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Concussions Trueman

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Michael Gallaway, Mitchell Scheiman, G Lynn Mitchell
PURPOSE: To determine the frequency and types of vision disorders associated with concussion, and to determine the success rate of vision therapy for these conditions in two private practice settings. METHODS: All records over an 18-month period of patients referred for post-concussion vision problems were reviewed from two private practices. Diagnoses of vergence, accommodative, or eye movement disorders were based on pre-established, clinical criteria. Vision therapy was recommended based on clinical findings and symptoms...
August 8, 2016: Optometry and Vision Science: Official Publication of the American Academy of Optometry
Kenneth P Stoller
Despite adequate evidence, including randomized controlled trials; hyperbaric oxygen is not yet recognized as efficacious for treating various forms of brain injury, specifically traumatic brain injury. Political-economic issues have kept this benign therapy from being widely adopted despite the lack of viable alternatives. Two football players with TBI/CTE are herewith shown to benefit from being treated with hyperbaric oxygen as documented by neurocognitive examinations and functional brain imaging, in one case treatment commenced decades after the brain injury...
2011: Medical Gas Research
Nam Pham, Hungbo Akonasu, Rhonda Shishkin, Changiz Taghibiglou
Sport-related mild traumatic brain injury (mTBI) or concussion is a significant health concern to athletes with potential long-term consequences. The diagnosis of sport concussion and return to sport decision making is one of the greatest challenges facing health care clinicians working in sports. Blood biomarkers have recently demonstrated their potential in assisting the detection of brain injury particularly, in those cases with no obvious physical injury. We have recently discovered plasma soluble cellular prion protein (PrP(C)) as a potential reliable biomarker for blast induced TBI (bTBI) in a rodent animal model...
2015: PloS One
Terry D Fife, Deepak Kalra
Vertigo, dizziness, and disequilibrium are common symptoms following concussion or mild traumatic brain injury (mTBI). Dizziness and vertigo may be the result of trauma to the peripheral vestibular system or the central nervous system, or, in some cases, may be due to anxiety, depression, or posttraumatic stress disorder; these mechanisms are not mutually exclusive. While most peripheral vestibular disorders can be identified by testing and examination, those without inner-ear causes that have persisting complaints of dizziness and motion sickness are more difficult to understand and to manage...
April 2015: Annals of the New York Academy of Sciences
Timothy B Meier, Patrick S F Bellgowan, Rashmi Singh, Rayus Kuplicki, David W Polanski, Andrew R Mayer
IMPORTANCE: Animal models suggest that reduced cerebral blood flow (CBF) is one of the most enduring physiological deficits following concussion. Despite this, longitudinal studies documenting serial changes in regional CBF following human concussion have yet to be performed. OBJECTIVE: To longitudinally assess the recovery of CBF in a carefully selected sample of collegiate athletes and compare time course of CBF recovery with that of cognitive and behavioral symptoms...
May 2015: JAMA Neurology
Alasdair Timothy Llewelyn Rathbone, Surejini Tharmaradinam, Shucui Jiang, Michel P Rathbone, Dinesh A Kumbhare
Post-concussion syndrome is an aggregate of symptoms that commonly present together after head injury. These symptoms, depending on definition, include headaches, dizziness, neuropsychiatric symptoms, and cognitive impairment. However, these symptoms are common, occurring frequently in non-head injured controls, leading some to question the existence of post-concussion syndrome as a unique syndrome. Therefore, some have attempted to explain post-concussion symptoms as post-traumatic stress disorder, as they share many similar symptoms and post-traumatic stress disorder does not require head injury...
May 2015: Brain, Behavior, and Immunity
Richelle M Williams, Tim W Puetz, Christopher C Giza, Steven P Broglio
BACKGROUND: Concussion diagnosis and management is made through the clinical exam using assessment tools that include self-report symptomatology, postural control, and cognitive evaluations. The specific timing of concussion resolution varies between individuals. However, despite a lack of research in concussion recovery, it is widely accepted that the majority of young adults will recover in 7-10 days, with youth athletes taking longer. OBJECTIVES: The purpose of this review is to directly compare the recovery duration among high school and collegiate athletes on symptom reports and cognitive assessments following concussion...
