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Mild concussions

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https://www.readbyqxmd.com/read/29152209/case-control-study-hyperbaric-oxygen-treatment-of-mild-traumatic-brain-injury-persistent-post-concussion-syndrome-and-post-traumatic-stress-disorder
#1
Paul G Harch, Susan R Andrews, Edward F Fogarty, Juliette Lucarini, Keith W Van Meter
Mild traumatic brain injury (TBI) persistent post-concussion syndrome (PPCS) and post-traumatic stress disorder (PTSD) are epidemic in United States Iraq and Afghanistan War veterans. Treatment of the combined diagnoses is limited. The aim of this study is to assess safety, feasibility, and effectiveness of hyperbaric oxygen treatments (HBOT) for mild TBI PPCS and PTSD. Thirty military subjects aged 18-65 with PPCS with or without PTSD and from one or more blast-induced mild-moderate traumatic brain injuries that were a minimum of 1 year old and occurred after 9/11/2001 were studied...
July 2017: Medical Gas Research
https://www.readbyqxmd.com/read/29149393/challenges-in-minor-tbi-and-indications-for-head-ct-in-pediatric-tbi-an-update
#2
Navneet Singh, Ash Singhal
INTRODUCTION: Pediatric head trauma is one of the commonest presentations to emergency departments. Over 90% of such head injuries are considered mild, but still present risk acute clinical deterioration and longer term morbidity. Identifying which children are at risk of clinically important brain injuries remains challenging and much of the data on minor head injuries is based on the adult population. CHALLENGES IN PEDIATRICS: Children, however, are different, both anatomically and in terms of mechanism of injury, to adults and, even within the pediatric group, there are differences with age and stage of development...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29149385/pre-clinical-models-in-pediatric-traumatic-brain-injury-challenges-and-lessons-learned
#3
REVIEW
Patrick M Kochanek, Jessica S Wallisch, Hülya Bayır, Robert S B Clark
PURPOSE: Despite the enormity of the problem and the lack of new therapies, research in the pre-clinical arena specifically using pediatric traumatic brain injury (TBI) models is limited. In this review, some of the key models addressing both the age spectrum of pediatric TBI and its unique injury mechanisms will be highlighted. Four topics will be addressed, namely, (1) unique facets of the developing brain important to TBI model development, (2) a description of some of the most commonly used pre-clinical models of severe pediatric TBI including work in both rodents and large animals, (3) a description of the pediatric models of mild TBI and repetitive mild TBI that are relatively new, and finally (4) a discussion of challenges, gaps, and potential future directions to further advance work in pediatric TBI models...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29139355/-post-concussion-syndrome-is-a-neuro-cognitive-condition
#4
EDITORIAL
Line Kirstine Hauptmann, Mahmoud Ashkanian
Post-concussion syndrome (PCS) is often caused by an uncomplicated mild head injury but followed by long-lasting somatic, cognitive and psychiatric symptoms. For many years PCS has been an area of controversy between clinicians. New diagnostic techniques and clinical researches has shed light to some neurobiological aspects behind PCS. In Diagnostic and Statistical Manual of Mental Disorders V PCS is redefined as a neuro-cognitive condition emphasizing the importance of neuropsychological deficits among these patients...
November 13, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29138156/return-to-learn-after-concussion-in-children
#5
Andrew Irvine, Shelina Babul, Ran D Goldman
Question Despite recent interest in the pathophysiology and management of concussion in children, as well as the ongoing concern about return to activity, advice regarding the type and length of cognitive rest has been inconsistent. What should I recommend to the children and adolescents in my clinic regarding cognitive rest following mild concussion? Answer Strict cognitive rest is not needed in those with mild concussion. Evidence suggests a decrease in usual activity to a level that allows children to remain asymptomatic, followed by a gradual return to learning, is appropriate...
