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Postconcussion syndrome

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https://www.readbyqxmd.com/read/29864098/activity-and-exercise-intolerance-after-concussion-identification-and-management-of-postural-orthostatic-tachycardia-syndrome
#1
Nicole A Miranda, Jeffrey R Boris, Kristen M Kouvel, Lauren Stiles
BACKGROUND AND PURPOSE: Postural orthostatic tachycardia syndrome (POTS) is increasingly recognized as a complication affecting recovery from concussion. Individuals with POTS demonstrate refractory dizziness, lightheadedness, cognitive dysfunction, fatigue, headache, chronic pain, nausea and gastrointestinal dysmotility, activity and exercise intolerance, syncope, and tachycardia. Subtypes of POTS may include hypovolemia, hyperadrenergic states, autonomic neuropathy, and underlying autoimmunity, which may variably impact response to rehabilitation in varying ways...
June 1, 2018: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/29770251/review-of-the-neurological-benefits-of-phytocannabinoids
#2
REVIEW
Joseph Maroon, Jeff Bost
Background: Numerous physical, psychological, and emotional benefits have been attributed to marijuana since its first reported use in 2,600 BC in a Chinese pharmacopoeia. The phytocannabinoids, cannabidiol (CBD), and delta-9-tetrahydrocannabinol (Δ9-THC) are the most studied extracts from cannabis sativa subspecies hemp and marijuana. CBD and Δ9-THC interact uniquely with the endocannabinoid system (ECS). Through direct and indirect actions, intrinsic endocannabinoids and plant-based phytocannabinoids modulate and influence a variety of physiological systems influenced by the ECS...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29694459/characterizing-hospitalizations-for-pediatric-concussion-and-trends-in-care
#3
Tara Rhine, Terri Byczkowski, Mekibib Altaye, Shari L Wade, Lynn Babcock
BACKGROUND: Children hospitalized for concussion may be at a higher risk for persistent symptoms, but little is known about this subset of children. OBJECTIVE: Delineate a cohort of children admitted for concussion, describe care practices received, examine factors associated with prolonged length of stay (LOS) or emergency department (ED) readmission, and investigate changes in care over time. DESIGN, SETTING: Retrospective analysis of data submitted by 40 pediatric hospitals to the Pediatric Health Information System...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29432249/pediatric-traumatic-brain-injury-and-concussion
#4
Meeryo Choe, Karen M Barlow
PURPOSE OF REVIEW: This article summarizes the impact and complications of mild traumatic brain injury and concussion in children and outlines the recent evidence for its assessment and early management. Useful evidence-based management strategies are provided for children who have a typical recovery following concussion as well as for those who have persistent postconcussion syndrome. Cases are used to demonstrate the commonly encountered pathologies of headache, cognitive issues, and mood disturbances following injury...
February 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29411374/a-survey-of-neurologists-on-postconcussion-syndrome
#5
Randolph W Evans, Kamalika Ghosh
BACKGROUND AND OBJECTIVES: Postconcussion syndrome (PCS) has been controversial for more than 150 years. As there have not been any surveys of PCS among neurologists in the United States since 1992, another was performed using most of the prior items to assess current opinions and practices and whether there have been any changes since 1992. METHODS: Two hundred and eighty-nine neurologists attending the Texas Neurological Society 20th Annual Winter Conference continuing medical education meeting in 2017 were supplied the survey instrument with registration materials...
February 7, 2018: Headache
https://www.readbyqxmd.com/read/29385018/quantitative-volumetric-imaging-and-clinical-outcome-characterization-of-symptomatic-concussion-in-10-to-14-year-old-adolescent-athletes
#6
Christine L Mac Donald, Jason Barber, Jason Wright, David Coppel, Nina De Lacy, Steve Ottinger, Suzanne Peck, Chris Panks, Kody Zalewski, Samantha Sun, Nancy Temkin
OBJECTIVE: Prior work suggests that younger athletes may be more vulnerable to postconcussive syndrome. We investigated measures of clinical outcome and quantitative volumetric imaging in 10- to 14-year-old adolescent athletes to better understand the impact of concussion on this younger population. SETTING: Outpatient clinics. PARTICIPANTS: Ten- to 14-year-old symptomatic pediatric sports concussion patients and typically developing active controls...
January 30, 2018: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/29248884/use-of-general-practice-before-and-after-mild-traumatic-brain-injury-a-nationwide-population-based-cohort-study-in-denmark
#7
Stine Fjendbo Galili, Bodil Hammer Bech, Claus Vestergaard, Morten Fenger-Gron, Jakob Christensen, Mogens Vestergaard, Jette Ahrensberg
OBJECTIVES: Traumatic brain injury (TBI) is commonly seen in the emergency department (ED). Approximately 85%-90% of TBIs are mild (mTBI). Some cause symptoms such as headache, dizziness, anxiety, blurred vision, insomnia and concentration difficulties, collectively known as postconcussion syndrome (PCS). Some studies suggest that recovery from mTBI is complete. Others find that symptoms persist for months, even years. The aim of this study was to describe the use of general practice, before and after mTBI, as a proxy for symptoms in a large cohort...
