ConcussionPub Date : 2023-06-01DOI: 10.2217/cnc-2023-0005
Alice Lux Fawzi, Christian Franck
{"title":"Beyond symptomatic diagnosis of mild traumatic brain injury.","authors":"Alice Lux Fawzi, Christian Franck","doi":"10.2217/cnc-2023-0005","DOIUrl":"https://doi.org/10.2217/cnc-2023-0005","url":null,"abstract":"<p><p>It is commonly assumed that there is no brain injury if there are no noticeable symptoms following a head impact. There is growing evidence that traumatic brain injuries can occur with no outward symptoms and that the damage from these injuries can accumulate over time resulting in disease and impairment later in life. It is time to rethink the role that symptoms play in traumatic brain injury and adopt a quantitative understanding of brain health at the cellular level to improve the way we diagnose, prevent, and ultimately heal brain injury.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10242431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9652996","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}
ConcussionPub Date : 2023-06-01DOI: 10.2217/cnc-2022-0010
James Stavitz
{"title":"Exploring athletic trainers' experience and perceptions associated with a multifaceted approach to concussion management.","authors":"James Stavitz","doi":"10.2217/cnc-2022-0010","DOIUrl":"https://doi.org/10.2217/cnc-2022-0010","url":null,"abstract":"<p><strong>Aim: </strong>To explore high school athletic trainers' experience with, and perceptions of, a multifaceted approach to concussion management.</p><p><strong>Participants: </strong>A total of 20 high school athletic trainers that are certified and licensed to practice (if their state requires a license to practice) participated in this study.</p><p><strong>Materials & methods: </strong>A general qualitative design with descriptive coding and saturation was met at 20 interviews.</p><p><strong>Results: </strong>Lack of standardization allows assessment, referral and return-to-play experiences to vary significantly; referral experiences vary pending upon athletic trainers ability to refer to a trusted and responsive physician; barriers include clearances from unqualified physicians; pressure from coaches, parents and students to return students to play; benefits include increased knowledge and awareness resulting in more effective care for students.</p><p><strong>Conclusion: </strong>Athletic trainers have varying experiences and perceptions regarding their approaches to concussion management. However, there were many notable similarities in the experiences, pressures, barriers and benefits when applying their concussion protocol.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10242438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9652995","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":"Return-to-learn after concussion in Washington state public high schools during the COVID-19 pandemic.","authors":"Shyam J Deshpande, Aspen Avery, Julian Takagi-Stewart, Brianna Mills, Qian Qiu, Monica S Vavilala","doi":"10.2217/cnc-2022-0011","DOIUrl":"https://doi.org/10.2217/cnc-2022-0011","url":null,"abstract":"<p><strong>Aim: </strong>To understand academic support structures for Washington state public high school students with concussion during the COVID-19 pandemic.</p><p><strong>Materials & methods: </strong>Prospective, repeated cross-sectional study of 21 schools in 2020 and 2021.</p><p><strong>Results: </strong>About 28% of schools reported not providing any return-to-learn (RTL) accommodations for students with concussion throughout the COVID-19 pandemic. RTL accommodation provision was associated with larger student body size (<i>β</i> = 0.002) and higher graduation rate (<i>β</i> = 0.261) but was not associated with presence of RTL school policy. About 38.1% of schools received no guidance on how to provide RTL accommodations during the COVID-19 pandemic, and many reported that students with concussion struggled more.</p><p><strong>Conclusion: </strong>Schools struggled to provide RTL accommodations for students with concussion during the COVID-19 pandemic, highlighting the need for evidence-based guidance and resource allocation to vulnerable schools.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9937029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9592693","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}
ConcussionPub Date : 2023-04-01DOI: 10.2217/cnc-2023-0004
Seth Strauss, Douglas F Lightstone, Curtis Fedorchuk, Robert Pomahac, Paul A Oakley, Deed E Harrison
{"title":"Post-concussion syndrome and concussion incidence improved in a pro rugby player following cervical spine rehab: case study and 6-year follow-up.","authors":"Seth Strauss, Douglas F Lightstone, Curtis Fedorchuk, Robert Pomahac, Paul A Oakley, Deed E Harrison","doi":"10.2217/cnc-2023-0004","DOIUrl":"https://doi.org/10.2217/cnc-2023-0004","url":null,"abstract":"<p><strong>Aim: </strong>To report improvements in post-concussion syndrome and concussion incidence following cervical spinal alignment correction.</p><p><strong>Case presentation: </strong>A 27-year-old professional rugby player with 20 documented concussions presented with abnormal cervical spinal alignment and post-concussion syndrome. After 30 sessions of cervical rehabilitation, health outcomes improved. Post-treatment radiographs showed improved cervical lordosis from -13.5° to -37.4° (ideal is -42°) and right head translation from -22.7 to -11.3 mm (ideal is 0 mm). 2-year follow-up radiographs and 6-year follow-up health outcomes showed post-treatment improvements were maintained. The patient reported two documented concussions in the 6 years following treatment while maintaining the same lifestyle and professional rugby career.</p><p><strong>Conclusion: </strong>Correction of abnormal cervical spinal alignment may help athletes with post-concussion syndrome and reduce risk of concussion.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10485734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10214407","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}
