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By Jessica Schwartz Orthopedic residency trained doctor of physical therapy
Robert P Olympia, Robert Wilkinson, Jennifer Dunnick, Brendan J Dougherty, Debra Zauner
OBJECTIVE: The aims of this study were to describe pediatric emergency department (ED) referrals from urgent care centers and to determine the percentage of referrals considered essential and serious. METHODS: A prospective study was conducted between April 2013 and April 2015 on patients younger than 21 years referred directly to an ED in central Pennsylvania from surrounding urgent care centers. Referrals were considered essential or serious based on investigations/procedures performed or medications/consultations received in the ED...
October 8, 2016: Pediatric Emergency Care
Saman Shabani, Ha Son Nguyen, Ninh Doan, Jamie L Baisden
BACKGROUND: The authors present a case of delayed acute subdural hematoma and review all reported cases in the literature. CASE DESCRIPTION: 75-year-old female on daily 81mg ASA who had a fall with LOC. Her GCS was 15 at the time of presentation to the ED. However, due to her post-concussive symptoms, CToH was obtained which was negative for any intracranial hemorrhage or fractures. She was admitted for work-up. The next day, she neurologically deteriorated to GCS of 6...
August 24, 2016: World Neurosurgery
Karen Barlow, Lorenzo D Marcil, Helen L Carlson, Deborah Dewey, Frank P MacMaster, Brian L Brooks, Marc Lebel
The biology of post-concussive symptoms is unclear. Symptoms are often increased during activities, and have been linked to decreased cerebrovascular reactivity and perfusion. The aim of this study was to examine cerebral blood flow (CBF) in children with different clinical recovery patterns following mild traumatic brain injury (mTBI). This was a prospective controlled cohort study of children with mTBI (ages 8 to 18 years) who were symptomatic with post concussive symptoms at one month post-injury (symptomatic, n=27) and children who had recovered quickly (asymptomatic, n=24)...
August 23, 2016: Journal of Neurotrauma
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)
Robert W Westermann, Zachary Y Kerr, Peter Wehr, Annuziato Amendola
BACKGROUND: Sports-related concussions (SRCs) have gained increased societal interest in the past decade. The National Collegiate Athletic Association (NCAA) has implemented legislation and rule changes to decrease the incidence and risk of head injury impacts. The "targeting" rule forbids initiating contact with the crown of a helmet and targeting defenseless players in the head and neck area; however, there are concerns that this rule change has unintentionally led to an increased incidence of lower extremity injuries...
August 10, 2016: American Journal of Sports Medicine
Enmanuel J Perez, Maria L Cepero, Sebastian U Perez, Joseph T Coyle, Thomas J Sick, Daniel J Liebl
Traumatic brain injury (TBI), ranging from mild concussion to severe penetrating wounds, can involve brain regions that contain damaged or lost synapses in the absence of neuronal death. These affected regions significantly contribute to sensory, motor and/or cognitive deficits. Thus, studying the mechanisms responsible for synaptic instability and dysfunction is important for protecting the nervous system from the consequences of progressive TBI. Our controlled cortical impact (CCI) injury produces ~20% loss of synapses and mild changes in synaptic protein levels in the CA3-CA1 hippocampus without neuronal losses...
October 2016: Neurobiology of Disease
Mersine A Bryan, Ali Rowhani-Rahbar, R Dawn Comstock, Frederick Rivara
OBJECTIVE: The incidence of sports- and recreation-related concussions (SRRCs) in the United States is unknown. More than 44 million youth participate in sports annually, thus understanding the frequency of SRRCs in children is important on a population level. Our objective was to determine the number of SRRCs occurring annually among US youth ≤18 years old. METHODS: We identified SRRCs using 3 national databases: MarketScan, National Electronic Injury Surveillance System, and National High School Sports Related Injury Surveillance System, Reporting Injury Online...
July 2016: Pediatrics
Zachary Y Kerr, Karen G Roos, Aristarque Djoko, Sara L Dalton, Steven P Broglio, Stephen W Marshall, Thomas P Dompier
CONTEXT:   Injury rates compare the relative frequency of sport-related concussions across groups. However, they may not be intuitive to policy makers, parents, or coaches in understanding the likelihood of concussion. OBJECTIVE:   To describe 4 measures of incidence (athlete-based rate, athlete-based risk, team-based rate, and team-based risk) during the 2011-2012 through 2014-2015 academic years. DESIGN:   Descriptive epidemiology study...
June 22, 2016: Journal of Athletic Training
Steven P Broglio, Richelle M Williams, Kathryn L O'Connor, Jason Goldstick
CONTEXT: Sporting organizations limit full-contact football practices to reduce concussion risk and based on speculation that repeated head impacts may result in long-term neurodegeneration. OBJECTIVE: To directly compare head-impact exposure in high school football players before and after a statewide restriction on full-contact practices. DESIGN: Cross-sectional study. SETTING: High school football field. PATIENTS OR OTHER PARTICIPANTS: Participants were varsity football athletes from a single high school...
July 2016: Journal of Athletic Training
Anthony P Kontos, Alicia Sufrinko, R J Elbin, Alicia Puskar, Michael W Collins
BACKGROUND: The Vestibular/Ocular Motor Screening (VOMS) is a newly developed screening tool that evaluates vestibular and ocular motor symptom (eg, headache, dizziness, nausea, fogginess) provocation after a sport-related concussion. Baseline data on the VOMS are needed to extend the application of this measure to broad age groups and to document normal variations in performance. PURPOSE: The primary purpose of this study was to examine the internal consistency of the VOMS in a large sample of healthy, nonconcussed collegiate athletes...
