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Concussion clinic

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827 papers 100 to 500 followers
By David Rhine MD FRCPC. Emergency medicine. Special interest in concussion management.
https://www.readbyqxmd.com/read/30175893/neurocognitive-testing-in-the-emergency-department-a-potential-assessment-tool-for-mild-traumatic-brain-injury
#1
Catherine M Lunter, Ellen L Carroll, Charlotte Housden, Joanne Outtrim, Faye Forsyth, Annie Rivera, Chris Maimaris, Adrian Boyle, Barbara J Sahakian, David K Menon, Virginia Fj Newcombe
OBJECTIVE: Despite mild traumatic brain injury (mTBI) accounting for 80% of head injury diagnoses, recognition of individuals at risk of cognitive dysfunction remains a challenge in the acute setting. The objective of this study was to evaluate the feasibility and potential role for computerised cognitive testing as part of a complete ED head injury assessment. METHODS: mTBI patients (n = 36) who incurred a head injury within 24 h of presentation to the ED were compared to trauma controls (n = 20) and healthy controls (n = 20) on tests assessing reaction time, speed and attention, episodic memory, working memory and executive functioning...
September 3, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/30307758/a-systematic-review-and-meta-analysis-of-return-to-work-after-mild-traumatic-brain-injury
#2
Ben Bloom, Stephen Thomas, Jette Møller Ahrensberg, Rachel Weaver, Alex Fowler, Jon Bestwick, Tim Harris, Rupert Pearse
OBJECTIVE: To perform a systematic review and meta-analysis of return to work (RTW) times for adult patients with mild traumatic brain injury (mTBI). METHODS: Six databases and six trials registries were searched. Inclusion: studies reporting RTW, > 30 patients, adults, with mTBI. Exclusion: final measurement RTW < 30 days after injury, first measurement > 1 year. RESULTS: Of 978 records, 14 eligible studies were identified. Two included patients exclusively in paid employment pre-injury; four included paid employment, students, homemakers or other activities; seven included pre-injury occupational status described but unclear; one included patients whose pre-injury occupational status not described...
October 11, 2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/30288131/using-sideline-concussion-tests-in-the-emergency-department
#3
Adam J Kruse, Andrew S Nugent, Andrew R Peterson
Purpose: Traumatic brain injury (TBI) is a significant cause of death and disability in the United States. Many patients with TBI are initially treated in the emergency department (ED), but there is no evidence-based method of detecting or grading TBI in patients who have normal structural neuroimaging. This study aims to evaluate the validity of two common sideline concussion tests. The Concussion Symptom Severity Score (CSSS) and modified Balance Error Scoring System (mBESS) tests are well-validated sideline tests for concussion, but have not been validated in the setting of non-sport-related concussion, in settings other than the sideline or athletic training room or in moderate or severe TBI...
2018: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/30288087/the-polytrauma-clinical-triad-in-patients-with-chronic-pain-after-motor-vehicle-collision
#4
Cayden Peixoto, Lindsay Hyland, Derrick Matthew Buchanan, Erika Langille, Richard Nahas
Background: The polytrauma clinical triad (PCT) is a complex disorder composed of three comorbid diagnoses of chronic pain, post-traumatic stress disorder (PTSD), and postconcussion syndrome (PCS). PCT has been documented in veterans returning from deployment, but this is the first report on PCT prevalence in nonmilitary personnel after a motor vehicle collision (MVC). Methods: Data were drawn from routine intake assessments completed by 71 patients referred to a community-based clinic for chronic pain management...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/30280043/distinguishing-between-enduring-and-dynamic-concussion-symptoms-applying-generalisability-theory-to-the-rivermead-post-concussion-symptoms-questionnaire-rpq
#5
Oleg N Medvedev, Alice Theadom, Suzanne Barker-Collo, Valery Feigin
Background: The Rivermead Post Concussion Symptoms Questionnaire (RPQ) is a widely-used, 16-item measure of concussion symptoms yet its ability to assess change in the symptom experience over time has come under criticism. We applied Generalisability theory to differentiate between dynamic and enduring aspects of post-concussion symptoms and to examine sources of measurement error in the RPQ. Materials and Methods: Generalisability theory was applied using the longitudinal design with persons as the object of measurement...
2018: PeerJ
https://www.readbyqxmd.com/read/30277194/comparison-of-pecarn-catch-and-chalice-clinical-decision-rules-for-pediatric-head-injury-in-the-emergency-department
#6
Mark McGraw, Todd Way
Clinical questionWhat is the diagnostic accuracy of the PECARN, CATCH, and CHALICE clinical decision rules for pediatric head injury, and are the clinical decision rules valid when applied to a novel data set?Article chosenBabl FE, Borland ML, Phillips N, et al. Accuracy of PECARN, CATCH, and CHALICE head injury decision rules in children: a prospective cohort study. Lancet (London, England) 2017;389(10087):2393-402. OBJECTIVES: The primary objective of the study was to determine the diagnostic accuracy and provide external validation for the PECARN, CATCH, and CHALICE clinical decision rules in a clinically homogeneous cohort of children...
