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Postconcussion syndrome

Tanya Bogoslovsky, Jessica Gill, Andreas Jeromin, Cora Davis, Ramon Diaz-Arrastia
Traumatic brain injury (TBI) is one of the leading causes of death and disability around the world. The lack of validated biomarkers for TBI is a major impediment to developing effective therapies and improving clinical practice, as well as stimulating much work in this area. In this review, we focus on different settings of TBI management where blood or cerebrospinal fluid (CSF) biomarkers could be utilized for predicting clinically-relevant consequences and guiding management decisions. Requirements that the biomarker must fulfill differ based on the intended context of use (CoU)...
October 18, 2016: Diagnostics
James M Bjork, Thomas K Burroughs, Laura M Franke, Treven C Pickett, Sade E Johns, F Gerard Moeller, William C Walker
In military populations, traumatic brain injury (TBI) also holds potential to increase impulsivity and impair mood regulation due to blast injury effects on ventral frontal cortex - to put military personnel at risk for suicide or substance abuse. We assessed a linkage between depression and impaired behavioral inhibition in 117 blast-exposed service members (SM) and veterans with post-concussion syndrome (PCS), where PCS was defined using a Rivermead Postconcussive Symptom Questionnaire (RPQ) modified to clarify whether each symptom worsened compared to pre-blast...
October 7, 2016: Psychiatry Research
Georgina Perez-Garcia, Miguel A Gama Sosa, Rita De Gasperi, Margaret Lashof-Sullivan, Eric Maudlin-Jeronimo, James R Stone, Fatemeh Haghighi, Stephen T Ahlers, Gregory A Elder
The postconcussion syndrome following mild traumatic brain injuries (mTBI) has been regarded as a mostly benign syndrome that typically resolves in the immediate months following injury. However, in some individuals, symptoms become chronic and persistent. This has been a striking feature of the mostly blast-related mTBIs that have been seen in veterans returning from the recent conflicts in Iraq and Afghanistan. In these veterans a chronic syndrome with features of both the postconcussion syndrome and post-traumatic stress disorder has been prominent...
September 28, 2016: Behavioural Brain Research
Michael J Ellis, Dean M Cordingley, Sara Vis, Karen M Reimer, Jeff Leiter, Kelly Russell
OBJECTIVE There were 2 objectives of this study. The first objective was to identify clinical variables associated with vestibulo-ocular dysfunction (VOD) detected at initial consultation among pediatric patients with acute sports-related concussion (SRC) and postconcussion syndrome (PCS). The second objective was to reexamine the prevalence of VOD in this clinical cohort and evaluate the effect of VOD on length of recovery and the development of PCS. METHODS A retrospective review was conducted for all patients with acute SRC and PCS who were evaluated at a pediatric multidisciplinary concussion program from September 2013 to May 2015...
September 30, 2016: Journal of Neurosurgery. Pediatrics
Maya Elin O'Neil, Megan Callahan, Kathleen F Carlson, Mai Roost, Benjamin Laman-Maharg, Elizabeth W Twamley, Grant L Iverson, Daniel Storzbach
OBJECTIVE: This study examined symptom reporting related to the 10th Edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) criteria for postconcussional syndrome (PCS) in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) Veterans. Our aims were to: (a) examine relationships among PCS symptoms by identifying potential subscales of the British Columbia Postconcussion Symptom Inventory (BC-PSI); and (b) examine group differences in BC-PSI items and subscales in Veterans with and without blast exposure, mild traumatic brain injury (mTBI), and posttraumatic stress disorder (PTSD)...
September 28, 2016: Journal of Clinical and Experimental Neuropsychology
Harold M Olson, Michael J Tunning, Ronnie J Boesch
OBJECTIVE: The purpose of this study is to describe the chiropractic management of a student athlete with postconcussion syndrome. CLINICAL FEATURES: A 14-year-old male hockey player presented to a chiropractic clinic with postconcussion symptoms 13 days after his initial injury. He experienced an occipital headache with a pain rating of 8/10, upset stomach, blurry vision, nausea, dizziness, balance problems, a "foggy feeling," difficulty with concentration, difficulty with memory, fatigue, confusion, drowsiness, and irritability...
