Posts Tagged ‘Concussion’
Concussion has a long and interesting history spanning at least the 5 millennia of written medical record and closely mirrors the development of surgery and neurosurgery. Not surprisingly, much of the past and present experimental head injury and concussion work has been performed within neurosurgically driven laboratories or by several surgically oriented neurologists. This historical review chronicles the key aspects of neurosurgical involvement in sports concussion as related to the diagnosis, treatment, mitigation, and prevention of injury using the example of American football. In addition, we briefly trace the developments that led to our current understanding of the biomechanical and neurophysiological basis of concussion.
Current Concepts in Sports Concussion is online and full-text access is free.
Background: Although research focused on mild traumatic brain injury (mTBI) has proliferated in recent years, few studies have examined the significance of a previous history of mTBI in children.
Objective: To compare the acute injury presentation and neuropsychological recovery in a pediatric sample after mTBI.
Methods: Participants 8 to 16 years of age were divided into 4 groups: no previous injury history, history of 1 mTBI, history of 2 mTBIs, and history of ≥ 3 mTBIs. Participants were evaluated within 3 months of the most recent injury by clinical interview and an abbreviated neuropsychological test battery.
Background: Concussion remains a symptom-based diagnosis clinically, yet preclinical studies investigating traumatic brain injury, of which concussion is believed to represent a ‘mild’ form, emphasize histological endpoints with functional assessments often minimized or ignored all together. Recently, clinical studies have identified the importance of cognitive and neuropsychiatric symptoms, in addition to somatic complaints, following concussion. How these findings may translate to preclinical studies is unclear at present.
Objective: To address the contrasting endpoints utilized clinically compared to those in preclinical studies and the potential role of functional assessments in a commonly used model of diffuse axonal injury (DAI).
Methods: Animals were subjected to DAI using the impact-acceleration model. Functional and behavioral assessments were conducted over 1 week following DAI prior to completion of histological assessment at 1-week post-DAI.
Background: The Centers for Disease Control and Prevention have called for studies detailing the prevalence and burden of mild traumatic brain injury (mTBI) in the outpatient clinical setting.
Objective: The aim of this study was to describe the prevalence of outpatient visits for minor head injury and compare the number of outpatient visits for minor head injury with the number of emergency department (ED) visits.
Methods: This was a cross-sectional study of outpatient visits for minor head injuries from the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS). We examined outpatient visits for minor head injury between 2005 and 2009 and compared them with visits in the ED for the same diagnoses using simple survey-weighted descriptive statistics.
Traditionally, the medical management of concussion has involved close observation and physical and cognitive rest. Most postconcussive symptoms resolve spontaneously and require only conservative treatment. However, some patients have prolonged recoveries and may benefit from treatment with medications. Some naturally occurring compounds demonstrate multimechanistic neuroprotective properties and may be potential treatment considerations. For the most part, however, current treatments are symptom based for those with persistent postconcussive symptoms. The evidence supporting the various pharmacologic treatments in concussion is equivocal. The choice of which medication to use for a patient depends on the symptom characteristics, and each decision should be made on an individual-case basis. There is a need for well-designed trials investigating the efficacy of various medical therapies.