November 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29135640/neuromechanical-considerations-for-postconcussion-musculoskeletal-injury-risk-management
#6
Gary B Wilkerson, Dustin R Grooms, Shellie N Acocello
Recent epidemiological studies have documented increased susceptibility to musculoskeletal injury after sport-related concussion, which raises questions about the adequacy of current clinical practices to ensure safe return to sport. A growing body of evidence derived from advanced neuroimaging and neurological assessment methods strongly suggests that mild traumatic brain injury has long-lasting adverse effects that persist beyond resolution of clinical symptoms. Plausible interrelationships among postconcussion changes in brain structure and function support the rationale for specific methods of clinical assessment and training to target the interaction of cognitive and motor function for reduction of musculoskeletal injury risk after concussion...
November 2017: Current Sports Medicine Reports
https://www.readbyqxmd.com/read/29117052/concussions-benefits-of-academic-reentry-plans
#7
Amy Coyle Connell
Purpose of this study was to identify whether children aged 12-14 years benefit from academic reentry plans when returning to school following a mild traumatic brain injury. An integrative review was carried out with data sourced from CINAHL, Medline, Education Full Text, Health Source: Nursing/Academic Edition, and hand searching of references. Abstracts were reviewed for inclusion/exclusion criteria, resulting with six articles appraised and analyzed for this article. The review shows the need for gradual return to physical and cognitive activity postconcussion to facilitate a quicker recovery with fewer postconcussive symptoms...
November 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29108477/hyperthermia-and-mild-traumatic-brain-injury-effects-on-inflammation-and-the-cerebral-vasculature
#8
Jessie Truettner, Helen M Bramlett, W Dalton Dietrich
Mild traumatic brain injury (mTBI) or concussion represents the majority of TBIs brain trauma in the United States. The pathophysiology of mTBI is complex and may include both focal and diffuse injury patterns. In addition to altered circuit dysfunction and diffuse traumatic axonal injury (DTAI), chronic neuroinflammation has also been implicated in the pathophysiology of mTBI. Recently, our laboratory has reported the detrimental effects of mild hyperthermic mTBI in terms of worsening histopathological and behavioral outcomes...
November 6, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29097755/lasting-deficit-in-inhibitory-control-with-mild-traumatic-brain-injury
#9
Benjamin Xu, Marco Sandrini, Sarah Levy, Rita Volochayev, Oluwole Awosika, John A Butman, Dzung L Pham, Leonardo G Cohen
Being able to focus on a complex task and inhibit unwanted actions or interfering information (i.e., inhibitory control) are essential human cognitive abilities. However, it remains unknown the extent to which mild traumatic brain injury (mTBI) may impact these critical functions. In this study, seventeen patients and age-matched healthy controls (HC) performed a variant of the Stroop task and attention-demanding 4-choice response tasks (4CRT) with identical stimuli but two contexts: one required only routine responses and the other with occasional response conflicts...
November 2, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29095055/diffusion-mri-findings-in-patients-with-extensive-and-minimal-post-concussion-symptoms-after-mtbi-and-healthy-controls-a-cross-sectional-study
#10
Erhard Trillingsgaard Næss-Schmidt, Jakob Udby Blicher, Anna Tietze, Charlotte Ulrikka Rask, Susanne Wulff Svendsen, Andreas Schröder, Mille Møller Thastum, Astrid Høeg Tuborgh, Oana-Veronica Frederiksen, Leif Østergaard, Simon Fristed Eskildsen, Brian Hansen, Sune Jespersen, Jørgen Feldbæk Nielsen
PRIMARY OBJECTIVES: We hypothesized that the microstructure of the corpus callosum, thalamus and hippocampus, as measured with diffusion and Mean of the Kurtosis Tensor (MKT) MRI, differs between healthy subjects and patients with extensive and minimal post-concussion symptoms (PCS) and that MKT measures correlate with PCS severity and self-reported cognitive symptoms. RESEARCH DESIGN: A cross-sectional study comparing patients with extensive PCS and patients with minimal PCS 2-5 months after mild traumatic brain injury (mTBI) with each other and with an external healthy control group...