September 2016: Journal of Chiropractic Medicine
Henrik Zetterberg, Kaj Blennow
Diagnostic and prognostic biomarkers for mild traumatic brain injury (TBI), also known as concussion, remain a major unmet clinical need. Moderate to severe TBI can be diagnosed definitively by clinical assessment and standard neuroimaging techniques that detect the gross damage to the brain parenchyma. Diagnostic tools for mild TBI are lacking and, currently, the diagnosis has to be made on clinical grounds alone, because most patients show no gross pathological changes on CT. Most patients with mild TBI recover quickly, but about 15% develop an ill-defined condition called postconcussive syndrome (PCS)...
October 2016: Nature Reviews. Neurology
Jennifer Strahle, Cormac O Maher
No abstract text is available yet for this article.
September 9, 2016: Journal of Neurosurgery
Antoine Chevalier, Kelly Armstrong, C Norwood-Williams, Raman Gokal
Introduction: This case study offers a detailed comparative analysis of the effects of direct-current electroacupuncture (DC-EA) on the autonomic nervous system (ANS), when DC-EA was applied to the cranial sutures and scars of a patient with a history of ischemic stroke and postconcussion syndrome (PCS) pain. Case: A 56-year-old female suffering from severe tremors and debilitating headaches requested acupuncture after conventional biomedicines failed to relieve her symptoms. Evaluations were performed to check the status of 27 ANS functions...
August 1, 2016: Medical Acupuncture
Xavier A Figueroa, James K Wright
OBJECTIVE: First, to demonstrate that B-level evidence exists for the use of hyperbaric oxygen therapy (HBOT) as an effective treatment in mild to moderate traumatic brain injury/persistent postconcussion syndrome (mTBI/PPCS). Second, to alert readers and researchers that currently used pressurized air controls (≥21% O2, >1.0 ATA) are therapeutically active and cannot be utilized as sham controls without further validation. METHOD: Review of published, peer-reviewed articles of HBOT prospective and controlled clinical trials of mTBI/PPCS symptoms...
September 27, 2016: Neurology
Michael Morin, Pierre Langevin, Philippe Fait
Background. There is a lack of scientific evidence in the literature on the involvement of the cervical spine in mTBI; however, its involvement is clinically accepted. Objective. This paper reviews evidence for the involvement of the cervical spine in mTBI symptoms, the mechanisms of injury, and the efficacy of therapy for cervical spine with concussion-related symptoms. Methods. A keyword search was conducted on PubMed, ICL, SportDiscus, PEDro, CINAHL, and Cochrane Library databases for articles published since 1990...
2016: Journal of Sports Medicine (Hindawi Publishing Corporation)
Michael D Lewis
Traumatic brain injury (TBI), with its diverse heterogeneity and prolonged secondary pathogenesis, remains a clinical challenge. Clinical studies thus far have failed to identify an effective treatment strategy when a combination of targets controlling aspects of neuroprotection, neuroinflammation, and neuroregeneration is needed. Omega-3 fatty acids (n-3FA) offer the advantage of this approach. Although further clinical trial research is needed, there is a growing body of strong preclinical evidence and clinical experience that suggests that benefits may be possible from aggressively adding substantial amounts of n-3FA to optimize the nutritional foundation of TBI, concussion, and postconcussion syndrome patients...
July 2016: Journal of the American College of Nutrition
Geneviève Chaput, Susanne P Lajoie, Laura M Naismith, Gilles Lavigne
Background. Identifying which patients are most likely to be at risk of chronic pain and other postconcussion symptoms following mild traumatic brain injury (MTBI) is a difficult clinical challenge. Objectives. To examine the relationship between pain catastrophizing, defined as the exaggerated negative appraisal of a pain experience, and early MTBI outcome. Methods. This cross-sectional design included 58 patients diagnosed with a MTBI. In addition to medical chart review, postconcussion symptoms were assessed by self-report at 1 month (Time 1) and 8 weeks (Time 2) after MTBI...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
Bruce A Schoneboom, Susan M Perry, William Keith Barnhill, Nicholas A Giordano, Kelly L Wiltse Nicely, Rosemary C Polomano
Chronic noncancer pain (CNCP) in military and veteran populations mirrors the experience of chronic pain in America; however, these two populations have unique characteristics and comorbid conditions such as traumatic brain injuries, postconcussive syndrome, posttraumatic stress disorder, and behavioral health disorders that complicate the diagnosis and treatment of chronic pain. Military members and veterans may also be stigmatized about their conditions and experience problems with integration back into healthy lifestyles and society as a whole following deployments and after military service...
