Concussion最新文献

{"title":"Selective head-neck cooling after concussion shortens return-to-play in ice hockey players.","authors":"Anna Gard,&nbsp;Yelverton Tegner,&nbsp;Mohammad Fazel Bakhsheshi,&nbsp;Niklas Marklund","doi":"10.2217/cnc-2021-0002","DOIUrl":"https://doi.org/10.2217/cnc-2021-0002","url":null,"abstract":"<p><p>We aimed to investigate whether selective head-neck cooling could shorten recovery after sports-related concussions (SRCs). In a nonrandomized study of 15 Swedish professional ice hockey teams, 29 concussed players received immediate head and neck cooling for ≥30 min (initiated at 12.3 ± 9.2 min post-SRC by a portable cooling system), and 52 SRC controls received standard management. Players receiving head-neck cooling had shorter time to return-to-play than controls (7 vs 12.5 days, p < 0.0001), and 7% in the intervention group versus 25% in the control group were out of play for ≥3 weeks (p = 0.07). Immediate selective head-neck cooling is a promising option in the acute management of SRC that should be addressed in larger cohorts.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"6 2","pages":"CNC90"},"PeriodicalIF":0.0,"publicationDate":"2021-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8162197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38979341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pilot study on exertional tasks with physiological measures designed for the assessment of military concussion.","authors":"Julianna H Prim,&nbsp;Maria I Davila,&nbsp;Karen L McCulloch","doi":"10.2217/cnc-2020-0018","DOIUrl":"https://doi.org/10.2217/cnc-2020-0018","url":null,"abstract":"<p><strong>Background: </strong>Guidelines for clinicians treating military concussion recommend exertional testing before return-to-duty, yet there is currently no standardized task or inclusion of an objective physiological measure like heart rate variability (HRV).</p><p><strong>Methodology & results: </strong>We pilot-tested two clinically feasible exertional tasks that include HRV measures and examined reliability of a commercially available heart rate monitor. Testing healthy participants confirmed that the 6-min step test and 2-min pushup test evoked the targeted physiological response, and the Polar H10 was reliable to the gold-standard electrocardiogram.</p><p><strong>Conclusion: </strong>Both tasks are brief assessments that can be implemented into primary care setting including the Polar H10 as an affordable way to access HRV. Additional research utilizing these tasks to evaluate concussion recovery can validate standardized exertional tasks for clinical use.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"6 1","pages":"CNC88"},"PeriodicalIF":0.0,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8097503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38972666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual snow syndrome: evolving neuro-optometric considerations in concussion/mild traumatic brain injury.","authors":"Kenneth J Ciuffreda,&nbsp;Mh Esther Han,&nbsp;Barry Tannen,&nbsp;Daniella Rutner","doi":"10.2217/cnc-2021-0003","DOIUrl":"https://doi.org/10.2217/cnc-2021-0003","url":null,"abstract":"Visual snow syndrome (VSS) is a relatively rare, unusual and enigmatic medical condition [1–4]. It frequently occurs in patients with concussion/mild traumatic brain injury (C/mTBI) and other brain-related abnormalities [1–7]. VSS presents with a constellation of visual and non-visual problems. The hallmark symptom is the appearance of pixelated ‘visual snow’ (VS) occurring in a single plane in front of and throughout the visual field, either achromatic or chromatic in nature. Individuals diagnosed with VSS must also report two or more of the following four primary visual perceptual phenomena: photosensitivity, night vision problems (nyctalopia), palinopsia and enhanced entoptic imagery [1,2]. They frequently also report some of the following secondary visual and non-visual symptoms: photopsia, migraine, phonophobia, hyperacusis, cutaneous allodynia, tinnitus, balance disturbances and tremor [1,2]. Based on the patient’s case history and the aforementioned possible symptomatology, we have developed a VSS symptom questionnaire to assist in diagnosis, as well as to assess the effect of a therapeutic intervention [5]. This questionnaire is used in our Vision Rehabilitation Service. We have also proposed a range of basic and advanced vision tests to assist in better understanding VSS [5]. The presence of VS per se was reported as early as 1944 in association with the use of digitalis for heart problems [8]. However, it is only over the past decade that VSS has received considerable attention [1–7], with emphasis on C/mTBI. This has focused on defining the diagnostic criteria and related aspects. Unfortunately, there has been a paucity of reports related to treatment, which has been minimally successful; for example, the work of van Dongan et al. [9]. Hence we have taken a different, neuro-optometrically based, approach in our evolving clinical studies [5–7] – especially in the patient with C/mTBI – with promising results. This has included the use of specialized chromatic and achromatic tints and a saccadic tracking paradigm. Our primary focus has involved the use of specialized spectacle tints, typically of a chromatic nature [5–7]. Different tints are tested on a patient, and the one that best reduces the perceived intensity of the VS is dispensed, being incorporated into the spectacle refractive correction. In addition, this tint typically also reduces the patient’s photosensitivity, as