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Concussion headache

Benjamin L Brett, Andrew W Kuhn, Aaron M Yengo-Kahn, Gary S Solomon, Scott L Zuckerman
Objective: The empirical identification of risk factors associated with sport-related concussion (SRC) may improve the management of student-athletes. The current study attempted to identify and quantify bio-cognitive risk factors associated with sustaining a SRC. Methods: Cross-sectional ambispective study; level of evidence, 3. Neurocognitive testing of 12,320 middle school, high school and collegiate athletes was completed at preseason baseline and post-SRC. Univariate and multivariable logistic regressions were used to determine which pre-injury variables accurately predicted the occurrence of SRC...
February 17, 2018: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
Raquel Langdon, Sharief Taraman
After sustaining a concussion or mild traumatic brain injury, headaches are one of the most common complaints. The pathophysiologic changes that occur in the setting of injury likely contribute to or cause posttraumatic headaches. Posttraumatic headaches often present as migraine or tension-type headaches. Unlike pain from other types of injuries, headaches following mild traumatic brain injury are more likely to persist. Preexisting conditions such as migraine and mood disorders may influence posttraumatic headache and complicate management...
February 1, 2018: Pediatric Annals
Nicola J Starkey, Kelly Jones, Rosalind Case, Alice Theadom, Suzanne Barker-Collo, Valery Feigin
OBJECTIVE: Mild traumatic brain injury (mTBI) is common injury during childhood and adolescence but the long-term outcomes are poorly understood. This study examined post-concussive symptoms and behavioural outcomes in children and adolescents up to 24 months post-mTBI. METHOD: Parents of children aged 8-15 years with mTBI completed the BASC-2 and Rivermead Post-Concussion Symptoms Questionnaire at baseline, 1-, 6-, 12- and 24 months post-injury. An age-matched traumatic brain injury-free cohort was recruited and assessed at 12- and 24 months...
February 15, 2018: Brain Injury: [BI]
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
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
Marco Daverio, Franz E Babl, Ruth Barker, Dario Gregori, Liviana Da Dalt, Silvia Bressan
OBJECTIVES: Helmets use has proved effective in reducing head trauma (HT) severity in children riding non-motorised recreational vehicles. Scant data are available on their role in reducing concussive symptoms in children with HT while riding non-motorised recreational vehicles such as bicycles, push scooters and skateboards (BSS). We aimed to investigate whether helmet use is associated with a reduction in acute concussive symptoms in children with BSS-related-HT. METHODS: Prospective study of children <18 years who presented with a BSS related-HT between April 2011 and January 2014 at a tertiary Paediatric Emergency Department (ED)...
January 22, 2018: Brain Injury: [BI]
Suzanne Barker-Collo, Alice Theadom, Nicola Starkey, Michael Kahan, Kelly Jones, Valery Feigin
BACKGROUND: We examined the factor structure of the Rivermead Post-Concussion Symptom Questionnaire (RPQ), the most commonly used measure of post-concussive symptoms, over the first year post-injury. METHOD: Factor analysis (orthogonal rotation) was used to examine the RPQ items that form coherent subsets/factors within 2-weeks, and 1, 6, and 12-months post-mTBI in 527 adults (age >16 years). RESULTS: At baseline, three factors accounted for 63...
January 22, 2018: Brain Injury: [BI]
Réjean M Guerriero, Karameh Kuemmerle, Michael J Pepin, Alex M Taylor, Robert Wolff, William P Meehan
The association between preexisting anxiety, depression, and/or neurodevelopmental disorders and symptom duration among younger children who sustain concussions is not well known. The authors conducted a prospective cohort study of 569 patients presenting to a pediatric neurology clinic with the diagnosis of concussion. The authors measured associations between symptom duration and premorbid conditions, as well as gender, age, mechanism of injury, and other factors. Premorbid conditions were common in both age groups...
February 2018: Journal of Child Neurology
Brian L Brooks, Noah Silverberg, Bruce Maxwell, Rebekah Mannix, Ross Zafonte, Paul D Berkner, Grant L Iverson
BACKGROUND: There has been increasing concern regarding the possible effect of multiple concussions on the developing brain, especially for adolescent females. Hypothesis/Purpose: The objectives were to determine if there are differences in cognitive functioning, symptom reporting, and/or sex effects from prior concussions. In a very large sample of youth soccer players, it was hypothesized that (1) there would be no differences in cognitive test performance between those with and without prior concussions, (2) baseline preseason symptoms would be better predicted by noninjury factors than concussion history, and (3) males and females with prior concussions would not have differences in cognition or symptoms...
January 1, 2018: American Journal of Sports Medicine
Temitayo Oyefunmike Oyegbile, Bronson Elizabeth Delasobera, Nassim Zecavati
OBJECTIVES: There are notable gender differences in concussion as well as sleep. Sleep disturbance is a major symptom of post-concussive syndrome. The interplay between sleep disturbance, concussion, and gender has yet to be examined. The objective of this study was to determine whether sleep disturbance plays a role in the known gender differences associated with concussion. METHODS: Males and females (ages 10-35 years) completed a pre-concussion and post-concussion evaluation...
December 2017: Sleep Medicine
James MacDonald, Neha Patel, Julie Young, Emily Stuart
OBJECTIVE: To determine which data collected on an initial patient clinic visit for a sports-related concussion (SRC) might influence physicians to clear an adolescent to return to drive (RTD) after injury. STUDY DESIGN: Retrospective cohort study of 189 adolescents with a SRC referred to a hospital-based concussion clinic between June 1, 2015, and May 31, 2016. Subjects were ≥16 years with a valid driver's license (median age = 16, IQR [16, 17]). Concussion evaluations included Post-Concussion Symptom Scale, modified Balance Error Scoring System, and postinjury computerized neurocognitive testing (CNT)...