November 2, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29084105/intracranial-pathology-ct-in-emergency-department-patients-with-high-gcs-and-high-standard-assessment-of-concussion-sac-scores
#11
Kenneth C Curley, Brian J OʼNeil, Rosanne Naunheim, David W Wright
OBJECTIVE: To demonstrate that a subpopulation of patients with mild/moderate traumatic brain injury (TBI) had intracranial pathology despite having a Glasgow Coma Scale (GCS) score of 15 and a Standardized Assessment of Concussion (SAC) score of 25 or higher. SETTING: A network of 11 US emergency departments (ED) enrolling patients in a multisite study of TBI. PARTICIPANTS: Men and women between the ages of 18 and 85 years admitted to a participating ED having sustained a closed head injury within the prior 72 hours and a GCS score of 13 to 15 at the time of enrollment...
October 27, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/29084034/risk-factors-for-prolonged-symptoms-of-mild-traumatic-brain-injury-a-pediatric-sports-concussion-clinic-cohort
#12
Shayne D Fehr, Lindsay D Nelson, Kyle R Scharer, Elizabeth A Traudt, Joshua M Veenstra, Sergey S Tarima, Xue-Cheng Liu, Kevin D Walter
OBJECTIVE: To examine predictors of prolonged symptom duration from mild traumatic brain injury (mTBI) in a pediatric sports medicine specialty clinic cohort as these predictors may be distinct in this population. DESIGN: Retrospective chart review. SETTING: Outpatient specialty clinic. PATIENTS: Charts of 549 patients (age range: 10-18 years) with concussions were reviewed in an outpatient clinic that predominantly managed sports-related injuries (77...
October 26, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29074068/an-exploratory-study-of-iv-metoclopramide-diphenhydramine-for-acute-post-traumatic-headache
#13
Benjamin W Friedman, Kayla Babbush, Eddie Irizarry, Deborah White, E John Gallagher
BACKGROUND: Headache is a frequent complaint among the 1.4 million patients who present to US emergency departments (ED) annually following trauma to the head. There are no evidence-based treatments of acute post-traumatic headache. METHODS: This was an ED-based, prospective study of intravenous (IV) metoclopramide 20mg+diphenhydramine 25mg for acute post-traumatic headache. Patients who presented to our EDs with a moderate or severe headache meeting international criteria were enrolled and followed by telephone 2 and 7days later...
October 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29072086/a-pilot-randomized-controlled-trial-of-on-line-interventions-to-improve-sleep-quality-in-adults-after-mild-or-moderate-traumatic-brain-injury
#14
Alice Theadom, Suzanne Barker-Collo, Kelly Jones, Margaret Dudley, Norah Vincent, Valery Feigin
OBJECTIVE: To explore feasibility and potential efficacy of on-line interventions for sleep quality following a traumatic brain injury (TBI). DESIGN: A two parallel-group, randomized controlled pilot study. SETTING: Community-based. SUBJECTS: In all, 24 participants (mean age: 35.9 ± 11.8 years) who reported experiencing sleep difficulties between 3 and 36 months after a mild or moderate TBI. INTERVENTIONS: Participants were randomized to receive either a cognitive behaviour therapy or an education intervention on-line...
October 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/29069278/performance-validity-neurocognitive-disorder-and-post-concussion-symptom-reporting-in-service-members-with-a-history-of-mild-traumatic-brain-injury
#15
Sara M Lippa, Rael T Lange, Louis M French, Grant L Iverson
Objective: To examine the influence of different performance validity test (PVT) cutoffs on neuropsychological performance, post-concussion symptoms, and rates of neurocognitive disorder and postconcussional syndrome following mild traumatic brain injury (MTBI) in active duty service members. Method: Participants were 164 service members (Age: M = 28.1 years [SD = 7.3]) evaluated on average 4.1 months (SD = 5.0) following injury. Participants were divided into three mutually exclusive groups using original and alternative cutoff scores on the Test of Memory Malingering (TOMM) and the Effort Index (EI) from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): (a) PVT-Pass, n = 85; (b) Alternative PVT-Fail, n = 53; and (c) Original PVT-Fail, n = 26...
