Auerbach, P S; Waggoner 2nd, W H
It's Time to Change the Rules Journal Article
In: JAMA, vol. 316, no. 12, pp. 1260–1261, 2016.
BibTeX | Tags: *Brain Concussion/co [Complications], *Football/in [Injuries], adult, Brain Concussion/et [Etiology], Brain Concussion/pc [Prevention & Control], Football/st [Standards], Humans, Male, Safety/st [Standards], UNITED States
@article{Auerbach2016,
title = {It's Time to Change the Rules},
author = {Auerbach, P S and {Waggoner 2nd}, W H},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {316},
number = {12},
pages = {1260--1261},
keywords = {*Brain Concussion/co [Complications], *Football/in [Injuries], adult, Brain Concussion/et [Etiology], Brain Concussion/pc [Prevention \& Control], Football/st [Standards], Humans, Male, Safety/st [Standards], UNITED States},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
Abstract | BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics & Numerical Data
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
O'Kane, J W
Is Heading in Youth Soccer Dangerous Play? Journal Article
In: Physician & Sportsmedicine, vol. 44, no. 2, pp. 190–194, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/et [Etiology], *Brain Injury, *Soccer/in [Injuries], Adolescent, Brain Concussion/et [Etiology], Brain Concussion/pc [Prevention & Control], Brain Injuries/pc [Prevention & Control], Brain Injury, Child, Chronic/et [Etiology], Chronic/pc [Prevention & Control], Humans, Risk Factors, UNITED States
@article{OKane2016,
title = {Is Heading in Youth Soccer Dangerous Play?},
author = {O'Kane, J W},
year = {2016},
date = {2016-01-01},
journal = {Physician \& Sportsmedicine},
volume = {44},
number = {2},
pages = {190--194},
abstract = {BACKGROUND: Soccer is among the most popular youth sports with over 3 million youth players registered in the U.S. Soccer is unique in that players intentionally use their head to strike the ball, leading to concerns that heading could cause acute or chronic brain injury, especially in the immature brains of children. METHODS: Pub Med search without date restriction was conducted in November 2014 and August 2015 using the terms soccer and concussion, heading and concussion, and youth soccer and concussion. 310 articles were identified and reviewed for applicable content specifically relating to youth athletes, heading, and/or acute or chronic brain injury from soccer. RESULTS: Soccer is a low-risk sport for catastrophic head injury, but concussions are relatively common and heading often plays a role. At all levels of play, concussions are more likely to occur in the act of heading than with other facets of the game. While concussion from heading the ball without other contact to the head appears rare in adult players, some data suggests children are more susceptible to concussion from heading primarily in game situations. Contributing factors include biomechanical forces, less developed technique, and the immature brain's susceptibility to injury. CONCLUSIONS: There is no evidence that heading in youth soccer causes any permanent brain injury and there is limited evidence that heading in youth soccer can cause concussion. A reasonable approach based on U.S. Youth Soccer recommendations is to teach heading after age 10 in controlled settings, and heading in games should be delayed until skill acquisition and physical maturity allow the youth player to head correctly with confidence.},
keywords = {*Brain Injuries/et [Etiology], *Brain Injury, *Soccer/in [Injuries], Adolescent, Brain Concussion/et [Etiology], Brain Concussion/pc [Prevention \& Control], Brain Injuries/pc [Prevention \& Control], Brain Injury, Child, Chronic/et [Etiology], Chronic/pc [Prevention \& Control], Humans, Risk Factors, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Bachynski, K E
Tolerable Risks? Physicians and Youth Tackle Football Journal Article
In: New England Journal of Medicine, vol. 374, no. 5, pp. 405–407, 2016.
BibTeX | Tags: *Athletic Injuries/pc [Prevention & Control], *Brain Concussion/pc [Prevention & Control], *Football/in [Injuries], *Guidelines as Topic, *Physician's Role, *SPORTS medicine, Adolescent, Brain Concussion/et [Etiology], Child, Craniocerebral Trauma/et [Etiology], Craniocerebral Trauma/pc [Prevention & Control], Head Protective Devices, Humans, Medical, pediatrics, Societies, UNITED States
@article{Bachynski2016,
title = {Tolerable Risks? Physicians and Youth Tackle Football},
author = {Bachynski, K E},
year = {2016},
date = {2016-01-01},
journal = {New England Journal of Medicine},
volume = {374},
number = {5},
pages = {405--407},
keywords = {*Athletic Injuries/pc [Prevention \& Control], *Brain Concussion/pc [Prevention \& Control], *Football/in [Injuries], *Guidelines as Topic, *Physician's Role, *SPORTS medicine, Adolescent, Brain Concussion/et [Etiology], Child, Craniocerebral Trauma/et [Etiology], Craniocerebral Trauma/pc [Prevention \& Control], Head Protective Devices, Humans, Medical, pediatrics, Societies, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Davis, J; Canty, G
Are Sports-Related Concussions Giving You a Headache? Journal Article
In: Missouri Medicine, vol. 112, no. 3, pp. 187–191, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/co [Complications], *Brain Concussion/di [Diagnosis], *Brain Concussion/th [Therapy], Adolescent, Brain Concussion/et [Etiology], Child, DIAGNOSTIC imaging, Emergency Medicine, Humans, Neuropsychological Tests, Patient Education as Topic
@article{Davis2015,
title = {Are Sports-Related Concussions Giving You a Headache?},
author = {Davis, J and Canty, G},
year = {2015},
date = {2015-01-01},
journal = {Missouri Medicine},
volume = {112},
number = {3},
pages = {187--191},
abstract = {Acute care visits for sports-related concussion (SRC) are increasing dramatically in adolescents. This review summarizes current concepts in the evaluation and management of pediatric SRC by health care providers in the acute care setting.},
keywords = {*Athletic Injuries/co [Complications], *Brain Concussion/di [Diagnosis], *Brain Concussion/th [Therapy], Adolescent, Brain Concussion/et [Etiology], Child, DIAGNOSTIC imaging, Emergency Medicine, Humans, Neuropsychological Tests, Patient Education as Topic},
pubstate = {published},
tppubtype = {article}
}
Hernandez, F; Shull, P B; Camarillo, D B
Evaluation of a laboratory model of human head impact biomechanics Journal Article
In: Journal of Biomechanics, vol. 48, no. 12, pp. 3469–3477, 2015.