ConcussionPub Date : 2023-01-17eCollection Date: 2022-12-01DOI: 10.2217/cnc-2022-0005
Catherine Willmott, Jonathan Reyes, Jack V K Nguyen, Andrew McIntosh, Jennifer Makovec-Knight, Michael Makdissi, Patrick Clifton, Peter Harcourt, Biswadev Mitra
{"title":"A pilot case crossover study of the use of padded headgear in junior Australian football.","authors":"Catherine Willmott, Jonathan Reyes, Jack V K Nguyen, Andrew McIntosh, Jennifer Makovec-Knight, Michael Makdissi, Patrick Clifton, Peter Harcourt, Biswadev Mitra","doi":"10.2217/cnc-2022-0005","DOIUrl":"10.2217/cnc-2022-0005","url":null,"abstract":"<p><strong>Aim: </strong>To explore soft-shell padded headgear (HG) use, player behavior and injuries associated with HG in junior Australian football.</p><p><strong>Methods: </strong>Prospective case-crossover with head impact measurement, injury surveillance and video review.</p><p><strong>Results: </strong>40 players (mean age: 12.43 years, standard deviation: 1.36) across 15 matches were observed. Frequency of head/neck (p = 0.916) or body (p = 0.883) contact events, and match incidents were similar between HG and no HG conditions. Without HG, females had higher frequency of body contacts compared with males (p = 0.015). Males sustained more body contacts with HG than without HG (p = 0.013).</p><p><strong>Conclusion: </strong>Use of HG in junior football was not associated with injury or head contact rate. Associations between HG use and body contact may differ across sexes. (ID: ACTRN12619001165178).</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9855304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9187696","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}
ConcussionPub Date : 2022-12-01DOI: 10.2217/cnc-2022-0007
Marko Ivancich, Vince Berry, Michael Clark, Andrew Beaumont, Corina Norrbom, Jeffrey C Amundson
{"title":"Self-reported concussion history among midwestern skiers and snowboarders.","authors":"Marko Ivancich, Vince Berry, Michael Clark, Andrew Beaumont, Corina Norrbom, Jeffrey C Amundson","doi":"10.2217/cnc-2022-0007","DOIUrl":"https://doi.org/10.2217/cnc-2022-0007","url":null,"abstract":"<p><strong>Aim: </strong>To assess the rate of self-reported concussion in midwestern skiers and snowboarders.</p><p><strong>Patients: </strong>Recreational skiers and snowboarders between the ages of 14 and 69 years during a single winter ski season (2020-2021) at a ski area in Wisconsin, USA.</p><p><strong>Methods: </strong>Survey study.</p><p><strong>Results: </strong>Among this survey population (n = 161), 9.32 and 19.25% reported one or more diagnosed concussion and suspected concussion respectively as a result of a skiing- or snowboarding-related incident. Skiers and snowboarders that self-identified as <i>advanced</i>, those who utilized terrain park features, and those that participated in freestyle competition had significantly higher self-reported rates of concussion.</p><p><strong>Conclusion: </strong>Self-reported concussion history indicates a concussion prevalence that is higher than expected based on previous studies. Participants reported significantly more suspected concussions than diagnosed concussions, indicating a possible issue with underreporting in this population.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9979102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10838219","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}
ConcussionPub Date : 2022-12-01DOI: 10.2217/cnc-2022-0003
David E Ross, John D Seabaugh, Jan M Seabaugh, Claudia Alvarez, Laura Peyton Ellis, Christopher Powell, Christopher Reese, Leah Cooper, Katherine Shepherd, For The Alzheimer's Disease Neuroimaging Initiative
{"title":"Journey to the other side of the brain: asymmetry in patients with chronic mild or moderate traumatic brain injury.","authors":"David E Ross, John D Seabaugh, Jan M Seabaugh, Claudia Alvarez, Laura Peyton Ellis, Christopher Powell, Christopher Reese, Leah Cooper, Katherine Shepherd, For The Alzheimer's Disease Neuroimaging Initiative","doi":"10.2217/cnc-2022-0003","DOIUrl":"https://doi.org/10.2217/cnc-2022-0003","url":null,"abstract":"<p><strong>Aim: </strong>Patients with chronic mild or moderate traumatic brain injury have some regions of brain atrophy (including cerebral white matter) but even more regions of abnormal brain enlargement (including other cerebral regions).</p><p><strong>Hypothesis: </strong>Ipsilateral injury and atrophy cause the eventual development of contralateral compensatory hypertrophy.