June 2015: Sports Medicine
Ryan Hung, Linda J Carroll, Carol Cancelliere, Pierre Côté, Peter Rumney, Michelle Keightley, James Donovan, Britt-Marie Stålnacke, J David Cassidy
OBJECTIVE: To synthesize the best available evidence on prognosis after pediatric mild traumatic brain injury (MTBI). DATA SOURCES: We searched MEDLINE, Embase, PsycINFO, CINAHL, and SPORTDiscus (2001-2012), as well as reference lists of eligible articles, and relevant systematic reviews and meta-analyses. STUDY SELECTION: Controlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to have a minimum of 30 MTBI pediatric cases...
March 2014: Archives of Physical Medicine and Rehabilitation
Cameron B Jeter, Georgene W Hergenroeder, Michael J Hylin, John B Redell, Anthony N Moore, Pramod K Dash
Mild traumatic brain injury (mTBI) results from a transfer of mechanical energy into the brain from traumatic events such as rapid acceleration/deceleration, a direct impact to the head, or an explosive blast. Transfer of energy into the brain can cause structural, physiological, and/or functional changes in the brain that may yield neurological, cognitive, and behavioral symptoms that can be long-lasting. Because mTBI can cause these symptoms in the absence of positive neuroimaging findings, its diagnosis can be subjective and often is based on self-reported neurological symptoms...
April 15, 2013: Journal of Neurotrauma
Robert L Conder, Alanna A Conder
The study of heart rate variability (HRV) has emerged as an essential component of cardiovascular health, as well as a physiological mechanism by which one can increase the interactive communication between the cardiac and the neurocognitive systems (i.e., the body and the brain). It is well-established that lack of HRV implies cardiopathology, morbidity, reduced quality-of-life, and precipitous mortality. On the positive, optimal HRV has been associated with good cardiovascular health, autonomic nervous system (ANS) control, emotional regulation, and enhanced neurocognitive processing...
2014: Frontiers in Psychology
Cara L Sedney, John Orphanos, Julian E Bailes
The pathophysiology of concussion may lead to a variety of both short- and long-term effects, which may lead to a decision to retire from contact sports. These effects follow a recognizable progression and may cause an athlete to opt out of play at any point along this progression. To elucidate the effect of concussion or mild traumatic brain injury and weigh in on a decision to retire, the treating physician needs to take into account the history, neurologic examination, brain imaging, and neuropsychological testing...
January 2011: Clinics in Sports Medicine
Stefano Signoretti, Giuseppe Lazzarino, Barbara Tavazzi, Roberto Vagnozzi
Concussion is defined as a biomechanically induced brain injury characterized by the absence of gross anatomic lesions. Early and late clinical symptoms, including impairments of memory and attention, headache, and alteration of mental status, are the result of neuronal dysfunction mostly caused by functional rather than structural abnormalities. The mechanical insult initiates a complex cascade of metabolic events leading to perturbation of delicate neuronal homeostatic balances. Starting from neurotoxicity, energetic metabolism disturbance caused by the initial mitochondrial dysfunction seems to be the main biochemical explanation for most postconcussive signs and symptoms...
October 2011: PM & R: the Journal of Injury, Function, and Rehabilitation
Aaron M Yengo-Kahn, Daniel J Johnson, Scott L Zuckerman, Gary S Solomon
BACKGROUND: Significant attention has been directed toward the immediate and long-term effects of sport-related concussions on athletes participating in contact sports, particularly football. The highest level of football, the National Football League (NFL), has received significant attention and criticism regarding player management and safety after mild traumatic brain injury (mTBI). Several review articles have reported data related to concussion in the NFL, but a succinct review and synthesis of data regarding NFL concussions is currently lacking...