June 2016: American Journal of Sports Medicine
B Johansson, A-P Wentzel, P Andréll, L Rönnbäck, C Mannheimer
OBJECTIVES: Traumatic brain injury (TBI) may cause long-lasting post-concussive symptoms, such as mental fatigue and concentration difficulties, and this may become the main hindrance for returning to work and studies. There is currently no effective treatment for long-lasting mental fatigue. In this hypothesis generating study, the long-term effects of methylphenidate on mental fatigue, cognitive function, and safety were assessed. MATERIALS & METHODS: Thirty participants who suffered from long-term post-concussion symptoms after a mild TBI or moderate TBI and who had reported positive effects with methylphenidate during an initial phase of this follow-up study were treated with methylphenidate for a further six months...
March 15, 2016: Acta Neurologica Scandinavica
J Gordon Millichap
Investigators from the Division of Emergency Medicine, Sports Medicine, and Department of Pediatrics, Children's Hospital of Philadelphia, PA, and Sports Medicine, Somerset, NJ, performed a retrospective cohort study of 247 patients ages 5-18 years with concussion referred from July 2010 to Dec 2011; 81% of patients showed a vestibular abnormality on initial clinical examination.
May 2015: Pediatric neurology briefs
Matti V Vartiainen, Anu Holm, Jani Lukander, Kristian Lukander, Sanna Koskinen, Robert Bornstein, Laura Hokkanen
INTRODUCTION: Mild traumatic brain injuries (MTBI) or concussions often result in problems with attention, executive functions, and motor control. For better identification of these diverse problems, novel approaches integrating tests of cognitive and motor functioning are needed. The aim was to characterize minor changes in motor and cognitive performance after sports-related concussions with a novel test battery, including balance tests and a computerized multilimb reaction time test...
2016: Journal of Clinical and Experimental Neuropsychology
Dave Milzman, Aidan Neustadtl, Jeremy Altman, Danny Milzman, Jack Sava, Sam FRenkel
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
Jerry Laws
No abstract text is available yet for this article.
October 2015: Occupational Health & Safety
William T Tsushima, Andrea M Siu, Annina M Pearce, Guangxiang Zhang, Ross S Oshiro
This research evaluated the 2-year test-retest reliability of the Immediate Postconcussion Assessment and Cognitive Testing (ImPACT) neuropsychological battery, and clarified the need for biennial updated baseline testing of high school athletes. This study compared the baseline test scores of 212 non-concussed athletes that were obtained in Grade 9 and again 2 years later when they were in Grade 11. Regression-based methods indicated that 4 of the 5 ImPACT scores were stable over 2 years, as they fell within the 80% and 95% confidence intervals (CIs)...
February 2016: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
Thomas W Sawyer, Yushan Wang, David V Ritzel, Tyson Josey, Mercy Villanueva, Yimin Shei, Peggy Nelson, Grant Hennes, Tracy Weiss, Cory Vair, Changyang Fan, Julia Barnes
The role of primary blast in blast-induced traumatic brain injury (bTBI) is controversial in part due to the technical difficulties of generating free-field blast conditions in the laboratory. The use of traditional shock tubes often results in artifacts, particularly of dynamic pressure, whereas the forces affecting the head are dependent on where the animal is placed relative to the tube, whether the exposure is whole-body or head-only, and on how the head is actually exposed to the insult (restrained or not)...
July 1, 2016: Journal of Neurotrauma
Zachary Y Kerr, Johna K Register-Mihalik, Emily Kroshus, Christine M Baugh, Stephen W Marshall
BACKGROUND: Previous studies examining nondisclosure among athletes in various settings have found substantial proportions of athletes with undisclosed concussions. Substantial gaps exist in our understanding of the factors influencing athletes' disclosure of sports-related concussions. PURPOSE: To examine the prevalence of, and factors associated with, nondisclosure of recalled concussions in former collegiate athletes. STUDY DESIGN: Cross-sectional study; Level of evidence, 3...
January 2016: American Journal of Sports Medicine
Stephen Stache, David Howell, William P Meehan
OBJECTIVE: The primary purpose of this study was to examine concussion management practice patterns among sports medicine physicians in the United States. DESIGN: Cross-sectional study using a web-based survey. PARTICIPANTS: Members of the American Medical Society for Sports Medicine (AMSSM). MAIN OUTCOME MEASURES: We distributed a questionnaire to physician members of the AMSSM assessing the current practices for evaluating and managing concussions sustained during sports...
September 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Lauriane Auvergne, Andrey V Bortsov, Jacob C Ulirsch, David A Peak, Jeffrey S Jones, Robert A Swor, Robert M Domeier, David C Lee, Niels K Rathlev, Phyllis L Hendry, Samuel A McLean
OBJECTIVES: To determine the influence of epidemiologic factors and the influence of genetic variants affecting FKBP5, a protein known to modulate hypothalamic-pituitary-adrenocortical axis function, on the severity of somatic symptoms commonly termed "postconcussive" 6 and 12 months after motor vehicle collision (MVC). METHODS: European Americans 18 to 65 years of age who presented to one of eight emergency departments (EDs) after MVC were enrolled. Exclusion criteria included hospital admission...
January 2016: Psychosomatic Medicine
2015-11-23 03:51:02
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