March 2018: Journal of Pediatrics
Jeremiah J Johnson, Andrea C Loeffert, Jennifer Stokes, Robert P Olympia, Harry Bramley, Steven D Hicks
Importance: Approximately one-third of children who experience a concussion develop prolonged concussion symptoms. To our knowledge, there are currently no objective or easily administered tests for predicting prolonged concussion symptoms. Several studies have identified alterations in epigenetic molecules known as microRNAs (miRNAs) following traumatic brain injury. No studies have examined whether miRNA expression can detect prolonged concussion symptoms. Objective: To evaluate the efficacy of salivary miRNAs for identifying children with concussion who are at risk for prolonged symptoms...
January 1, 2018: JAMA Pediatrics
Donald Moss
This article presents a case study in which self-hypnosis, hypnosis-assisted psychotherapy, and palliative care strategies were provided within a multi-modal integrative treatment program for a 38-year-old woman with traumatic brain injury (TBI) secondary to motor vehicle accident. Self-hypnosis was helpful in anxiety reduction and pain management. Hypnosis-assisted psychotherapy was beneficial in de-sensitizing many post-traumatic memories, and in managing post-concussion pain, including neuropathic pain and post-traumatic migraine headaches...
September 12, 2017: Annals of Palliative Medicine
Catherine D Chong, Visar Berisha, Chia-Chun Chiang, Katherine Ross, Todd J Schwedt
OBJECTIVE: To investigate differences in cortical thickness in patients with persistent post-traumatic headache (PPTH) relative to healthy controls and to interrogate whether cortical morphology relates to headache burden (headache frequency, years with post-traumatic headache, PTH) in patients with PPTH. BACKGROUND: PTHs are one of the most common symptoms following concussion. In some patients, PTHs continue for longer than three months and are classified as PPTH...
January 2018: Headache
Nina Feddermann-Demont, Ruben J Echemendia, Kathryn J Schneider, Gary S Solomon, K Alix Hayden, Michael Turner, Jiří Dvořák, Dominik Straumann, Alexander A Tarnutzer
BACKGROUND: Sport-related concussion (SRC) is a clinical diagnosis made after a sport-related head trauma. Inconsistency exists regarding appropriate methods for assessing SRC, which focus largely on symptom-scores, neurocognitive functioning and postural stability. DESIGN: Systematic literature review. DATA SOURCES: MEDLINE, EMBASE, PsycINFO, Cochrane-DSR, Cochrane CRCT, CINAHL, SPORTDiscus (accessed July 9, 2016). ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Original (prospective) studies reporting on postinjury assessment in a clinical setting and evaluation of diagnostic tools within 2 weeks after an SRC...
June 2017: British Journal of Sports Medicine
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
Christina L Master, Stephen R Master, Douglas J Wiebe, Eileen P Storey, Julia E Lockyer, Olivia E Podolak, Matthew F Grady
OBJECTIVE: Up to one-third of children with concussion have prolonged symptoms lasting beyond 4 weeks. Vision and vestibular dysfunction is common after concussion. It is unknown whether such dysfunction predicts prolonged recovery. We sought to determine which vision or vestibular problems predict prolonged recovery in children. DESIGN: A retrospective cohort of pediatric patients with concussion. SETTING: A subspecialty pediatric concussion program...
October 20, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Jack W Tsao, Lauren A Stentz, Minoo Rouhanian, Robin S Howard, Briana N Perry, F Jay Haran, Paul F Pasquina, Mikias Wolde, Carolyn E Taylor, Radhames Lizardo, Scott Liu, Eusebio Flores, Alia H Creason, Katalina Sher
OBJECTIVE: To examine whether blast exposure alone and blast-associated concussion result in similar neurologic and mental health symptoms. METHODS: A 14-item questionnaire was administered to male US Marines on their return from deployment in Iraq and/or Afghanistan. RESULTS: A total of 2,612 Marines (median age 22 years) completed the survey. Of those, 2,320 (88.9%) reported exposure to ≥1 blast during their current and/or prior deployments...
November 7, 2017: Neurology
Michael Rossiter, Michael Challis
OBJECTIVES: To identify the incidence and mechanisms of concussion in elite Field Hockey in different age groups and also the postconcussion symptoms and recovery times. METHODS: Data was collected retrospectively, for both training and matches, over a 12-month period from national level Field Hockey players across under-16, under-18, under-21, Development and Senior players. Mechanism of injury (including player role and field position), postconcussive symptoms and recovery times were recorded following a semistructured interview with each player...
2017: BMJ Open Sport & Exercise Medicine
Eric Zwemer, Miya Bernson-Leung, Corinna Rea, Archana A Patel, Rejean Guerriero, David K Urion, Sara L Toomey
The national shortage of pediatric neurologists is worsening, yet referral rates by pediatricians are high. Suboptimal training of pediatric residents in care of patients with neurologic disease may be a contributing factor. We formed a partnership between the Boston Children's Primary Care at Longwood clinic and Child Neurology Residency Training Program. The educational intervention included lectures, observed neurologic examinations, in-person and virtual triage, and an electronic medical record-based consult system...
January 2018: Clinical Pediatrics
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