Concussion最新文献

{"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":"The cost of a single concussion in American high school football: a retrospective cohort study.","authors":"Aaron M Yengo-Kahn, Patrick D Kelly, David C Liles, Lydia J McKeithan, Candace J Grisham, Muhammad Saad Khan, Timothy Lee, Andrew W Kuhn, Christopher M Bonfield, Scott L Zuckerman","doi":"10.2217/cnc-2020-0012","DOIUrl":"10.2217/cnc-2020-0012","url":null,"abstract":"<p><strong>Aim: </strong>The potential financial burden of American football-related concussions (FRC) is unknown. Our objective was to describe the healthcare costs associated with an FRC and determine factors associated with increased costs.</p><p><strong>Methodology/results: </strong>A retrospective cohort study of concussed high school football players presenting between November 2017 and March 2020 was undertaken; 144 male high school football players were included. Total costs were about $115,000, for an average direct healthcare cost of $800.10/concussion. Visiting the emergency department (β = 502.29, 95% CI: 105.79-898.61; p = 0.01), the initial post-concussion symptom scale score (β = 0.39, 95% CI: 0.11-0.66; p = 0.01) and a post-concussion syndrome diagnosis (β = 670.37, 95% CI: 98.96-1241.79; p = 0.02) were each independently associated with total costs.</p><p><strong>Conclusion: </strong>A granular understanding of cost-driving factors associated with FRC is the first step in understanding the cost-effectiveness of prevention and treatment methods.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7653506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38614719","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":"Persistent alterations of cortical hemodynamic response in asymptomatic concussed patients.","authors":"Allyssa K Memmini, Xin Sun, Xiaosu Hu, Jessica Kim, Noelle K Herzog, Mohammed N Islam, Daniel H Weissman, Alexander J Rogers, Ioulia Kovelman, Steven P Broglio","doi":"10.2217/cnc-2020-0014","DOIUrl":"10.2217/cnc-2020-0014","url":null,"abstract":"<p><strong>Aim: </strong>The underlying neurophysiological effects of concussion often result in attenuated cognitive and cortical function. To understand the relation between cognition and brain injury, we investigated the effects of concussion on attentional networks using functional near-infrared spectroscopy (fNIRS).</p><p><strong>Materials & methods: </strong>Healthy controls and concussed patients, tested within 72 h from injury (T1) and after symptoms resolved (T2) completed a computerized attention task during fNIRS imaging.</p><p><strong>Results: </strong>T1 patients exhibited slower reaction times and reduced brain activation pattern relative to healthy controls. Interestingly, the cortical oxygenation hemoglobin response at T2 was greater relative to T1 and healthy controls, while reaction time was normative.</p><p><strong>Conclusion: </strong>The exploratory findings of this study suggest once asymptomatic, a compensatory hemodynamic response may support the restoration of reaction time despite ongoing physiological recovery.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8097509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38972257","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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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}

{"title":"Quality of life of ice hockey players after retirement due to concussions.","authors":"Anna Gard,&nbsp;Niklas Lehto,&nbsp;Åsa Engström,&nbsp;Pashtun Shahim,&nbsp;Henrik Zetterberg,&nbsp;Kaj Blennow,&nbsp;Niklas Marklund,&nbsp;Yelverton Tegner","doi":"10.2217/cnc-2020-0007","DOIUrl":"https://doi.org/10.2217/cnc-2020-0007","url":null,"abstract":"<p><strong>Background: </strong>Sports-related concussion (SRC) is increasingly recognized as a potential health problem in ice hockey. Quality of life (QoL) in players retiring due to SRC has not been thoroughly addressed.</p><p><strong>Materials & methods: </strong>QoL using the Sports Concussion Assessment Tool 5th Edition, Impact of Event Scale-Revised and Short Form Health Survey was measured in Swedish ice hockey players who retired due to persistence of postconcussion symptoms or fear of attaining additional SRC.</p><p><strong>Results: </strong>A total of 76 players were assessed, on average of 5 years after their most recent SRC. Overall, retired players had a high burden of postconcussion symptoms and reduced QoL.</p><p><strong>Conclusion: </strong>Retired concussed ice hockey players have a reduced QoL, particularly those retiring due to postconcussion symptoms. Symptom burden should be continuously evaluated and guide the decision to retire.</p>","PeriodicalId":37006,"journal":{"name":"Concussion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cnc-2020-0007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38447377","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":"Vision care in concussion and traumatic brain injury: unmet needs.","authors":"Kenneth J Ciuffreda,&nbsp;Barry Tannen,&nbsp;Penelope S Suter","doi":"10.2217/cnc-2020-0009","DOIUrl":"https://doi.org/10.2217/cnc-2020-0009","url":null,"abstract":"The world of concussion and traumatic brain injury (TBI) entered a new dimension with the advent of the Iraq and Afghanistan wars, which have persisted over the past 2 decades [1]. This was later further echoed and amplified by the sports concussion ‘epidemic’ [1]. The effect of both occurrences drew much needed attention to the medical condition of concussion/TBI both diagnostically and therapeutically [1], with one emphasis being on the visual sequelae persisting in at least 20% of the patients [2]. Despite this renewed and on-going attention, at least two areas currently have unmet needs: acute concussion detection and clinical intervention for visual sequellae of severe TBI. The first area of unmet need – namely improved detection and diagnosis of acute concussion – is critical to prevent additional closely spaced, additive concussions [3], especially in our youths. Over the past decade or so, many subjective and objective diagnostic tests have been proposed [4,5]. A subjective test has been the King-Devick oculomotor-based test [6]. The King-Devick test has proven to be a sensitive, noninvasive test, with well-established normative data, which can be administered in the sports field and perhaps in the military theater. However, it is somewhat cumbersome to use, requires several minutes to explain, administer and score, relies heavily on having prior baseline testing done for pre/postcomparison and is best performed by either an experienced professional or a semi-experienced individual in a quiet setting. An objective test is dynamic pupillometry [7–10]. This approach is very rapid (taking about 5 s), noninvasive and easily administered in the sports field or military theater by relatively inexperienced personnel. Additionally, the quantitative results are immediate and have well-established normative data. Unfortunately, despite being a good potential vision biomarker for acute concussion [11] as well as other phases of TBI (e.g., subacute and chronic) [7–10], dynamic pupillometry has not been embraced by many. We suggest that dynamic pupillometry be the first line of diagnostic defense and, if the result is borderline, then the King-Devick test should also be used to improve diagnostic capability (i.e., specificity and sensitivity). Alternatively, both can be used if circumstances permit, which is optimal. The second area of unmet need is the wider, more aggressive use of simple, therapeutic visual interventions in the severe TBI population [12–14]. Vision care in this population remains a grossly underserved, orphan area. There are many reasons for this, with a likely primary one being the relative difficulty in interacting with this population in the presence of considerable physical, cognitive, attentional and/or language processing deficits, in addition to their constellation of visual dysfunctions. Although this group only accounts for approximately 20% of the overall TBI population [1], it is this subgroup for which the visual system ","PeriodicalId":37006,"journal":{"name":"Concussion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7506479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38447375","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}