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Concussion clinic

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By David Rhine MD FRCPC. Emergency medicine. Special interest in concussion management.
Pierre Frémont
No abstract text is available yet for this article.
March 2019: Canadian Family Physician Médecin de Famille Canadien
Anthony P Kontos, Alicia Sufrinko, Natalie Sandel, Kouros Emami, Michael W Collins
Sport-related concussion (SRC) is a heterogeneous injury that involves varied symptoms and impairment that presents a significant clinical challenge to sports medicine professionals. In response to this challenge, clinical researchers have proposed clinical profiles or subtype models for assessing and treating athletes with SRC. One such model emphasizes five concussion clinical profiles including cognitive/fatigue, vestibular, ocular, migraine, and anxiety/mood. Sleep is a common modifier that co-occurs across these clinical profiles...
March 2019: Current Sports Medicine Reports
Alicia M Sufrinko, Erin K Howie, Daniel B Charek, R J Elbin, Michael W Collins, Anthony P Kontos
OBJECTIVE: Evaluate mobile ecological momentary assessment (mEMA) as an approach to measure sport-related concussion (SRC) symptoms, explore the relationships between clinical outcomes and mEMA, and determine whether mEMA was advantageous for predicting recovery outcomes compared to traditional symptom report. SETTING: Outpatient concussion clinic. PARTICIPANTS: 20 athletes aged 12 to 19 years with SRC. METHODS: Prospective study of mEMA surveys assessing activity and symptoms delivered via mobile application (3 time blocks daily) and clinical assessment at visit 1 (<72 hours postinjury) and visit 2 (6-18 days postinjury)...
February 27, 2019: Journal of Head Trauma Rehabilitation
Max N Yang, Brian Parrish, Wei Yang
Objectives: Population-based research on the relationship between concussions and self-harm, depression, and suicidal behaviors among adolescents is limited. Methods: A statewide Youth Risk Behavior Surveillance Survey (YRBSS) was conducted among students from 98 high schools in Nevada in 2017. Students were asked if they had a concussion from playing a sport as well as their mental health outcomes 12 months before the survey. Weighted multiple logistic regression was used to assess the relationship between experiencing a concussion and adverse mental health outcomes...
March 1, 2019: American Journal of Health Behavior
Einat Yehene, Gal Lichtenstern, Yirmi Harel, Eran Druckman, Yaron Sacher
Recovery from mild traumatic brain injury (mTBI) and regaining emotional equilibrium afterward can take much longer than the typical three months. Recent works attribute persisting complaints to psychological factors, primarily the negative perception of mTBI. However, research has yet to demonstrate how self-beliefs concerning capability are linked to perception and ability to accept injury. The objective of this study was to investigate how perceived general self-efficacy (GSE) and acceptance of disability (AD) relate to emotional outcome following mTBI...
February 26, 2019: Applied Neuropsychology. Adult
Russell E Banks, Delfina C Domínguez
Concussion is a transitory brain injury resulting from a blow to the head. Concussion is considered a mild traumatic brain injury (mTBI), which is self-limited. Repetitive mTBI has been associated with chronic, progressive neurological damage. Extreme biochemical changes occur in neuron cells as a result of mTBI. These metabolic disturbances may reflect the symptoms observed in patients who had suffered concussions. However, it has been difficult to correlate clinical signs and symptoms. Currently, there are no laboratory tests to diagnose concussion, though several biomarkers are being investigated...
February 14, 2019: Seminars in Speech and Language
Mitul Kapadia, Alison Scheid, Eric Fine, Rachel Zoffness
PURPOSE OF REVIEW: Post-concussion syndrome (PCS), when the patient's concussion symptoms last longer than 4-6 weeks, affects 10-30% of concussion patients. PCS presents a significant source of morbidity to patients and a management challenge to providers. In this review, we present the current evidence and best management approaches for pediatric PCS. RECENT FINDINGS: There is limited high-quality evidence in pediatric PCS. There is some evidence supporting pharmaceutical management of post-traumatic headaches, cognitive symptoms, and emotional symptoms...
February 13, 2019: Current Reviews in Musculoskeletal Medicine
Rami Burstein, Rodrigo Noseda, Anne B Fulton
BACKGROUND: Photophobia is commonly associated with migraine, meningitis, concussion, and a variety of ocular diseases. Advances in our ability to trace multiple brain pathways through which light information is processed have paved the way to a better understanding of the neurobiology of photophobia and the complexity of the symptoms triggered by light. PURPOSE: The purpose of this review is to summarize recent anatomical and physiological studies on the neurobiology of photophobia with emphasis on migraine...