Abstract | BibTeX | Tags: *HEAD, *Laboratories, *Mechanical Phenomena, *Models, Acceleration, Biological, Biomechanical Phenomena, Brain Concussion/et [Etiology], Football/in [Injuries], Head Protective Devices, Humans, Male, Neck/ph [Physiology], Rotation, SAFETY
@article{Hernandez2015,
title = {Evaluation of a laboratory model of human head impact biomechanics},
author = {Hernandez, F and Shull, P B and Camarillo, D B},
year = {2015},
date = {2015-01-01},
journal = {Journal of Biomechanics},
volume = {48},
number = {12},
pages = {3469--3477},
abstract = {This work describes methodology for evaluating laboratory models of head impact biomechanics. Using this methodology, we investigated: how closely does twin-wire drop testing model head rotation in American football impacts? Head rotation is believed to cause mild traumatic brain injury (mTBI) but helmet safety standards only model head translations believed to cause severe TBI. It is unknown whether laboratory head impact models in safety standards, like twin-wire drop testing, reproduce six degree-of-freedom (6DOF) head impact biomechanics that may cause mTBI. We compared 6DOF measurements of 421 American football head impacts to twin-wire drop tests at impact sites and velocities weighted to represent typical field exposure. The highest rotational velocities produced by drop testing were the 74th percentile of non-injury field impacts. For a given translational acceleration level, drop testing underestimated field rotational acceleration by 46% and rotational velocity by 72%. Primary rotational acceleration frequencies were much larger in drop tests ($sim$100 Hz) than field impacts ($sim$10 Hz). Drop testing was physically unable to produce acceleration directions common in field impacts. Initial conditions of a single field impact were highly resolved in stereo high-speed video and reconstructed in a drop test. Reconstruction results reflected aggregate trends of lower amplitude rotational velocity and higher frequency rotational acceleration in drop testing, apparently due to twin-wire constraints and the absence of a neck. These results suggest twin-wire drop testing is limited in modeling head rotation during impact, and motivate continued evaluation of head impact models to ensure helmets are tested under conditions that may cause mTBI. Copyright © 2015 Elsevier Ltd. All rights reserved.},
keywords = {*HEAD, *Laboratories, *Mechanical Phenomena, *Models, Acceleration, Biological, Biomechanical Phenomena, Brain Concussion/et [Etiology], Football/in [Injuries], Head Protective Devices, Humans, Male, Neck/ph [Physiology], Rotation, SAFETY},
pubstate = {published},
tppubtype = {article}
}
Neselius, S; Brisby, H; Granholm, F; Zetterberg, H; Blennow, K
Monitoring concussion in a knocked-out boxer by CSF biomarker analysis Journal Article
In: Knee Surgery, Sports Traumatology, Arthroscopy, vol. 23, no. 9, pp. 2536–2539, 2015.