March 2016: American Journal of Sports Medicine
Roger Zemek, Kaylee Eady, Katherine Moreau, Ken J Farion, Beverly Solomon, Margaret Weiser, Carol Dematteo
UNLABELLED: Introduction The diagnosis of concussion is a critical step in the appropriate management of patients following minor head trauma. The authors hypothesized that wide practice variation exists among pediatric emergency medicine physicians in the application of physical and cognitive rest recommendations following an acute concussion. METHODS: The authors developed a 35-item questionnaire incorporating case vignettes to examine pediatric emergency physician knowledge of concussion diagnosis, understanding of initial management using return-to-play/school/work guidelines, use of existing concussion protocols, and perceived barriers to protocol use...
March 2015: CJEM
Lai Gwen Chan, Anthony Feinstein
OBJECTIVE: To investigate the effect of sleep disturbances on functional and social outcomes after mild traumatic brain injury. SETTING: Outpatient traumatic brain injury clinic in a tertiary trauma center. PARTICIPANTS: A total of 374 mild traumatic brain injury patients were assessed within 3 months of injury and followed up every 3 months for 1 year. DESIGN: Analysis of a historical cohort in a naturalistic clinical setting...
November 2015: Journal of Head Trauma Rehabilitation
Peter A Benedict, Natali V Baner, G Kyle Harrold, Nicholas Moehringer, Lisena Hasanaj, Liliana P Serrano, Mara Sproul, Geraldine Pagnotta, Dennis A Cardone, Steven R Flanagan, Janet Rucker, Steven L Galetta, Laura J Balcer
OBJECTIVE: This study examined components of the Sports Concussion Assessment Tool, 3rd Edition (SCAT3) and a vision-based test of rapid number naming (King-Devick [K-D]) to evaluate sports and non-sports concussion patients in an outpatient, multidisciplinary concussion center. While the Symptom Evaluation, Standardized Assessment of Concussion (SAC), modified Balance Error Scoring System (BESS), and K-D are used typically for sideline assessment, their use in an outpatient clinical setting following concussion has not been widely investigated...
2015: Journal of the Neurological Sciences
Danielle M Ransom, Christopher G Vaughan, Lincoln Pratson, Maegan D Sady, Catherine A McGill, Gerard A Gioia
OBJECTIVE: The aim of this work is to study the nature and extent of the adverse academic effects faced by students recovering from concussion. METHOD: A sample of 349 students ages 5 to 18 who sustained a concussion and their parents reported academic concerns and problems (eg, symptoms interfering, diminished academic skills) on a structured school questionnaire within 4 weeks of injury. Postconcussion symptoms were measured as a marker of injury severity. Results were examined based on recovery status (recovered or actively symptomatic) and level of schooling (elementary, middle, and high school)...
June 2015: Pediatrics
Dana A Brown, Julie A Elsass, Ashley J Miller, Lauren E Reed, Jennifer C Reneker
BACKGROUND: Concussion literature and treatment guidelines are inconclusive regarding the role of sex in symptom reporting at baseline and post-concussion. Although empirical evidence is lacking, it is generally regarded that females have a more severe symptomatic presentation than males at all time-points on the concussion spectrum. OBJECTIVES: Our objective was to determine whether differences exist between males and females at baseline (pre-season/before concussion) or post-concussion for self-reported (1) prevalence of individual symptoms and (2) total symptom scores in high school and college athletes...
July 2015: Sports Medicine
A M Bronstein, T Lempert, B M Seemungal
Patients with chronic dizziness pose a particular challenge to the clinician, partly because their symptoms correlate poorly with standard vestibular tests; so a 'test and think later' approach is likely to lead to diagnostic confusion rather than clarity. Rather, a meticulous clinical assessment is required. Here our approach to the chronic dizzy patient is described with an emphasis on treating the patient's symptoms.
June 2010: Practical Neurology
A Sealy
This paper presents an evidence-based introduction to assessing and managing the dizzy patient. It is based upon a literature review highlighting current best practice and the clinical experience of the author. Dizziness is common, often chronic and largely untreated, resulting in great personal and economic loss. Serious pathological causes of dizziness may be quickly and effectively screened by a simple ocular motor examination, differentiating these from peripheral vestibular lesions. A triage, differentiating dizziness into either acute onset, intermittent episodes or continuous symptoms is proposed, along with management strategies for the commonest causes of dizziness...
March 2014: Occupational Medicine
2015-12-09 14:07:31
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