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Concussion clinic

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814 papers 100 to 500 followers
By David Rhine MD FRCPC. Emergency medicine. Special interest in concussion management.
John J Leddy, Mohammad N Haider, Michael Ellis, Barry S Willer
Sport-related concussion (SRC) is a physiological brain injury that produces cerebral and systemic effects, including exercise intolerance. Exercise intolerance after concussion is believed to be the result of autonomic nervous system (ANS) dysfunction. Ventilation is inappropriately low for the level of exercise intensity, raising arterial carbon dioxide (PaCO2) levels. Elevated PaCO2 increases cerebral blood flow (CBF) out of proportion to exercise intensity, which is associated with symptoms that limit exercise performance...
August 2018: Current Sports Medicine Reports
Isabelle Gagnon, Debbie Friedman, Miriam H Beauchamp, Brian Christie, Carol DeMatteo, Gail Macartney, Bradford J McFadyen, Katia Sirois, Chand Taneja, Karl Zabjek, Roger Zemek, Martin Mrazik
A critical component for accelerating the clinical uptake of research data in the area of pediatric concussion or mild traumatic brain injury (MTBI) pertains to the establishment and utilization of common databases. The objective of the first phase of our CanPedCDE initiative was to agree upon pediatric common data elements (CDEs) that could best characterize children with MTBI over their recovery period. The selection of CDEs for our framework aimed to balance factors such as the comprehensiveness of outcomes collected, their applicability to diverse settings, as well as the costs associated with their use...
August 15, 2018: Journal of Neurotrauma
April L McPherson, Takashi Nagai, Kate E Webster, Timothy E Hewett
BACKGROUND: Clinical management of sport-related concussion typically involves a symptom checklist, clinical examination of mental status, and neurocognitive testing. However, recent studies have identified unresolved, impaired sensorimotor function after athletes return to sport. A review and meta-analysis of all current literature regarding risk of subsequent musculoskeletal (MSK) injury after concussion has yet to be published in the medical literature. Purpose/Hypothesis: To determine the odds that athletes will sustain MSK injury after concussion...
August 3, 2018: American Journal of Sports Medicine
Jonathan A Edlow
No abstract text is available yet for this article.
July 27, 2018: Annals of Emergency Medicine
Ingerid Kleffelgaard, Helene Lundgaard Soberg, Anne-Lise Tamber, Kari Anette Bruusgaard, Are Hugo Pripp, Maria Sandhaug, Birgitta Langhammer
OBJECTIVE: To investigate the effects of group-based vestibular rehabilitation in patients with traumatic brain injury. DESIGN: A single-blind randomized controlled trial. SETTING: University Hospital (recruitment and baseline assessments) and Metropolitan University (experimental intervention). SUBJECTS: A total of 65 patients (45 women) with mild-to-moderate traumatic brain injury (mean age 39.4 ± 13.0 years) were randomly assigned to intervention ( n = 33) or control group ( n = 32)...
July 30, 2018: Clinical Rehabilitation
Daniel M Costello, Andrew H Kaye, Terence J O'Brien, Sandy R Shultz
Sport-related concussion is a common form of mild traumatic brain injury that is now recognised as a serious health issue. Growing evidence suggests concussion may result in long-term and severe neurological disabilities. Recent research into the diagnosis and management of concussion may provide new approaches to concussion management that limit the potential long-term adverse effects of concussion. This paper summarises the problem of sport-related concussion and reviews key factors (sex, age, genetics) that may modify concussion outcomes...
July 25, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Elizabeth A Beverly, Todd R Fredricks, Andrew Leubitz, Benjamin R Oldach, Daniel Kana, Michael D Grant, Jonathon Whipps, Emily H Guseman
BACKGROUND: Despite the risks, concussion symptoms often go underreported by athletes, leading to delayed or forgone treatment and increased potential for concussion recurrence. One of the most serious long-term consequences of sports-related concussions is Chronic Traumatic Encephelopathy (CTE), a disorder associated with progressive neurological deterioration. The purpose of this study was to explore former collegiate athletes' understanding of concussions and motivations behind concussion non-disclosure in order to better assist family medicine providers in screening for and managing a history of concussions...