September 2016: Nursing Outlook
Tanju Surmeli, Emin Eralp, Ilham Mustafazade, Ismet Hadi Kos, Gül Elif Özer, Orkun H Surmeli
Postconcussion syndrome (PCS) has been used to describe a range of residual symptoms that persist 12 months or more after the injury, often despite a lack of evidence of brain abnormalities on magnetic resonance imaging and computed tomography scans. In this clinical case series, the efficacy of quantitative EEG-guided neurofeedback in 40 subjects diagnosed with PCS was investigated. Overall improvement was seen in all the primary (Symptom Assessment-45 Questionnaire, Clinical Global Impressions Scale, Hamilton Depression Scale) and secondary measures (Minnesota Multiphasic Personality Inventory, Test of Variables for Attention)...
June 27, 2016: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
Laura Heinmiller, Kammi B Gunton
PURPOSE OF REVIEW: Concussions and their related sequelae have received significant attention given the high-profile media coverage from professional sports and recreational leagues. A better understanding of the diagnosis and symptom management may limit the long-term impact these injuries have on the affected individual. The aim of this review is to provide updated information for both diagnosis and ongoing management for visual symptoms of concussions. RECENT FINDINGS: New testing including a brief vestibular/ocular motor screening assessment and the importance of near point of convergence measurements may prove beneficial to the diagnosis and identification of patients at greater risk for developing postconcussion syndrome...
September 2016: Current Opinion in Ophthalmology
Mary Miller Phillips, Cara Camiolo Reddy
Persistent symptoms following concussion can be debilitating for patients and challenging for clinicians; however, evidence-based approaches to symptom management are emerging. The presentation of postconcussion syndrome can be variable among patients. Given this variability, a thorough history and physical examination are necessary to tailor an individualized treatment approach. Pharmacologic interventions can be considered when prolonged symptoms are negatively affecting quality of life. This article reviews evidence available to guide such treatment decisions...
May 2016: Physical Medicine and Rehabilitation Clinics of North America
Scott L Zuckerman, Aaron M Yengo-Kahn, Thomas A Buckley, Gary S Solomon, Allen K Sills, Zachary Y Kerr
OBJECTIVE Sport-related concussion (SRC) has emerged as a public health problem, especially among student-athletes. Whereas most concussions resolve by 2 weeks, a minority of patients experience postconcussion syndrome (PCS), in which symptoms persist for months. The objective of this study was to elucidate factors predictive of PCS among a sample of National Collegiate Athletic Association (NCAA) student-athletes in the academic years 2009-2010 to 2014-2015. METHODS The SRC data originated from the NCAA Injury Surveillance Program (ISP) in the 2009-2010 to 2014-2015 academic seasons...
April 2016: Neurosurgical Focus
John Leddy, Andrea Hinds, Dan Sirica, Barry Willer
Concussion affects the autonomic nervous system and its control of cerebral blood flow, which may be why uncontrolled activity can exacerbate symptoms after concussion. Traditionally, patients have been advised to restrict physical and cognitive activity until all symptoms resolve. However, recent research suggests that prolonged rest beyond the first couple of days after a concussion might hinder rather than aid recovery. Humans do not respond well to removal from their social and physical environments, and sustained rest adversely affects the physiology of concussion and can lead to physical deconditioning and reactive depression...
March 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Carolyn M Cook, Julie A Suhr
OBJECTIVE: Many non-neurological factors are related to postconcussive syndrome (PCS) symptom report and neuropsychological test performance in mild traumatic brain injury (mTBI). Use of mTBI screening instruments may also contribute to report of PCS symptoms and neuropsychological performance. We examined the impact of randomized PCS screening feedback on PCS symptom report and neuropsychological performance in 152 young adults with no history of mTBI. METHOD: Participants were 158 undergraduates attending a medium-sized Midwestern university who completed the Postconcussive Syndrome Questionnaire (PCSQ) prior to the study and were randomly assigned to one of three conditions...
February 2016: Clinical Neuropsychologist
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