October 2, 2018: CJEM
https://www.readbyqxmd.com/read/30262454/international-study-of-video-review-of-concussion-in-professional-sports
#7
Gavin A Davis, Michael Makdissi, Paul Bloomfield, Patrick Clifton, Ruben J Echemendia, Éanna Cian Falvey, Gordon Ward Fuller, Gary Green, Peter Rex Harcourt, Thomas Hill, Nathan McGuirk, Willem Meeuwisse, John W Orchard, Martin Raftery, Allen K Sills, Gary S Solomon, Alex Valadka, Paul McCrory
BACKGROUND: Video review has become an important tool in professional sporting codes to help sideline identification and management of players with a potential concussion. AIM: To assess current practices related to video review of concussion in professional sports internationally, and compare protocols and diagnostic criteria used to identify and manage potential concussions. METHODS: Current concussion management guidelines from professional national and international sporting codes were reviewed...
September 27, 2018: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/30206709/graded-combined-aerobic-resistance-exercise-care-to-prevent-or-treat-the-persistent-post-concussion-syndrome
#8
REVIEW
Karen A Sullivan, Andrew P Hills, Grant L Iverson
PURPOSE OF REVIEW: To review the growing body of indirect and direct evidence that suggests that exercise can be helpful for children, adolescents, and adults with persistent symptoms following a mild traumatic brain injury (mTBI). RECENT FINDINGS: The direct evidence shows that graded exercise assessments are safe, and that aerobic exercise interventions are associated with improvement of multiple symptoms and other benefits, including earlier return-to-sport. The indirect evidence supports this approach via studies that reveal the potential mechanisms, and show benefits for related presentations and individual symptoms, including headaches, neck pain, vestibular problems, sleep, stress, anxiety, and depression...
September 12, 2018: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/30197233/use-of-the-vestibular-and-oculomotor-examination-for-concussion-in-a-pediatric-emergency-department
#9
Daniel J Corwin, Kathleen J Propert, Joseph J Zorc, Mark R Zonfrillo, Douglas J Wiebe
BACKGROUND: Concussion guidelines recommend a vestibular and oculomotor (VOM) examination be performed for all patients with concern for concussion, however the feasibility of performing testing is unknown. We aimed to measure rates of exam performance after implementation of training and support tools in a pediatric emergency department. METHODS: We conducted a retrospective study of patients age 6 to 18 years old presenting over a 12-month period. Charts were obtained via natural language processing, where concussion was suggested as a diagnosis in the electronic health record, and then manually reviewed to record patient and provider factors...
September 5, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30193284/centers-for-disease-control-and-prevention-guideline-on-the-diagnosis-and-management-of-mild-traumatic-brain-injury-among-children
#10
Angela Lumba-Brown, Keith Owen Yeates, Kelly Sarmiento, Matthew J Breiding, Tamara M Haegerich, Gerard A Gioia, Michael Turner, Edward C Benzel, Stacy J Suskauer, Christopher C Giza, Madeline Joseph, Catherine Broomand, Barbara Weissman, Wayne Gordon, David W Wright, Rosemarie Scolaro Moser, Karen McAvoy, Linda Ewing-Cobbs, Ann-Christine Duhaime, Margot Putukian, Barbara Holshouser, David Paulk, Shari L Wade, Stanley A Herring, Mark Halstead, Heather T Keenan, Meeryo Choe, Cindy W Christian, Kevin Guskiewicz, P B Raksin, Andrew Gregory, Anne Mucha, H Gerry Taylor, James M Callahan, John DeWitt, Michael W Collins, Michael W Kirkwood, John Ragheb, Richard G Ellenbogen, Theodore J Spinks, Theodore G Ganiats, Linda J Sabelhaus, Katrina Altenhofen, Rosanne Hoffman, Tom Getchius, Gary Gronseth, Zoe Donnell, Robert E O'Connor, Shelly D Timmons
Importance: Mild traumatic brain injury (mTBI), or concussion, in children is a rapidly growing public health concern because epidemiologic data indicate a marked increase in the number of emergency department visits for mTBI over the past decade. However, no evidence-based clinical guidelines have been developed to date for diagnosing and managing pediatric mTBI in the United States. Objective: To provide a guideline based on a previous systematic review of the literature to obtain and assess evidence toward developing clinical recommendations for health care professionals related to the diagnosis, prognosis, and management/treatment of pediatric mTBI...