March 2019: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Phillip R Worts, Scott O Burkhart, Jeong-Su Kim
Clinical management of concussion has evolved over the last 20 years, and complete cognitive and physical rest remains a common clinical recommendation. The duration of rest may vary widely, from 24-48 h to several weeks or until the patient's symptoms have resolved or returned to near baseline levels. Following a period of rest, a stepwise progression of exercise is used for gradual return to play or to work. Previous research in healthy people suggested that prolonged periods of physical inactivity consistently induced deleterious physiological and psychological effects...
February 11, 2019: Sports Medicine
Tyler A Wood, Katherine L Hsieh, Ruopeng An, Randy A Ballard, Jacob J Sonoff
OBJECTIVE: To systematically review and quantitatively synthesize the existing evidence of balance and gait alternations lasting more than two weeks following concussion in adults. DESIGN: A systematic review was conducted through PubMed, CINAHL, SPORTDiscus, and Web of Science. Investigations must include adult participants with at least 1 concussion, were measured over 14 days after injury, and reported balance or gait measures. Balance error scoring system (BESS) scores, center of pressure (COP) sway area and displacement, and gait velocity were extracted for the meta-analysis...
February 5, 2019: American Journal of Physical Medicine & Rehabilitation
Kimberly G Harmon, James R Clugston, Katherine Dec, Brian Hainline, Stanley A Herring, Shawn Kane, Anthony P Kontos, John J Leddy, Michael A McCrea, Sourav K Poddar, Margot Putukian, Julie C Wilson, William O Roberts
Sport-related concussion (SRC) is a common injury in recreational and organized sport. Over the past 30 years, there has been significant progress in our scientific understanding of SRC, which in turn has driven the development of clinical guidelines for diagnosis, assessment, and management of SRC. In addition to a growing need for knowledgeable health care professionals to provide evidence-based care for athletes with SRC, media attention and legislation have created awareness and, in some cases, fear about many issues and unknowns surrounding SRC...
March 2019: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Susan A Reid, Robin Callister, Michael G Katekar, Julia M Treleaven
BACKGROUND: Cervicogenic dizziness (CGD) is hard to diagnose as there is no objective test. OBJECTIVE: Can a brief assessment tool be derived from the Dizziness Handicap Inventory (DHI) to assist in screening for CGD? DESIGN: Case-control study with split-sample analysis. METHOD: 86 people with CGD and 86 people with general dizziness completed the DHI as part of the assessment of their dizziness. Descriptive statistics were used to assess how frequently each question on the DHI was answered 'yes' or 'sometimes' by participants with CGD and by participants with general dizziness...
August 2017: Musculoskeletal Science & Practice
Alexander S Reiley, Frank M Vickory, Sarah E Funderburg, Rachel A Cesario, Richard A Clendaniel
Cervicogenic dizziness (CGD) is a clinical syndrome characterized by the presence of dizziness and associated neck pain. There are no definitive clinical or laboratory tests for CGD and therefore CGD is a diagnosis of exclusion. It can be difficult for healthcare professionals to differentiate CGD from other vestibular, medical and vascular disorders that cause dizziness, requiring a high level of skill and a thorough understanding of the proper tests and measures to accurately rule in or rule out competing diagnoses...
2017: Archives of physiotherapy
Kimberly G Harmon, James R Clugston, Katherine Dec, Brian Hainline, Stanley Herring, Shawn F Kane, Anthony P Kontos, John J Leddy, Michael McCrea, Sourav K Poddar, Margot Putukian, Julie C Wilson, William O Roberts
Sport-related concussion (SRC) is a common injury in recreational and organised sport. Over the past 30 years, there has been significant progress in our scientific understanding of SRC, which in turn has driven the development of clinical guidelines for diagnosis, assessment and management of SRC. In addition to a growing need for knowledgeable healthcare professionals to provide evidence-based care for athletes with SRC, media attention and legislation have created awareness and, in some cases, fear about many issues and unknowns surrounding SRC...
February 2019: British Journal of Sports Medicine
Lisa A Brenner, Nazanin H Bahraini
No abstract text is available yet for this article.
January 29, 2019: Nature Reviews. Neurology
Justine B Lawrence, Mohammad N Haider, John J Leddy, Andrea Hinds, Jeffery C Miecznikowski, Barry S Willer
OBJECTIVE: This study investigated the diagnostic and prognostic value of the King-Devick (K-D) test in conjunction with treadmill testing in adolescents after sport-related concussion (SRC) in an outpatient concussion management clinic without baseline measures. DESIGN: Prospective cohort. METHODS: The K-D test was administered pre- and post-exercise on a graded treadmill test to acutely concussed (AC, <10 days from injury, n = 46, 15...