October 21, 2017: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/29060581/evidence-of-brain-functional-deficits-following-sport-related-mild-traumatic-brain-injury
#16
Tamanna Tabassum Khan Munia, Ali Haider, Reza Fazel-Rezai
Sport related mild traumatic brain injury (mTBI), generally known as a concussion, is a worldwide critical public health concern nowadays. Despite growing concern emphasized by scientific research and recent media presentation regarding mTBI and its effect in athletics life, the management, and prevention of mTBI are still not properly done. The evaluation mainly hampered due to the lack of proper knowledge, subjective nature of assessment tools including the fact that the brain functional deficits after mTBI can be mild or hidden...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29033888/concussion-as-a-multi-scale-complex-system-an-interdisciplinary-synthesis-of-current-knowledge
#17
REVIEW
Erin S Kenzie, Elle L Parks, Erin D Bigler, Miranda M Lim, James C Chesnutt, Wayne Wakeland
Traumatic brain injury (TBI) has been called "the most complicated disease of the most complex organ of the body" and is an increasingly high-profile public health issue. Many patients report long-term impairments following even "mild" injuries, but reliable criteria for diagnosis and prognosis are lacking. Every clinical trial for TBI treatment to date has failed to demonstrate reliable and safe improvement in outcomes, and the existing body of literature is insufficient to support the creation of a new classification system...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29030453/gaba-alterations-in-pediatric-sport-concussion
#18
Seth D Friedman, Andrew V Poliakov, Christopher Budech, Dennis W W Shaw, David Breiger, Thomas Jinguji, Brian Krabak, David Coppel, Tressa Mattioli Lewis, Samuel Browd, Jeffrey G Ojemann
OBJECTIVE: To evaluate whether frontal-lobe magnetic resonance spectroscopy measures of γ-aminobutyric acid (GABA) would be altered in a sample of adolescents scanned after sport concussion because mild traumatic brain injury is often associated with working memory problems. METHODS: Eleven adolescents (age 14-17 years) who had sustained a first-time sport concussion were studied with MRI/magnetic resonance spectroscopy within 23 to 44 days after injury (mean 30...
October 13, 2017: Neurology
https://www.readbyqxmd.com/read/29020848/concussion-alters-the-functional-brain-processes-of-visual-attention-and-working-memory
#19
Priyanka Shah-Basak, Charline Urbain, Simeon Wong, Leodante Da Costa, Elizabeth W Pang, Benjamin Dunkley, Margot Taylor
Millions of North Americans suffer a concussion or a mild traumatic brain injury annually and are at risk of cognitive, emotional and physical sequelae. While fMRI studies have provided an initial framework for examining functional deficits induced by concussion, particularly working memory and attention, the temporal dynamics underlying these deficits are not well understood. We used magnetoencephalography (MEG), a modality with millisecond temporal resolution, in conjunction with a 1-back visual working memory (VWM) paradigm using scenes from everyday life to characterize spatiotemporal functional differences at specific VWM stages, in adults who did or did not suffer a recent concussion...
October 12, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28980825/does-the-fear-avoidance-model-explain-persistent-symptoms-after-traumatic-brain-injury
#20
Melloney L M Wijenberg, Sven Z Stapert, Jeanine A Verbunt, Jennie L Ponsford, Caroline M Van Heugten
BACKGROUND: A minority of patients with mild traumatic brain injury (mTBI) experience a persistent symptom complex also known as post-concussion syndrome. Explanations for this syndrome are still lacking. OBJECTIVE: To investigate if the fear avoidance model, including catastrophizing thoughts and fear avoidance behaviour, poses a possible biopsychosocial explanation for lingering symptoms and delay in recovery after traumatic brain injury (TBI) with special focus on mTBI...
October 5, 2017: Brain Injury: [BI]
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