Abstract | BibTeX | Tags: *Boxing/in [Injuries], *Brain Concussion/di [Diagnosis], *Neurofilament Proteins/cf [Cerebrospinal Fluid], 0 (Biomarkers), 0 (neurofilament protein L), 0 (Neurofilament Proteins), Biomarkers/cf [Cerebrospinal Fluid], Brain Concussion/cf [Cerebrospinal Fluid], Brain Concussion/et [Etiology], Humans, Male, Young Adult
@article{Neselius2015,
title = {Monitoring concussion in a knocked-out boxer by CSF biomarker analysis},
author = {Neselius, S and Brisby, H and Granholm, F and Zetterberg, H and Blennow, K},
year = {2015},
date = {2015-01-01},
journal = {Knee Surgery, Sports Traumatology, Arthroscopy},
volume = {23},
number = {9},
pages = {2536--2539},
abstract = {Concussion is common in many sports, and the incidence is increasing. The medical consequences after a sport-related concussion have received increased attention in recent years since it is known that concussions cause axonal and glial damage, which disturbs the cerebral physiology and makes the brain more vulnerable for additional concussions. This study reports on a knocked-out amateur boxer in whom cerebrospinal fluid (CSF) neurofilament light (NFL) protein, reflecting axonal damage, was used to identify and monitor brain damage. CSF NFL was markedly increased during 36 weeks, suggesting that neuronal injury persists longer than expected after a concussion. CSF biomarker analysis may be valuable in the medical counselling of concussed athletes and in return-to-play considerations.},
keywords = {*Boxing/in [Injuries], *Brain Concussion/di [Diagnosis], *Neurofilament Proteins/cf [Cerebrospinal Fluid], 0 (Biomarkers), 0 (neurofilament protein L), 0 (Neurofilament Proteins), Biomarkers/cf [Cerebrospinal Fluid], Brain Concussion/cf [Cerebrospinal Fluid], Brain Concussion/et [Etiology], Humans, Male, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Ritchie, L J; Koltek, M; Hosain, S; Cordingley, D; Chu, S; Selci, E; Leiter, J; Russell, K
Psychiatric outcomes after pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 16, no. 6, pp. 709–718, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/co [Complications], *Brain Concussion/ep [Epidemiology], *Brain Concussion/px [Psychology], *Emotions, *Post-Concussion Syndrome/ep [Epidemiology], *Post-Concussion Syndrome/px [Psychology], Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/et [Etiology], Child, Female, Humans, Male, Manitoba/ep [Epidemiology], MEDICAL records, Neuropsychological Tests, Patient Care Team, Post-Concussion Syndrome/et [Etiology], Prevalence, Retrospective Studies, Risk Factors, Sports
@article{Ellis2015ab,
title = {Psychiatric outcomes after pediatric sports-related concussion},
author = {Ellis, M J and Ritchie, L J and Koltek, M and Hosain, S and Cordingley, D and Chu, S and Selci, E and Leiter, J and Russell, K},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {16},
number = {6},
pages = {709--718},
abstract = {OBJECT: The objectives of this study were twofold: (1) to examine the prevalence of emotional symptoms among children and adolescents with a sports-related concussion (SRC) who were referred to a multidisciplinary pediatric concussion program and (2) to examine the prevalence, clinical features, risk factors, and management of postinjury psychiatric outcomes among those in this clinical population. METHODS: The authors conducted a retrospective chart review of all patients with SRC referred to a multidisciplinary pediatric concussion program between September 2013 and October 2014. Clinical assessments carried out by a single neurosurgeon included clinical history, physical examination, and Post-Concussion Symptom Scale (PCSS) scoring. Postinjury psychiatric outcomes were defined as a subjective worsening of symptoms of a preinjury psychiatric disorder or new and isolated suicidal ideation or diagnosis of a novel psychiatric disorder (NPD). An NPD was defined as a newly diagnosed psychiatric disorder that occurred in a patient with or without a lifetime preinjury psychiatric disorder after a concussion. Clinical resources, therapeutic interventions, and clinical and return-to-play outcomes are summarized. RESULTS: One hundred seventy-four patients (mean age 14.2 years, 61.5% male) were included in the study. At least 1 emotional symptom was reported in 49.4% of the patients, and the median emotional PCSS subscore was 4 (interquartile range 1-8) among those who reported at least 1 emotional symptom. Overall, 20 (11.5%) of the patients met the study criteria for a postinjury psychiatric outcome, including 14 patients with an NPD, 2 patients with isolated suicidal ideation, and 4 patients with worsening symptoms of a preinjury psychiatric disorder. Female sex, a higher initial PCSS score, a higher emotional PCSS subscore, presence of a preinjury psychiatric history, and presence of a family history of psychiatric illness were significantly associated with postinjury psychiatric outcomes. Interventions for patients with postinjury psychiatric outcomes included pharmacological therapy alone in 2 patients (10%), cognitive behavioral therapy alone in 4 (20%), multimodal therapy in 9 (45%), and no treatment in 5 (25%). Overall, 5 (25%) of the patients with postinjury psychiatric disorders were medically cleared to return to full sports participation, whereas 5 (25%) were lost to follow-up and 9 (45%) remained in treatment by the multidisciplinary concussion program at the end of the study period. One patient who was asymptomatic at the time of initial consultation committed suicide. CONCLUSIONS: Emotional symptoms were commonly reported among pediatric patients with SRC referred to a multidisciplinary pediatric concussion program. In some cases, these symptoms contributed to the development of an NPD, isolated suicidal ideation, and worsening symptoms of a preexisting psychiatric disorder. Future research is needed to clarify the prevalence, pathophysiology, risk factors, and evidence-based management of postinjury psychiatric outcomes after pediatric SRC. Successful management of these patients requires prompt recognition and multidisciplinary care by experts with clinical training and experience in concussion and psychiatry.},
