of epidemiologic factors and the influence of genetic variants affecting FKBP5, a protein known to modulate hypothalamic-pituitary-adrenocortical axis function, on the severity of somatic symptoms commonly termed "postconcussive" 6 and 12 months after motor vehicle collision (MVC). METHODS: European Americans 18 to 65 years of age who presented to one of eight emergency departments (EDs) after MVC were enrolled. Exclusion criteria included hospital admission...
January 2016: Psychosomatic Medicine
Christian Oldenburg, Anders Lundin, Gunnar Edman, Catharina Nygren-de Boussard, Aniko Bartfai
PRIMARY OBJECTIVE: Having three or more persisting (i.e. > 3 months) post-concussion symptoms (PCS) affects a significant number of patients after a mild traumatic brain injury (mTBI). A common complaint is cognitive deficits. However, several meta-analyses have found no evidence of long-term cognitive impairment in mTBI patients. The study sought to answer two questions: first, is there a difference in cognitive performance between PCS and recovered mTBI patients? Second, is lower cognitive reserve a risk factor for developing PCS? RESEARCH DESIGN: Prospective inception cohort study...
2016: Brain Injury: [BI]
Shweta Bharadwaj, Joshua Rocker
PURPOSE OF REVIEW: We review recommendations from recent publications on the evaluation of minor head trauma. We focus on the risks of radiation from computed tomographies (CTs), the establishment of patient risk stratifications to help guide the necessity of emergent neuroimaging, and current thoughts regarding concussions. RECENT FINDINGS: Pediatric minor head injury is a common complaint in ambulatory settings. There is a significant amount of parental and practitioner anxiety regarding prognosis and whether or not to obtain CT imaging...
February 2016: Current Opinion in Pediatrics
Adam W Kiefer, Kim Barber Foss, Amit Reches, Brooke Gadd, Michael Gordon, Ken Rushford, Ilan Laufer, Michal Weiss, Gregory D Myer
Children and adolescent athletes are at a higher risk for concussion than adults, and also experience longer recovery times and increased associated symptoms. It has also recently been demonstrated that multiple, seemingly mild concussions may result in exacerbated and prolonged neurological deficits. Objective assessments and return-to-play criteria are needed to reduce risk and morbidity associated with concussive events in these populations. Recent research has pushed to study the use of electroencephalography as an objective measure of brain injury...
2015: Frontiers in Neurology
Daniel R Westfall, John D West, Jessica N Bailey, Todd W Arnold, Patrick A Kersey, Andrew J Saykin, Brenna C McDonald
PURPOSE: The neural substrate of post-concussive symptoms following the initial injury period after mild traumatic brain injury (mTBI) in pediatric populations remains poorly elucidated. This study examined neuropsychological, behavioral, and brain functioning in adolescents post-mTBI to assess whether persistent differences were detectable up to a year post-injury. METHODS: Nineteen adolescents on average 7.5 months post-mTBI completed neuropsychological testing and an fMRI auditory-verbal N-back working memory task...
2015: Journal of Pediatric Rehabilitation Medicine
Heidi K Blume
Concussion and mild traumatic brain injury (TBI) are common pediatric injuries. Headaches are one of the most common and disabling complaints following concussion in the acute phase and are pervasive in those who have prolonged symptoms following concussion. The body of evidence regarding the epidemiology of and risk factors for pediatric concussion and post-traumatic headache is growing rapidly, but there still is a distinct lack of strong scientific evidence to support the best treatment strategies for post-traumatic headaches in either children or adults...
September 2015: Current Pain and Headache Reports
D Kimberley Molina, Vincent J M DiMaio
There has been much recent attention regarding "concussions" and the role they may play in death. As most medical professionals are aware, concussions exist on a spectrum ranging from minimal or no loss of consciousness with no residual sequelae to diffuse axonal injury and sudden death. The location on the spectrum depends not only on the nature of the impact or blow but also on the state of the individual impacted. Three previous reports have illustrated 7 deaths due to blunt force head trauma with acute ethanol intoxication (postconcussive apnea)...
December 2015: American Journal of Forensic Medicine and Pathology
Philip E Stieg
No abstract text is available yet for this article.
September 2014: Cerebrum: the Dana Forum on Brain Science
Jameson D Voss, Joseph Connolly, Karen A Schwab, Ann I Scher
Mild traumatic injuries to the brain (e.g., concussion) are common and have been recognized since antiquity, although definitions have varied historically. Nonetheless, studying the epidemiology of concussion helps clarify the overall importance, risk factors, and at-risk populations for this injury. The present review will focus on recent findings related to the epidemiology of concussion including definition controversies, incidence, and patterns in the population overall and in the military and athlete populations specifically...
July 2015: Current Pain and Headache Reports
2015-06-20 22:57:37
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