well as the perceived intensity of the disturbing palinopsia, if either or both are present. Two commercially available tints found to be effective are BPI-Omega (Brain Power Miami, FL, USA) and FL-41 (Brain Power Miami). In an earlier medically based study [10], the Intuitive ColorimeterTM (Cerium Visual Technologies Tenterden, Kent, UK) was used to assess chromatic tint preferences in 12 individuals with VSS. Eleven of the individuals (92%) had a distinct, repeatable chromatic preference, typically in the blue–yellow color spectrum. We have also used the Intuitiv","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"6 2","pages":"CNC89"},"PeriodicalIF":0.0,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8162163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38979340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum.","authors":"","doi":"10.2217/cnc-2020-0008c2","DOIUrl":"https://doi.org/10.2217/cnc-2020-0008c2","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2217/cnc-2020-0008.].</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"6 1","pages":"CNC87"},"PeriodicalIF":0.0,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8097505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38972664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helmet use in equestrian athletes: opportunities for intervention.","authors":"Ansley Grimes Stanfill,&nbsp;Kayla Wynja,&nbsp;Xueyuan Cao,&nbsp;Drew Prescott,&nbsp;Sarah Shore,&nbsp;Brandon Baughman,&nbsp;Anthony Oddo,&nbsp;Jack W Tsao","doi":"10.2217/cnc-2020-0019","DOIUrl":"https://doi.org/10.2217/cnc-2020-0019","url":null,"abstract":"<p><strong>Background: </strong>Equestrian athletes (horse riders) are at high risk for head injury, including concussions.</p><p><strong>Materials & methods: </strong>Adults riders were recruited via social media posting to complete a branching survey collecting data on demographics, riding experience, helmet use, injury history and concussion symptom knowledge. Results are reported as frequencies and percentages, with associations tested using chi-square with significance level p < 0.05.</p><p><strong>Results: </strong>Of the 2598 subjects, about 75% reported always wearing a helmet. Of those who did not, the most common reasons were that helmets are unnecessary (57.4%) or do not fit well (48.6%). Many indicated improper storage conditions and/or did not follow manufacturer's replacement recommendations. Most (75.4%) reported a high level of comfort with recognizing concussion signs, with half experiencing a prior head injury.</p><p><strong>Conclusion: </strong>This information suggests opportunities for intervention to improve helmet use through increased fit, while the responses indicate a need for further education on proper helmet use.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"6 1","pages":"CNC85"},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8097506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38972660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum.","authors":"","doi":"10.2217/cnc-2020-0008c1","DOIUrl":"https://doi.org/10.2217/cnc-2020-0008c1","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2217/cnc-2020-0008.].</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"5 4","pages":"CNC85"},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7653502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38615692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of two portable pupillometers to assess clinical utility.","authors":"Rachel Eshima McKay,&nbsp;Michael A Kohn,&nbsp;Elliot S Schwartz,&nbsp;Merlin D Larson","doi":"10.2217/cnc-2020-0016","DOIUrl":"https://doi.org/10.2217/cnc-2020-0016","url":null,"abstract":"<p><strong>Background: </strong>Pupillometers have been proposed as clinical assessment tools. We compared two pupillometers to assess measurement agreement.</p><p><strong>Materials & methods: </strong>We enrolled 30 subjects and simultaneously measured the pupil diameter and light reflex amplitude with an iPhone pupillometer and a portable infrared pupillometer. We then enrolled 40 additional subjects and made serial measurements with each device.</p><p><strong>Results: </strong>Failure occurred in 30% of attempts made with the iPhone pupillometer compared with 4% of attempts made with the infrared pupillometer (Fisher's exact p = 0.0001). Method comparison of the two devices used simultaneously showed significant disagreement in dynamic measurements.</p><p><strong>Conclusion: </strong>The iPhone pupillometer had poor repeatability and suggests that it is not a practical tool to support clinical decisions.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"5 4","pages":"CNC82"},"PeriodicalIF":0.0,"publicationDate":"2020-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2020-0016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38614720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concussion among soccer players in the 2017 Brazilian championship - the gap between protocol and medical practice.","authors":"Cármine Porcelli Salvarani,&nbsp;Lucas Ribeiro de Medeiros,&nbsp;Fernando Henrique Sapatero,&nbsp;Diego Ciotta de Castro,&nbsp;Vinícius Simon Tomazini,&nbsp;Leonardo Henrique Micheletti Sotocorno,&nbsp;Paulo Sérgio Teixeira da Costa,&nbsp;Bruno Bueno Pimenta,&nbsp;Diego Almeida de Oliveira,&nbsp;Eduardo Almeida Dias,&nbsp;Eduardo Vinícius Colman da Silva","doi":"10.2217/cnc-2020-0015","DOIUrl":"https://doi.org/10.2217/cnc-2020-0015","url":null,"abstract":"<p><strong>Background: </strong>The present study aims to report traumatic brain injury (TBI) among soccer players in the 2017 Brazilian Soccer Championship and discuss the protocols for concussion evaluation.