keywords = {*Athletic Injuries/co [Complications], *Brain Concussion/ep [Epidemiology], *Brain Concussion/px [Psychology], *Emotions, *Post-Concussion Syndrome/ep [Epidemiology], *Post-Concussion Syndrome/px [Psychology], Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/et [Etiology], Child, Female, Humans, Male, Manitoba/ep [Epidemiology], MEDICAL records, Neuropsychological Tests, Patient Care Team, Post-Concussion Syndrome/et [Etiology], Prevalence, Retrospective Studies, Risk Factors, Sports},
pubstate = {published},
tppubtype = {article}
}
Hutchison, M G; Comper, P; Meeuwisse, W H; Echemendia, R J
A systematic video analysis of National Hockey League (NHL) concussions, part I: who, when, where and what? Journal Article
In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 547–551, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/ep [Epidemiology], *Hockey/in [Injuries], adult, Athletic Injuries/ep [Epidemiology], Athletic Injuries/et [Etiology], Body Height/ph [Physiology], Body Weight/ph [Physiology], Brain Concussion/et [Etiology], Canada/ep [Epidemiology], checklist, Head Protective Devices/sn [Statistics & Numerical, Hockey/sn [Statistics & Numerical Data], Humans, Male, Sports Equipment/sn [Statistics & Numerical Data], VIDEO recording, Young Adult
@article{Hutchison2015,
title = {A systematic video analysis of National Hockey League (NHL) concussions, part I: who, when, where and what?},
author = {Hutchison, M G and Comper, P and Meeuwisse, W H and Echemendia, R J},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
number = {8},
pages = {547--551},
abstract = {BACKGROUND: Although there is a growing understanding of the consequences of concussions in hockey, very little is known about the precipitating factors associated with this type of injury. AIM: To describe player characteristics and situational factors associated with concussions in the National Hockey League (NHL). METHODS: Case series of medically diagnosed concussions for regular season games over a 3.5-year period during the 2006-2010 seasons using an inclusive cohort of professional hockey players. Digital video records were coded and analysed using the Heads Up Checklist. RESULTS: Of 197 medically diagnosed concussions, 88% involved contact with an opponent. Forwards accounted for more concussions than expected compared with on-ice proportional representation (95% CI 60 to 73; p=0.04). Significantly more concussions occurred in the first period (47%) compared with the second and third periods (p=0.047), with the majority of concussions occurring in the defensive zone (45%). Approximately 47% of the concussions occurred in open ice, 53% occurred in the perimeter. Finally, 37% of the concussions involved injured players' heads contacting the boards or glass. CONCLUSIONS: This study describes several specific factors associated with concussions in the NHL, including period of the game, player position, body size, and specific locations on the ice and particular situations based on a player's position.Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},
keywords = {*Brain Concussion/ep [Epidemiology], *Hockey/in [Injuries], adult, Athletic Injuries/ep [Epidemiology], Athletic Injuries/et [Etiology], Body Height/ph [Physiology], Body Weight/ph [Physiology], Brain Concussion/et [Etiology], Canada/ep [Epidemiology], checklist, Head Protective Devices/sn [Statistics \& Numerical, Hockey/sn [Statistics \& Numerical Data], Humans, Male, Sports Equipment/sn [Statistics \& Numerical Data], VIDEO recording, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Utecht, B
Concussed Journal Article
In: Neurology, vol. 83, no. 13, pp. 1126–1127, 2014.
BibTeX | Tags: *Athletic Injuries, *Brain Concussion, *Memory/ph [Physiology], Athletic Injuries/et [Etiology], Athletic Injuries/pp [Physiopathology], Brain Concussion/et [Etiology], Brain Concussion/pp [Physiopathology], Humans, Sports
@article{Utecht2014,
title = {Concussed},
author = {Utecht, B},
year = {2014},
date = {2014-01-01},
journal = {Neurology},
volume = {83},
number = {13},
pages = {1126--1127},
keywords = {*Athletic Injuries, *Brain Concussion, *Memory/ph [Physiology], Athletic Injuries/et [Etiology], Athletic Injuries/pp [Physiopathology], Brain Concussion/et [Etiology], Brain Concussion/pp [Physiopathology], Humans, Sports},
pubstate = {published},
tppubtype = {article}
}
Anonymous,
Concussion in sport: fair play for young people Journal Article
In: Lancet, vol. 382, no. 9904, pp. 1536, 2013.
BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Adolescent, Athletic Injuries/et [Etiology], Brain Concussion/et [Etiology], Child, Humans, Preschool, Risk Factors, Sports, Young Adult
@article{Anonymous2013,
title = {Concussion in sport: fair play for young people},
author = {Anonymous},
year = {2013},
date = {2013-01-01},
journal = {Lancet},
volume = {382},
number = {9904},
pages = {1536},
keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Adolescent, Athletic Injuries/et [Etiology], Brain Concussion/et [Etiology], Child, Humans, Preschool, Risk Factors, Sports, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Duenas, M J; Hsu, S N; Jandial, R
Visual screening test for rapid sideline determination of concussive and sub-concussive events Journal Article
In: Neurosurgery, vol. 73, no. 4, pp. N17–8, 2013.
BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Vision Screening/mt [Methods], Athletic Injuries/co [Complications], Brain Concussion/et [Etiology], Humans
@article{Duenas2013,
title = {Visual screening test for rapid sideline determination of concussive and sub-concussive events},
author = {Duenas, M J and Hsu, S N and Jandial, R},
year = {2013},
date = {2013-01-01},
journal = {Neurosurgery},
volume = {73},
number = {4},
pages = {N17--8},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Vision Screening/mt [Methods], Athletic Injuries/co [Complications], Brain Concussion/et [Etiology], Humans},
pubstate = {published},
tppubtype = {article}
}
Matthews, S; Simmons, A; Strigo, I
The effects of loss versus alteration of consciousness on inhibition-related brain activity among individuals with a history of blast-related concussion.[Erratum appears in Psychiatry Res. 2011 May 31;192(2):131] Journal Article
In: Psychiatry Research, vol. 191, no. 1, pp. 76–79, 2011.
Abstract | BibTeX | Tags: *Brain Concussion/pa [Pathology], *Brain Mapping, *Brain/pp [Physiopathology], *Consciousness/ph [Physiology], *Inhibition (Psychology), *Unconsciousness/pp [Physiopathology], 0 (Peroxides), 31PZ2VAU81 (carbamide peroxide), 8W8T17847W (Urea), adult, Blast Injuries/co [Complications], Brain Concussion/et [Etiology], Brain/bs [Blood Supply], Computer-Assisted/mt [Methods], Humans, image processing, Magnetic Resonance Imaging/mt [Methods], Male, Monte Carlo Method, Peroxides/bl [Blood], Unconsciousness/pa [Pathology], Urea/aa [Analogs & Derivatives], Urea/bl [Blood], Young Adult
@article{Matthews2011a,
title = {The effects of loss versus alteration of consciousness on inhibition-related brain activity among individuals with a history of blast-related concussion.[Erratum appears in Psychiatry Res. 2011 May 31;192(2):131]},
author = {Matthews, S and Simmons, A and Strigo, I},
year = {2011},
date = {2011-01-01},
journal = {Psychiatry Research},
volume = {191},
number = {1},
pages = {76--79},
abstract = {In this investigation, 27 individuals who experienced blast-related concussion, i.e., brief loss (LOC) or alteration (AOC) of consciousness, performed a stop task during functional magnetic resonance imaging. LOC versus AOC subjects displayed altered ventromedial prefrontal cortex activity, which correlated with somatic symptom severity-findings which may suggest a neural correlate of impaired self awareness after LOC. Copyright Published by Elsevier Ireland Ltd.},
keywords = {*Brain Concussion/pa [Pathology], *Brain Mapping, *Brain/pp [Physiopathology], *Consciousness/ph [Physiology], *Inhibition (Psychology), *Unconsciousness/pp [Physiopathology], 0 (Peroxides), 31PZ2VAU81 (carbamide peroxide), 8W8T17847W (Urea), adult, Blast Injuries/co [Complications], Brain Concussion/et [Etiology], Brain/bs [Blood Supply], Computer-Assisted/mt [Methods], Humans, image processing, Magnetic Resonance Imaging/mt [Methods], Male, Monte Carlo Method, Peroxides/bl [Blood], Unconsciousness/pa [Pathology], Urea/aa [Analogs \& Derivatives], Urea/bl [Blood], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Falconer, E K; Geffen, G M; Olsen, S L; McFarland, K
The rapid screen of concussion: an evaluation of the non-word repetition test for use in mTBI research Journal Article
In: Brain Injury, vol. 20, no. 12, pp. 1251–1263, 2006.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Mass Screening/mt [Methods], *Neuropsychological Tests, Adolescent, adult, Brain Concussion/et [Etiology], Brain Concussion/px [Psychology], Brain Injuries/co [Complications], Brain Injuries/px [Psychology], Female, Humans, Male, Mental Recall, middle aged, Reproducibility of Results, Sensitivity and Specificity, Verbal Learning
@article{Falconer2006,
title = {The rapid screen of concussion: an evaluation of the non-word repetition test for use in mTBI research},
author = {Falconer, E K and Geffen, G M and Olsen, S L and McFarland, K},
year = {2006},
date = {2006-01-01},
journal = {Brain Injury},
volume = {20},
number = {12},
pages = {1251--1263},
abstract = {PRIMARY OBJECTIVES: (1) To investigate the Nonword Repetition test (NWR) as an index of sub-vocal rehearsal deficits after mild traumatic brain injury (mTBI); (2) to assess the reliability, validity and sensitivity of the NWR; and (3) to compare the NWR to more sensitive tests of verbal memory. RESEARCH DESIGN: An independent groups design. METHODS AND PROCEDURES: Study 1 administered the NWR to 46 mTBI and 61 uninjured controls with the Rapid Screen of Concussion (RSC). Study 2 compared mTBI, orthopaedic and uninjured participants on the NWR and the Hopkins Verbal Learning Test (HVLT-R). MAIN OUTCOMES AND RESULTS: The NWR did not improve the diagnostic accuracy of the RSC. However, it is reliable and indexes sub-vocal rehearsal speed. These findings provide evidence that although the current form of the NWR lacks sensitivity to the impact of mTBI, the development of a more sensitive test of sub-vocal rehearsal deficits following mTBI is warranted.},
keywords = {*Brain Concussion/di [Diagnosis], *Mass Screening/mt [Methods], *Neuropsychological Tests, Adolescent, adult, Brain Concussion/et [Etiology], Brain Concussion/px [Psychology], Brain Injuries/co [Complications], Brain Injuries/px [Psychology], Female, Humans, Male, Mental Recall, middle aged, Reproducibility of Results, Sensitivity and Specificity, Verbal Learning},
pubstate = {published},
tppubtype = {article}
}
Horner, A; VanDemark, M; Jensen, G A
The challenge of assessing a patient with dementia and head injury Journal Article
In: AACN Clinical Issues, vol. 13, no. 1, pp. 73–83, 2002.