December 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29192541/chronic-post-traumatic-headache-in-children-and-adolescents-systematic-review-of-prevalence-and-headache-features
#8
Lauren Shaw, Maria Morozova, Ishaq Abu-Arafeh
The aim of this systematic review is to determine the prevalence and clinical features of chronic post-traumatic headache (CPTH) in children and adolescents. Literature search of PubMed, Embase, Cochrane databases and Google Scholar was carried out for all studies reporting on CPTH in children and young people under the age of 18 years between January 1980 and November 2016. Search command included post-traumatic headache, postconcussion syndrome, child and adolescent. Demographic data, diagnostic criteria of headache disorders, occurrence of headache after head injury and headache phenotypes were collected...
January 2018: Pain Management
https://www.readbyqxmd.com/read/28963310/characteristics-of-patients-included-and-enrolled-in-studies-on-the-prognostic-value-of-serum-biomarkers-for-prediction-of-postconcussion-symptoms-following-a-mild-traumatic-brain-injury-a-systematic-review
#9
Eric Mercier, Pier-Alexandre Tardif, Marcel Emond, Marie-Christine Ouellet, Élaine de Guise, Biswadev Mitra, Peter Cameron, Natalie Le Sage
OBJECTIVE: Mild traumatic brain injury (mTBI) has been insufficiently researched, and its definition remains elusive. Investigators are confronted by heterogeneity in patients, mechanism of injury and outcomes. Findings are thus often limited in generalisability and clinical application. Serum protein biomarkers are increasingly assessed to enhance prognostication of outcomes, but their translation into clinical practice has yet to be achieved. A systematic review was performed to describe the adult populations included and enrolled in studies that evaluated the prognostic value of protein biomarkers to predict postconcussion symptoms following an mTBI...
September 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28878731/head-eye-vestibular-motion-therapy-affects-the-mental-and-physical-health-of-severe-chronic-postconcussion-patients
#10
Frederick Robert Carrick, Joseph F Clark, Guido Pagnacco, Matthew M Antonucci, Ahmed Hankir, Rashid Zaman, Elena Oggero
CONTEXT: Approximately 1.8-3.6 million annual traumatic brain injuries occur in the United States. An evidence-based treatment for concussions that is reliable and effective has not been available. OBJECTIVE: The objective of this study is to test whether head-eye vestibular motion (HEVM) therapy is associated with decreased symptoms and increased function in postconcussive syndrome (PCS) patients that have been severely impaired for greater than 6 months after a mild traumatic brain injury...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28760573/work-productivity-loss-after-mild-traumatic-brain-injury
#11
Noah D Silverberg, William J Panenka, Grant L Iverson
OBJECTIVES: To examine the completeness of return to work (RTW) and the degree of productivity loss in individuals who do achieve a complete RTW after mild traumatic brain injury (MTBI). DESIGN: Multisite prospective cohort. SETTING: Outpatient concussion clinics. PARTICIPANTS: Patients (N=79; mean age, 41.5y; 55.7% women) who sustained an MTBI and were employed at the time of the injury. Participants were enrolled at their first clinic visit and assessed by telephone 6 to 8 months postinjury...
February 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28693073/-resting-state-fmri-study-of-emotional-network-in-patients-with-postconcussion-syndrome
#12
X Zhang, R B Qian, X M Fu, B Lin, D Zhang, C S Xia, X P Wei, C S Niu, Y H Wang
Objective: To discuss functional connectivity changes in the emotional network of patients with post-concussion syndrome (PCS) and their clinical significance by resting-state functional magnetic resonance imaging (rs-fMRI). Methods: Twenty-seven patients with PCS were recruited from the Department of Neurosurgery of Anhui provincial hospital affiliated to Anhui medical university from October 2015 to April 2016, and 27 healthy subjects were recruited as the controls. The Hamilton Anxiety Scale (HAMA) and The Hamilton Depression Scale (HAMD) were used to evaluate the emotional state of two groups of subjects...
July 4, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28595276/premorbid-iq-predicts-postconcussive-symptoms-in-oef-oif-ond-veterans-with-mtbi
#13
Jada J Stewart-Willis, Daniel Heyanka, Zoe Proctor-Weber, Heather England, Maya Bruhns
Objective: Extant literature has demonstrated that symptoms of postconcussive syndrome (PCS) persist well beyond the expected 3-month post-injury recovery period in a minority of individuals with mild traumatic brain injury (mTBI). Suboptimal performance on validity measures and pre- and post-injury psychosocial stressors - rather than actual mTBI or current cognitive functioning - have been identified as predictors of chronic PCS. Whether premorbid IQ has any influence on chronic PCS has been understudied, in the context of established psychogenic etiologies...