</p><p><strong>Materials & methods: </strong>50 patients with mild or moderate traumatic brain injury were compared to 80 normal controls (n = 80) with respect to MRI brain volume asymmetry. Asymmetry-based correlations were used to test the primary hypothesis.</p><p><strong>Results: </strong>The group of patients had multiple regions of abnormal asymmetry.</p><p><strong>Conclusion: </strong>The correlational analyses supported the conclusion that acute injury to ipsilateral cerebral white matter regions caused atrophy, leading eventually to abnormal enlargement of contralateral regions due to compensatory hypertrophy.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9979152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10838217","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":"Enhanced education for adult patients with persistent post-concussion headaches: a randomized controlled trial.","authors":"Emily Collett, Tianru Wang, Candice Todd, Anil Dosaj, Andrew Baker, Cindy Hunt","doi":"10.2217/cnc-2022-0008","DOIUrl":"https://doi.org/10.2217/cnc-2022-0008","url":null,"abstract":"<p><strong>Aim & patients: </strong>We conducted a randomized clinical trial to determine if an e-learning intervention can enhance recovery in adult patients with persistent post-concussion headaches (PPCH).</p><p><strong>Materials & methods: </strong>The intervention consisted of three e-learning modules administered at baseline, 6 and 12 weeks. Data were collected on symptoms, community integration, quality of life and healthcare utilization at baseline and 12-week follow-up. ANCOVA was conducted to compare changes.</p><p><strong>Results: </strong>No statistically significant difference was observed on symptoms although we observed a trend toward reduced healthcare utilization and improved quality of life in the intervention group.</p><p><strong>Conclusion: </strong>E-learning modules for patients experiencing PPCH warrant further investigation with data on participant compliance and measures focusing on simpler short-term outcomes.<b>Clinical Trial Registration</b>: NCT03391583 (ClinicalTrials.gov).</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9841394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10582863","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}
ConcussionPub Date : 2022-11-01DOI: 10.2217/cnc-2022-0004
Iftakher Hossain, Kaj Blennow, Jussi P Posti, Henrik Zetterberg
{"title":"Tau as a fluid biomarker of concussion and neurodegeneration.","authors":"Iftakher Hossain, Kaj Blennow, Jussi P Posti, Henrik Zetterberg","doi":"10.2217/cnc-2022-0004","DOIUrl":"https://doi.org/10.2217/cnc-2022-0004","url":null,"abstract":"<p><p>Concussion is predominant among the vast number of traumatic brain injuries that occur worldwide. Difficulties in timely identification, whether concussion led to neuronal injury or not, diagnosis and the lack of prognostic tools for adequate management could lead this type of brain injury to progressive neurodegenerative diseases. Tau has been extensively studied in recent years, particularly in repetitive mild traumatic brain injuries and sports-related concussions. Tauopathies, the group of neurodegenerative diseases, have also been studied with advanced functional imaging. Nevertheless, neurodegenerative diseases, such as chronic traumatic encephalopathy, are still conclusively diagnosed at autopsy. Here, we discuss the diagnostic dilemma and the relationship between concussion and neurodegenerative diseases and review the literature on tau as a promising biomarker for concussion.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9841393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10637696","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}
ConcussionPub Date : 2022-05-19eCollection Date: 2022-03-01DOI: 10.2217/cnc-2021-0006
Justis Barcelona, David E Ross, John D Seabaugh, Jan M Seabaugh
{"title":"Abnormal asymmetry correlates with abnormal enlargement in a patient with chronic moderate traumatic brain injury.","authors":"Justis Barcelona, David E Ross, John D Seabaugh, Jan M Seabaugh","doi":"10.2217/cnc-2021-0006","DOIUrl":"https://doi.org/10.2217/cnc-2021-0006","url":null,"abstract":"<p><strong>Aim: </strong>Recent studies found patients with chronic, mild or moderate traumatic brain injury had more regions of enlargement than atrophy. There is little research discussing brain volume enlargement, asymmetry and TBI.</p><p><strong>Materials & methods: </strong>In this report, we describe a 40-year-old man who suffered a left cerebral hemorrhage resulting in a moderate TBI, suggesting greater forces on the left side of his brain. NeuroQuant<sup>®</sup> brain volumetric analyses of his MRI obtained 1.7 years post injury showed left cerebral white matter atrophy but right gray matter abnormal enlargement. Abnormal asymmetry of multiple regions (R >L) was confirmed by NeuroGage<sup>®</sup> asymmetry analyses.</p><p><strong>Discussion: </strong>The findings suggested that abnormal brain volume enlargement was due to hyperactivity and hypertrophy of less-injured brain regions as a compensatory response to more-injured regions.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9219597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40646414","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}