Posts Tagged ‘Concussion’
Free CME Article: From the Field of Play to the Field of Combat
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.
Free Article: Chronic Traumatic Encephalopathy in American Athletes
Background: We define chronic traumatic encephalopathy (CTE) as a progressive neurodegenerative syndrome caused by single, episodic, or repetitive blunt force impacts to the head and transfer of acceleration-deceleration forces to the brain.
Objective: We present emerging histomorphologic phenotypes of CTE that we identified in our cohort of CTE cases with apolipoprotein E genotyping and causes and manners of death.
Methods: Autopsy brain tissue of 14 professional athletes and 3 high school football players was examined after unexpected deaths. Histochemical and immunohistochemical tissue staining was performed with apolipoprotein E genotyping.
In the News: Enduring Symptoms after Multiple Concussions
“Early Indicators of Enduring Symptoms in High School Athletes With Multiple Previous Concussions“ by Schatz et al is referenced in a Grantland.com article titled “The Fragile Teenage Brain,” by Jonah Lehrer.
“The consequences appear to be particularly severe for the adolescent brain. According to a study published last year in Neurosurgery, high school football players who suffered two or more concussions reported mental problems at much higher rates, including headaches, dizziness, and sleeping issues. The scientists describe these symptoms as “neural precursors,” warning signs that something in the head has gone seriously wrong.”
Ahead of Print: Cutoffs Predicting Protracted Concussion Recovery
Background: Many studies address diagnosing concussions but few look at predicting prognosis. A prior discriminant function analysis showed that symptom clusters derived from the Post-Concussion Symptom Scale (PCSS) and ImPACT composite scores used together improved predictions of protracted recovery following a sports-related concussion.
Objective: To determine cutoff scores in neurocognitive and PCSS symptom cluster scores when classifying protracted recovery in concussed athletes.
Methods: 108 male high school football athletes completed a computer-based neurocognitive test battery (ImPACT) within a median of 2 days following injury. Patients completed graded exertional protocols requiring athletes to be symptom free at rest and during increasing levels of activity and had recovery of neurocognitive scores before return-to-play. Following return-to-play, athletes were classified as protracted recovery (>14 days, N=58) or short-recovery (<=14 days, N=50). ROC curves analyzed each of the neurocognitive (verbal, visual, processing speed, and reaction time) and symptom cluster (migraine, cognitive, sleep, and neuropsychiatric) scores.