Abstract | BibTeX | Tags: *Craniocerebral Trauma/co [Complications], *Dementia/co [Complications], Accidental Falls, Accidents, aged, Alzheimer Disease/di [Diagnosis], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Brain Concussion/pp [Physiopathology], Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/pp [Physiopathology], Delirium/di [Diagnosis], Delirium/et [Etiology], Home, Humans
@article{Horner2002,
title = {The challenge of assessing a patient with dementia and head injury},
author = {Horner, A and VanDemark, M and Jensen, G A},
year = {2002},
date = {2002-01-01},
journal = {AACN Clinical Issues},
volume = {13},
number = {1},
pages = {73--83},
abstract = {Alzheimer's disease is emerging as a major health challenge for the 21st century. The reported case study discusses a 74-year-old woman with dementia of the Alzheimer type who sustained a head injury when she fell down the basement stairs. Differentiating the head injury from the preexisting dementia was complicated and required creative and astute assessment. Objective assessment tools discussed include the Mini-Mental State Examination, a delirium guide, and the Tinetti assessment tool. Predisposition to delirium is significant because of the comorbidities associated with cognitive impairment and head injury. Interventions to prevent delirium are recommended.},
keywords = {*Craniocerebral Trauma/co [Complications], *Dementia/co [Complications], Accidental Falls, Accidents, aged, Alzheimer Disease/di [Diagnosis], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Brain Concussion/pp [Physiopathology], Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/pp [Physiopathology], Delirium/di [Diagnosis], Delirium/et [Etiology], Home, Humans},
pubstate = {published},
tppubtype = {article}
}
Jordan, B D
Neurologic aspects of boxing Journal Article
In: Archives of Neurology, vol. 44, no. 4, pp. 453–459, 1987.
Abstract | BibTeX | Tags: *Athletic Injuries, *Boxing, *Brain Injuries, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pa [Pathology], Athletic Injuries/pc [Prevention & Control], Athletic Injuries/pp [Physiopathology], Brain Concussion/et [Etiology], Brain Injuries/ep [Epidemiology], Brain Injuries/pa [Pathology], Brain Injuries/pc [Prevention & Control], Brain Injuries/pp [Physiopathology], Humans, Magnetic Resonance Spectroscopy, Tomography, X-Ray Computed
@article{Jordan1987,
title = {Neurologic aspects of boxing},
author = {Jordan, B D},
year = {1987},
date = {1987-01-01},
journal = {Archives of Neurology},
volume = {44},
number = {4},
pages = {453--459},
abstract = {The assessment and prevention of potentially adverse neurologic consequences of boxing requires two important considerations. Acute neurologic injuries should be distinguished from chronic brain injuries and the level of competitive boxing (ie, amateur vs professional) must also be taken into account. Acute neurologic injuries such as concussion, post-concussion syndrome, intracranial hemorrhage, and brain contusion are more readily identified than chronic neurologic injuries because of their immediate devastation of the nervous system. In contrast, chronic neurologic injuries differ in their pathophysiologic mechanisms that are exemplified by an insidious onset and progression after the cessation of boxing. Accordingly, the chronic traumatic encephalopathy of boxing poses the most serious neurologic threat of boxing. Amateur boxing differs from professional boxing in the duration of fights, rules and regulatory policies, medical evaluation, and protective devices. These factors could produce a differential effect on the risk of injury to the brain. The prevention of neurologic injuries in boxing requires the integration of proper neurologic evaluation by qualified ring-side physicians, the design and utilization of effective protective devices, and the establishment of national regulatory agencies.},
keywords = {*Athletic Injuries, *Boxing, *Brain Injuries, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pa [Pathology], Athletic Injuries/pc [Prevention \& Control], Athletic Injuries/pp [Physiopathology], Brain Concussion/et [Etiology], Brain Injuries/ep [Epidemiology], Brain Injuries/pa [Pathology], Brain Injuries/pc [Prevention \& Control], Brain Injuries/pp [Physiopathology], Humans, Magnetic Resonance Spectroscopy, Tomography, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Auerbach, P S; Waggoner 2nd, W H
It's Time to Change the Rules Journal Article
In: JAMA, vol. 316, no. 12, pp. 1260–1261, 2016.