July 27, 2018: BMC Family Practice
Sean P Patrick, Lindsay A Gaudet, Lynette D Krebs, Thane Chambers, Brian H Rowe
Objectives: Mild traumatic brain injury (mTBI) is the most common emergency department (ED) brain injury presentation worldwide. Despite its frequency, practice variation and care gaps exist among emergency physicians (EPs) in diagnosing and appropriately managing mTBI in the ED. The objective of this review was to identify mTBI-specific training undertaken to improve the detection and management of mTBIs by EPs and its impact on practice. Methods: A comprehensive search strategy utilized four bibliographic databases, the gray literature and the keywords concussion, mild traumatic brain injury, medical education, and continuing medical education (CME)...
October 2017: AEM education and training
John Neidecker, Nitin K Sethi, Randolph Taylor, Raymond Monsell, Don Muzzi, Bruce Spizler, Larry Lovelace, Edmund Ayoub, Rick Weinstein, Joseph Estwanik, Patricio Reyes, Robert C Cantu, Barry Jordan, Margaret Goodman, John W Stiller, Jonathan Gelber, Robert Boltuch, Domenic Coletta, Angela Gagliardi, Stephen Gelfman, Patrick Golden, Nicholas Rizzo, Paul Wallace, Allan Fields, Calvin Inalsingh
Various organisations and experts have published numerous statements and recommendations regarding different aspects of sports-related concussion including definition, presentation, treatment, management and return to play guidelines.1-7 To date, there have been no written consensus statements specific for combat sports regarding management of combatants who have suffered a concussion or for return to competition after a concussion. In combat sports, head contact is an objective of the sport itself. Accordingly, management and treatment of concussion in combat sports should, and must, be more stringent than for non-combat sports counterparts...
July 26, 2018: British Journal of Sports Medicine
Rachel Micay, Doug Richards, Michael G Hutchison
Objective: The utility of structured exercise for rehabilitation purposes early in the postacute phase (ie, beyond the initial 24-48 hours of advised rest) following sport-related concussion (SRC) remains largely unexplored. This study examined the feasibility of implementing a standardised aerobic exercise (AE) intervention in the postacute stage of SRC recovery in a sample of adolescent students with SRC compared with usual care. Methods: Symptomatic adolescents with SRC were randomised to one of two groups: Aerobic Exercise (n=8) or Usual Care (n=7)...
2018: BMJ Open Sport & Exercise Medicine
Jean-Paul Chung Pin Yong, Jin H Lee, David R Howell, William P Meehan, Grant L Iverson, Andrew J Gardner
OBJECTIVE: The purpose of this study was to examine the influence of a brief exercise protocol on Sport Concussion Assessment Tool-Third Edition (SCAT3) performance in amateur women athletes. DESIGN: Cross-over repeated-measures design. SETTING: Off-season, uninjured community amateur athletes. PARTICIPANTS: We examined 87 amateur women athlete volunteers (age = 29.9, SD = 6.9 years). INDEPENDENT VARIABLES: Participants were assessed using the SCAT3 under 2 conditions: at rest and after a 5-minute physical exertion protocol, completed in a counterbalanced order...
July 13, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Vincent Wu, Bonnie Cooke, Susan Eitutis, Matthew T W Simpson, Jason A Beyea
OBJECTIVE: To provide family physicians with an evidence-based and practical approach to managing patients with tinnitus. SOURCES OF INFORMATION: MEDLINE was searched for English-language tinnitus guidelines and reviews. All such articles published between 1980 and 2016 were reviewed, with most providing level II and III evidence. MAIN MESSAGE: Tinnitus affects more than 40% of Canadians at least once in their lifetimes, most commonly older adults...
July 2018: Canadian Family Physician Médecin de Famille Canadien
Martin H Osmond, Terry P Klassen, George A Wells, Jennifer Davidson, Rhonda Correll, Kathy Boutis, Gary Joubert, Serge Gouin, Simi Khangura, Troy Turner, Francois Belanger, Norm Silver, Brett Taylor, Janet Curran, Ian G Stiell
BACKGROUND: There is uncertainty about which children with minor head injury need to undergo computed tomography (CT). We sought to prospectively validate the accuracy and potential for refinement of a previously derived decision rule, Canadian Assessment of Tomography for Childhood Head injury (CATCH), to guide CT use in children with minor head injury. METHODS: This multicentre cohort study in 9 Canadian pediatric emergency departments prospectively enrolled children with blunt head trauma presenting with a Glasgow Coma Scale score of 13-15 and loss of consciousness, amnesia, disorientation, persistent vomiting or irritability...