March 1, 2018: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/28390514/rehabilitation-of-persistent-symptoms-after-concussion
#14
REVIEW
Rebecca N Tapia, Blessen C Eapen
One of the more challenging aspects beyond acute concussion management occurs when symptoms do not resolve as anticipated over time. The term postconcussion syndrome generally refers to a presentation of multiple ongoing symptoms months to years from injury, typically comprised of physical, cognitive, and emotional complaints such as headaches, poor sleep, poor concentration, dizziness, and irritability. Although individual factors vary, the condition is often regarded as multifactorial. Persistent issues can pose a threat to full community reintegration following concussion and reduce overall quality of life; thus early recognition and treatment are essential to optimize long-term outcomes...
May 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28387557/a-physiological-approach-to-prolonged-recovery-from-sport-related-concussion
#15
REVIEW
John Leddy, John G Baker, Mohammad Nadir Haider, Andrea Hinds, Barry Willer
Management of the athlete with postconcussion syndrome (PCS) is challenging because of the nonspecificity of PCS symptoms. Ongoing symptoms reflect prolonged concussion pathophysiology or conditions such as migraine headaches, depression or anxiety, chronic pain, cervical injury, visual dysfunction, vestibular dysfunction, or some combination of these. In this paper, we focus on the physiological signs of concussion to help narrow the differential diagnosis of PCS in athletes. The physiological effects of exercise on concussion are especially important for athletes...
March 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28295837/compromised-hippocampus-striatum-pathway-as-a-potential-imaging-biomarker-of-mild-traumatic-brain-injury-and-posttraumatic-stress-disorder
#16
MULTICENTER STUDY
D Rangaprakash, Gopikrishna Deshpande, Thomas A Daniel, Adam M Goodman, Jennifer L Robinson, Nouha Salibi, Jeffrey S Katz, Thomas S Denney, Michael N Dretsch
OBJECTIVES: Military service members risk acquiring posttraumatic stress disorder (PTSD) and mild-traumatic brain injury (mTBI), with high comorbidity. Owing to overlapping symptomatology in chronic mTBI or postconcussion syndrome (PCS) and PTSD, it is difficult to assess the etiology of a patient's condition without objective measures. Using resting-state functional MRI in a novel framework, we tested the hypothesis that their neural signatures are characterized by functionally hyperconnected brain regions which are less variable over time...
June 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28283595/astroglial-activation-and-altered-amyloid-metabolism-in-human-repetitive-concussion
#17
MULTICENTER STUDY
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
https://www.readbyqxmd.com/read/28207508/concussion-mild-traumatic-brain-injury-related-chronic-pain-in-males-and-females-a-diagnostic-modelling-study
#18
Tatyana Mollayeva, J David Cassidy, Colin M Shapiro, Shirin Mollayeva, Angela Colantonio
Pain is an unpleasant, complex, and perceived experience that places a significant burden on patients and clinicians. Its severity may be mediated by emotion, attitude, and environmental influences, and pain may be expressed differently in males and females. Traumatic brain injury (TBI) is frequently associated with chronic pain. This diagnostic modeling study examined sex differences in the construct of chronic pain in patients with delayed recovery from concussion/mild traumatic brain injury (mTBI).Data were collected from standardized questionnaires, neuroimaging records, and comprehensive clinical assessments...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28195951/assessment-of-oculomotor-function-in-patients-with-postconcussion-syndrome-a-systematic-review
#19
Foad Taghdiri, Brenda Varriano, Maria Carmela Tartaglia
BACKGROUND: Concussion and its associated sequel, postconcussion syndrome (PCS), have a debilitating impact on the lives of concussed patients. However, a diagnostic biomarker for this condition is lacking. Recently, there has been a surge of interest in using oculomotor function testing as an objective assessment of patients with PCS. OBJECTIVES: To systematically synthesize, appraise, and summarize all published empirical studies that have assessed alteration of oculomotor functions in patients with PCS...
February 10, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28122826/uncoupling-between-cerebral-perfusion-and-oxygenation-during-incremental-exercise-in-an-athlete-with-postconcussion-syndrome-a-case-report
#20
Sarah Imhoff, Simon Malenfant, Éric Nadreau, Paul Poirier, Damian M Bailey, Patrice Brassard
High-intensity exercise may pose a risk to patients with postconcussion syndrome (PCS) when symptomatic during exertion. The case of a paralympic athlete with PCS who experienced a succession of convulsion-awakening periods and reported a marked increase in postconcussion symptoms after undergoing a graded symptom-limited aerobic exercise protocol is presented. Potential mechanisms of cerebrovascular function failure are then discussed.
January 2017: Physiological Reports
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