@article{Auerbach2016,
title = {It's Time to Change the Rules},
author = {Auerbach, P S and {Waggoner 2nd}, W H},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {316},
number = {12},
pages = {1260--1261},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
O'Kane, J W
Is Heading in Youth Soccer Dangerous Play? Journal Article
In: Physician & Sportsmedicine, vol. 44, no. 2, pp. 190–194, 2016.
@article{OKane2016,
title = {Is Heading in Youth Soccer Dangerous Play?},
author = {O'Kane, J W},
year = {2016},
date = {2016-01-01},
journal = {Physician \& Sportsmedicine},
volume = {44},
number = {2},
pages = {190--194},
abstract = {BACKGROUND: Soccer is among the most popular youth sports with over 3 million youth players registered in the U.S. Soccer is unique in that players intentionally use their head to strike the ball, leading to concerns that heading could cause acute or chronic brain injury, especially in the immature brains of children. METHODS: Pub Med search without date restriction was conducted in November 2014 and August 2015 using the terms soccer and concussion, heading and concussion, and youth soccer and concussion. 310 articles were identified and reviewed for applicable content specifically relating to youth athletes, heading, and/or acute or chronic brain injury from soccer. RESULTS: Soccer is a low-risk sport for catastrophic head injury, but concussions are relatively common and heading often plays a role. At all levels of play, concussions are more likely to occur in the act of heading than with other facets of the game. While concussion from heading the ball without other contact to the head appears rare in adult players, some data suggests children are more susceptible to concussion from heading primarily in game situations. Contributing factors include biomechanical forces, less developed technique, and the immature brain's susceptibility to injury. CONCLUSIONS: There is no evidence that heading in youth soccer causes any permanent brain injury and there is limited evidence that heading in youth soccer can cause concussion. A reasonable approach based on U.S. Youth Soccer recommendations is to teach heading after age 10 in controlled settings, and heading in games should be delayed until skill acquisition and physical maturity allow the youth player to head correctly with confidence.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bachynski, K E
Tolerable Risks? Physicians and Youth Tackle Football Journal Article
In: New England Journal of Medicine, vol. 374, no. 5, pp. 405–407, 2016.
@article{Bachynski2016,
title = {Tolerable Risks? Physicians and Youth Tackle Football},
author = {Bachynski, K E},
year = {2016},
date = {2016-01-01},
journal = {New England Journal of Medicine},
volume = {374},
number = {5},
pages = {405--407},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Davis, J; Canty, G
Are Sports-Related Concussions Giving You a Headache? Journal Article
In: Missouri Medicine, vol. 112, no. 3, pp. 187–191, 2015.
@article{Davis2015,
title = {Are Sports-Related Concussions Giving You a Headache?},
author = {Davis, J and Canty, G},
year = {2015},
date = {2015-01-01},
journal = {Missouri Medicine},
volume = {112},
number = {3},
pages = {187--191},
abstract = {Acute care visits for sports-related concussion (SRC) are increasing dramatically in adolescents. This review summarizes current concepts in the evaluation and management of pediatric SRC by health care providers in the acute care setting.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hernandez, F; Shull, P B; Camarillo, D B
Evaluation of a laboratory model of human head impact biomechanics Journal Article
In: Journal of Biomechanics, vol. 48, no. 12, pp. 3469–3477, 2015.
@article{Hernandez2015,
title = {Evaluation of a laboratory model of human head impact biomechanics},
author = {Hernandez, F and Shull, P B and Camarillo, D B},
year = {2015},
date = {2015-01-01},
journal = {Journal of Biomechanics},
volume = {48},
number = {12},
pages = {3469--3477},
abstract = {This work describes methodology for evaluating laboratory models of head impact biomechanics. Using this methodology, we investigated: how closely does twin-wire drop testing model head rotation in American football impacts? Head rotation is believed to cause mild traumatic brain injury (mTBI) but helmet safety standards only model head translations believed to cause severe TBI. It is unknown whether laboratory head impact models in safety standards, like twin-wire drop testing, reproduce six degree-of-freedom (6DOF) head impact biomechanics that may cause mTBI. We compared 6DOF measurements of 421 American football head impacts to twin-wire drop tests at impact sites and velocities weighted to represent typical field exposure. The highest rotational velocities produced by drop testing were the 74th percentile of non-injury field impacts. For a given translational acceleration level, drop testing underestimated field rotational acceleration by 46% and rotational velocity by 72%. Primary rotational acceleration frequencies were much larger in drop tests ($sim$100 Hz) than field impacts ($sim$10 Hz). Drop testing was physically unable to produce acceleration directions common in field impacts. Initial conditions of a single field impact were highly resolved in stereo high-speed video and reconstructed in a drop test. Reconstruction results reflected aggregate trends of lower amplitude rotational velocity and higher frequency rotational acceleration in drop testing, apparently due to twin-wire constraints and the absence of a neck. These results suggest twin-wire drop testing is limited in modeling head rotation during impact, and motivate continued evaluation of head impact models to ensure helmets are tested under conditions that may cause mTBI. Copyright © 2015 Elsevier Ltd. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Neselius, S; Brisby, H; Granholm, F; Zetterberg, H; Blennow, K
Monitoring concussion in a knocked-out boxer by CSF biomarker analysis Journal Article
In: Knee Surgery, Sports Traumatology, Arthroscopy, vol. 23, no. 9, pp. 2536–2539, 2015.