September 4, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/30193325/diagnosis-and-management-of-mild-traumatic-brain-injury-in-children-a-systematic-review
#11
Angela Lumba-Brown, Keith Owen Yeates, Kelly Sarmiento, Matthew J Breiding, Tamara M Haegerich, Gerard A Gioia, Michael Turner, Edward C Benzel, Stacy J Suskauer, Christopher C Giza, Madeline Joseph, Catherine Broomand, Barbara Weissman, Wayne Gordon, David W Wright, Rosemarie Scolaro Moser, Karen McAvoy, Linda Ewing-Cobbs, Ann-Christine Duhaime, Margot Putukian, Barbara Holshouser, David Paulk, Shari L Wade, Stanley A Herring, Mark Halstead, Heather T Keenan, Meeryo Choe, Cindy W Christian, Kevin Guskiewicz, P B Raksin, Andrew Gregory, Anne Mucha, H Gerry Taylor, James M Callahan, John DeWitt, Michael W Collins, Michael W Kirkwood, John Ragheb, Richard G Ellenbogen, T J Spinks, Theodore G Ganiats, Linda J Sabelhaus, Katrina Altenhofen, Rosanne Hoffman, Tom Getchius, Gary Gronseth, Zoe Donnell, Robert E O'Connor, Shelly D Timmons
Importance: In recent years, there has been an exponential increase in the research guiding pediatric mild traumatic brain injury (mTBI) clinical management, in large part because of heightened concerns about the consequences of mTBI, also known as concussion, in children. The CDC National Center for Injury Prevention and Control's (NCIPC) Board of Scientific Counselors (BSC), a federal advisory committee, established the Pediatric Mild TBI Guideline workgroup to complete this systematic review summarizing the first 25 years of literature in this field of study...
September 4, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/30169435/self-reported-balance-disturbance-and-performance-based-balance-impairment-after-concussion-in-the-general-population
#12
Elizabeth L Inness, Michelle Sweeny, Olinda Habib Perez, Cynthia Danells, Tharshini Chandra, Evan Foster, Cristina Saverino, Paul Comper, Mark Bayley, George Mochizuki
OBJECTIVE: To characterize the prevalence of, and relationship between, self-reported balance disturbance and performance-based balance impairment in the general population with concussion. SETTING: Rehabilitation hospital outpatient concussion clinic. PARTICIPANTS: One hundred six individuals with concussion (49 males, mean age = 32.4; SD = 11.5 years), mean (SD) = 5 (1.8) days postinjury. DESIGN: Cross-sectional observational study...
August 30, 2018: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/30120477/association-between-traumatic-brain-injury-and-risk-of-suicide
#13
Trine Madsen, Annette Erlangsen, Sonja Orlovska, Ramy Mofaddy, Merete Nordentoft, Michael E Benros
Importance: Traumatic brain injuries (TBIs) can have serious long-term consequences, including psychiatric disorders. However, few studies have assessed the association between TBI and risk of suicide. Objective: To examine the association between TBI and subsequent suicide. Design, Setting, and Participants: Retrospective cohort study using nationwide registers covering 7 418 391 individuals (≥10 years) living in Denmark (1980-2014) with 164 265 624 person-years' follow-up; 567 823 (7...
August 14, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/30109948/normative-performance-on-the-balance-error-scoring-system-by-youth-high-school-and-collegiate-athletes
#14
Sarah J Ozinga, Susan M Linder, Mandy Miller Koop, Tanujit Dey, Richard Figler, Andrew N Russman, Richard So, Alan H Rosenthal, Jason Cruickshank, Jay L Alberts
CONTEXT:   Annually, more than 1 million youth athletes in the United States receive or are suspected of receiving a concussion. The Balance Error Scoring System (BESS) is the most commonly used clinical balance evaluation designed to provide a better understanding of the motor-control processes of individuals with concussion. Despite the widespread use of the BESS, a fundamental gap exists in applying this tool to young athletes, as normative values are lacking for this population...
July 2018: Journal of Athletic Training
https://www.readbyqxmd.com/read/30095546/exercise-is-medicine-for-concussion
#15
REVIEW
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
https://www.readbyqxmd.com/read/30074870/the-canadian-pediatric-mild-traumatic-brain-injury-common-data-elements-project-harmonizing-outcomes-to-increase-understanding-of-pediatric-concussion
#16
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
https://www.readbyqxmd.com/read/30074832/musculoskeletal-injury-risk-after-sport-related-concussion-a-systematic-review-and-meta-analysis
#17
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
https://www.readbyqxmd.com/read/30060897/managing-patients-with-acute-episodic-dizziness
#18
REVIEW
Jonathan A Edlow
No abstract text is available yet for this article.
July 27, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/30056743/the-effects-of-vestibular-rehabilitation-on-dizziness-and-balance-problems-in-patients-after-traumatic-brain-injury-a-randomized-controlled-trial
#19
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
https://www.readbyqxmd.com/read/30055944/sport-related-concussion-potential-for-biomarkers-to-improve-acute-management
#20
REVIEW
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
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