July 9, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Christina L Master, Andrew R Mayer, Davin Quinn, Matthew F Grady
Concussions are a common injury for which patients often present first to primary care physicians. They can affect the day-to-day function of patients in school and work, as well as in sports and recreational activities. Recognizing common physical signs and symptoms after injury facilitates timely diagnosis and treatment, permitting initiation of an active management approach to recovery while preventing secondary injury. For persons with persistent symptoms, active rehabilitation may be utilized, with the goal of returning patients to full function...
July 3, 2018: Annals of Internal Medicine
Hussein Assi, R Davis Moore, Dave Ellemberg, Sylvie Hébert
Sensitivity to sounds is one frequent symptom of a sport-related concussion, but its assessment rarely goes beyond a single question. Here we examined sensitivity to sounds using psychoacoustic and psychometric outcomes in athletes beyond the acute phase of injury. Fifty-eight college athletes with normal hearing who either had incurred one or more sport-related concussions (N = 28) or who had never suffered head injury (N = 30) participated. Results indicated that the Concussed group scored higher on the Hyperacusis questionnaire and displayed greater sensitivity to sounds in psychoacoustic tasks compared to the Control group...
July 2, 2018: Scientific Reports
Stuart Donaldson, Mary Donaldson, Sohel Shivji
Concussions represent a major concern for hockey teams. During one winter season, all players on two Junior Hockey Teams were assessed in order to establish an incidence baseline for concussions. The qEEG was utilized as it measures the probability of concussion and its severity. The SCL 90-R and CNS questionnaire were used to provide insight into various aspects of cognitive functioning. Results indicated that of the players assessed (N = 46) approximately two-thirds (N = 32) tested positive for concussions...
June 28, 2018: Applied Psychophysiology and Biofeedback
Amanda L McGowan, Abigail C Bretzin, Jennifer L Savage, Kyle M Petit, Andrew C Parks, Tracey Covassin, Matthew B Pontifex
OBJECTIVE: A critical barrier to the understanding of disruptions to cognitive flexibility following sports-related concussion is the use of assessments that conflate shifts of visuospatial attention and contextual rules. Because these dissociable forms of cognitive flexibility are subserved by distinct neural networks, the utility of a cognitive flexibility assessment following concussion may be reduced, depending upon the extent to which the task requires shifting visuospatial attention relative to shifting contextual rules...
July 2018: Neuropsychology
David R Howell, Peter Kriz, Rebekah C Mannix, Tyler Kirchberg, Christina L Master, William P Meehan
OBJECTIVES: (1) To examine how age influences initial symptom presentation following concussion; and (2) to determine whether specific symptom profiles are associated with duration of postconcussion symptoms, and whether they vary by age group. DESIGN: A total of 689 patients (20% children 7-12 years of age, 69% adolescents 13-18 years of age, and 11% young adults 19-30 years of age) were seen and diagnosed with a concussion within 21 days after injury. Patients completed the Post-Concussion Symptom Scale (PCSS) and were followed until they no longer required care...
June 21, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Amir M Molaie, Jamie Maguire
Neuropsychiatric symptoms following traumatic brain injury (TBI) are common and contribute negatively to TBI outcomes by reducing overall quality of life. The development of neurobehavioral sequelae, such as concentration deficits, depression, anxiety, fatigue, and loss of emotional well-being has historically been attributed to an ambiguous "post-concussive syndrome," considered secondary to frank structural injury and axonal damage. However, recent research suggests that neuroendocrine dysfunction, specifically hypopituitarism, plays an important role in the etiology of these symptoms...
2018: Frontiers in Endocrinology
Carson Gill, Brendan Arnold, Sean Nugent, Alykhan Rajwani, Michael Xu, Tyler Black, Quynh Doan
OBJECTIVES: The goal of this study was to assess the reliability of HEARTSMAP as a standardized tool for evaluating the quality of psychosocial assessment documentation of pediatric mental health presentations to the emergency department. In addition, we report on current documentation practices. METHODS: We conducted a retrospective cross-sectional study of pediatric (up to age 17) mental health-related visits to four emergency departments between April 1, 2013 and March 31, 2014...
June 20, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
2018-06-22 19:00:05
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