December 22, 2018: Journal of the Neurological Sciences
Sandro J Corti, Natalie M Pizzimenti, Matthew T McCarthy, Kate M Essad, Jeffrey S Kutcher
Despite growing research on concussion, there is minimal evidence comparing the acute presentation of concussion between pediatric and adult patients. This cross-sectional study compares injury characteristics, symptoms, and neurologic examination in sport-related concussion based on age. Patients presenting to an outpatient sports neurology clinic for initial assessment of concussion within 7 days of injury were divided into 2 groups, 18 and older (n = 28) and 17 and younger (n = 107). There were no significant differences between pediatric and adult patients in any score of the Sport Concussion Assessment Tool-3rd Edition symptom scale, neurologic examination category, pertinent elements of past medical history, or characteristics of the concussion...
January 22, 2019: Journal of Child Neurology
Michael Streifer, Allison M Brown, Tara Porfido, Ellen Zambo Anderson, Jennifer Buckman, Carrie Esopenko
Sports-related concussions (SRC) occur due to biomechanical forces to the head or neck that can result in pathophysiological changes in the brain. The musculature of the cervical spine has been identified as one potential factor in reducing SRC risk as well as underlying sex differences in SRC rates. Recent research has demonstrated that linear and rotational head acceleration, as well as the magnitude of force, upon impact is influenced by cervical spine biomechanics. Increased neck strength and girth is associated with reduced linear and rotational head acceleration during impact...
January 15, 2019: Journal of Orthopaedic and Sports Physical Therapy
Seth A Seabury, Étienne Gaudette, Dana P Goldman, Amy J Markowitz, Jordan Brooks, Michael A McCrea, David O Okonkwo, Geoffrey T Manley, Opeolu Adeoye, Neeraj Badjatia, Kim Boase, Yelena Bodien, M Ross Bullock, Randall Chesnut, John D Corrigan, Karen Crawford, Ramon Diaz-Arrastia, Sureyya Dikmen, Ann-Christine Duhaime, Richard Ellenbogen, V Ramana Feeser, Adam Ferguson, Brandon Foreman, Raquel Gardner, Joseph Giacino, Luis Gonzalez, Shankar Gopinath, Rao Gullapalli, J Claude Hemphill, Gillian Hotz, Sonia Jain, Frederick Korley, Joel Kramer, Natalie Kreitzer, Harvey Levin, Chris Lindsell, Joan Machamer, Christopher Madden, Alastair Martin, Thomas McAllister, Randall Merchant, Pratik Mukherjee, Lindsay Nelson, Florence Noel, Eva Palacios, Daniel Perl, Ava Puccio, Miri Rabinowitz, Claudia Robertson, Jonathan Rosand, Angelle Sander, Gabriella Satris, David Schnyer, Mark Sherer, Murray Stein, Sabrina Taylor, Nancy Temkin, Arthur Toga, Alex Valadka, Mary Vassar, Paul Vespa, Kevin Wang, John Yue, Esther Yuh, Ross Zafonte
Importance: Mild traumatic brain injury (mTBI) affects millions of Americans each year. Lack of consistent clinical practice raises concern that many patients with mTBI may not receive adequate follow-up care. Objective: To characterize the provision of follow-up care to patients with mTBI during the first 3 months after injury. Design, Setting, and Participants: This cohort study used data on patients with mTBI enrolled in the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study between February 26, 2014, and August 25, 2016...
May 18, 2018: JAMA network open
Ryan N Moran, Tracey Covassin, Jessica Wallace
OBJECTIVEMigraine history has recently been identified as a risk factor for concussion and recovery. The authors performed a cross-sectional study examining baseline outcome measures on newly developed and implemented concussion assessment tools in pediatrics. The purpose of this study was to examine the effects of premorbid, diagnosed migraine headaches as a risk factor on vestibular and oculomotor baseline assessment in pediatric athletes.METHODSPediatric athletes between the ages of 8 and 14 years with a diagnosed history of migraine headache (n = 28) and matched controls without a history of diagnosed migraine headache (n = 28) were administered a baseline concussion assessment battery, consisting of the Vestibular/Ocular Motor Screening (VOMS), near point of convergence (NPC), and the King-Devick (K-D) tests...
January 11, 2019: Journal of Neurosurgery. Pediatrics
2019-01-17 19:39:52
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