</p><p><strong>Materials & methods: </strong>This is an observational study utilizing video analysis of 380 matches. TBI was considered as any event in which one or more soccer player(s) had a head trauma. For potential concussion diagnosis, we analyzed players with one of the following signs: slowness to get up, disorientation, motor incoordination, loss of consciousness, head clutching and impact seizure.</p><p><strong>Results: </strong>There were 374 TBIs in total. The average time for medical assessment was 1'35\". 13 players had concussion with an average time of 3'19″ for medical evaluation. Four players were replaced after having a concussion.</p><p><strong>Conclusion: </strong>There is a gap between concussion protocols and medical practices in Brazilian elite soccer. Further discussion about soccer replacement rules are imperative.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"5 4","pages":"CNC83"},"PeriodicalIF":0.0,"publicationDate":"2020-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7653505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38615691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Future directions in neuro-optometry.","authors":"Kenneth J Ciuffreda,&nbsp;Barry Tannen","doi":"10.2217/cnc-2020-0013","DOIUrl":"https://doi.org/10.2217/cnc-2020-0013","url":null,"abstract":"The area of neuro-optometry has evolved over the past 40 years to provide essential vision care for the brain-injured population. Here we present some proposed future directions in the field that could improve and expand this area of patient care. What do we mean by neuro-optometry? It represents a broad and evolving subspecialty within the profession of optometry [1,2]. More specifically, neuro-optometry deals with the diagnosis and treatment of vision-based problems commonly found in the brain-injured population (e.g., concussion and cerebrovascular accident). It \"addresses the oculomotor, accommodative, visuomotor, binocular, vestibular, perceptual/visual information processing and specific ocular/neurobiological sequalae of this population\" [2] (see also the COVD and NORA websites). Some of these problems include marked light and visual motion sensitivity, vergence dysfunction, oculomotor-based reading problems, blur, multimodal sensory integration deficits and deficient visuomotor planning and execution. Treatment includes vision therapy, lenses, prisms, selective occlusion and lens tints/coatings. The aforementioned neurooptometric rehabilitation follows the scientifically based tenets of neuroplasticity, incorporating the principles of perceptual and motor learning [2]. At last, it is remarkable that the vision problems in many of these patients can be remediated, at least in part, even in an older damaged brain. Where is the exciting field of neuro-optometry headed in the future? This is an important question as our crucial role in traumatic brain injury, and more broadly the diagnostic categories of acquired brain injury, as well as basic neurological/developmental disorders continues to expand. This includes both diagnostic and therapeutic aspects of vision care. It is, and will continue, to be performed in conjunction with other healthcare providers, as needed (e.g., the physiatrist, cognitive psychologist, occupational therapist, vision therapist), as well as in partnership with industry and the university (e.g., for development of specialized computer hardware/software and test devices). There are several possible areas of future focus and expansion of vision care. Some of these include:","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"5 4","pages":"CNC80"},"PeriodicalIF":0.0,"publicationDate":"2020-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7653504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38614718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographics and management of outpatient concussion visits among neurologists and non-neurologists: 2006-2016.","authors":"Patrick D Asselin,&nbsp;Rebekah Mannix","doi":"10.2217/cnc-2020-0008","DOIUrl":"https://doi.org/10.2217/cnc-2020-0008","url":null,"abstract":"<p><strong>Aim: </strong>Describe the patient demographics and management of outpatient concussion visits, focusing on neurologists.</p><p><strong>Materials & methods: </strong>We used the National Ambulatory Medical Care Survey to provide national estimates on the demographics and clinical decisions of concussion visits from 2006 to 2016, which were identified with International Classification of Disease-9/10 codes.</p><p><strong>Results: </strong>From 2006 to 2016, there were an estimated 11 million visits nationally. Neurologists saw significantly more patients over 18 years old and more nonacute care compared with non-neurologists. Neurologists performed imaging and prescribed new medications at similar rates as non-neurologists. Non-neurology subspecialties had a significant increase in visits during the study period.</p><p><strong>Conclusion: </strong>Neurologists saw older patients and more subacute patient care with similar rates prescribing new medications and imaging. Non-neurology subspecialists are more involved in concussions than previously.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":"5 3","pages":"CNC79"},"PeriodicalIF":0.0,"publicationDate":"2020-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2020-0008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38447378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}