@article{Neselius2015,
title = {Monitoring concussion in a knocked-out boxer by CSF biomarker analysis},
author = {Neselius, S and Brisby, H and Granholm, F and Zetterberg, H and Blennow, K},
year = {2015},
date = {2015-01-01},
journal = {Knee Surgery, Sports Traumatology, Arthroscopy},
volume = {23},
number = {9},
pages = {2536--2539},
abstract = {Concussion is common in many sports, and the incidence is increasing. The medical consequences after a sport-related concussion have received increased attention in recent years since it is known that concussions cause axonal and glial damage, which disturbs the cerebral physiology and makes the brain more vulnerable for additional concussions. This study reports on a knocked-out amateur boxer in whom cerebrospinal fluid (CSF) neurofilament light (NFL) protein, reflecting axonal damage, was used to identify and monitor brain damage. CSF NFL was markedly increased during 36 weeks, suggesting that neuronal injury persists longer than expected after a concussion. CSF biomarker analysis may be valuable in the medical counselling of concussed athletes and in return-to-play considerations.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Ritchie, L J; Koltek, M; Hosain, S; Cordingley, D; Chu, S; Selci, E; Leiter, J; Russell, K
Psychiatric outcomes after pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 16, no. 6, pp. 709–718, 2015.
@article{Ellis2015ab,
title = {Psychiatric outcomes after pediatric sports-related concussion},
author = {Ellis, M J and Ritchie, L J and Koltek, M and Hosain, S and Cordingley, D and Chu, S and Selci, E and Leiter, J and Russell, K},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {16},
number = {6},
pages = {709--718},
abstract = {OBJECT: The objectives of this study were twofold: (1) to examine the prevalence of emotional symptoms among children and adolescents with a sports-related concussion (SRC) who were referred to a multidisciplinary pediatric concussion program and (2) to examine the prevalence, clinical features, risk factors, and management of postinjury psychiatric outcomes among those in this clinical population. METHODS: The authors conducted a retrospective chart review of all patients with SRC referred to a multidisciplinary pediatric concussion program between September 2013 and October 2014. Clinical assessments carried out by a single neurosurgeon included clinical history, physical examination, and Post-Concussion Symptom Scale (PCSS) scoring. Postinjury psychiatric outcomes were defined as a subjective worsening of symptoms of a preinjury psychiatric disorder or new and isolated suicidal ideation or diagnosis of a novel psychiatric disorder (NPD). An NPD was defined as a newly diagnosed psychiatric disorder that occurred in a patient with or without a lifetime preinjury psychiatric disorder after a concussion. Clinical resources, therapeutic interventions, and clinical and return-to-play outcomes are summarized. RESULTS: One hundred seventy-four patients (mean age 14.2 years, 61.5% male) were included in the study. At least 1 emotional symptom was reported in 49.4% of the patients, and the median emotional PCSS subscore was 4 (interquartile range 1-8) among those who reported at least 1 emotional symptom. Overall, 20 (11.5%) of the patients met the study criteria for a postinjury psychiatric outcome, including 14 patients with an NPD, 2 patients with isolated suicidal ideation, and 4 patients with worsening symptoms of a preinjury psychiatric disorder. Female sex, a higher initial PCSS score, a higher emotional PCSS subscore, presence of a preinjury psychiatric history, and presence of a family history of psychiatric illness were significantly associated with postinjury psychiatric outcomes. Interventions for patients with postinjury psychiatric outcomes included pharmacological therapy alone in 2 patients (10%), cognitive behavioral therapy alone in 4 (20%), multimodal therapy in 9 (45%), and no treatment in 5 (25%). Overall, 5 (25%) of the patients with postinjury psychiatric disorders were medically cleared to return to full sports participation, whereas 5 (25%) were lost to follow-up and 9 (45%) remained in treatment by the multidisciplinary concussion program at the end of the study period. One patient who was asymptomatic at the time of initial consultation committed suicide. CONCLUSIONS: Emotional symptoms were commonly reported among pediatric patients with SRC referred to a multidisciplinary pediatric concussion program. In some cases, these symptoms contributed to the development of an NPD, isolated suicidal ideation, and worsening symptoms of a preexisting psychiatric disorder. Future research is needed to clarify the prevalence, pathophysiology, risk factors, and evidence-based management of postinjury psychiatric outcomes after pediatric SRC. Successful management of these patients requires prompt recognition and multidisciplinary care by experts with clinical training and experience in concussion and psychiatry.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hutchison, M G; Comper, P; Meeuwisse, W H; Echemendia, R J
A systematic video analysis of National Hockey League (NHL) concussions, part I: who, when, where and what? Journal Article
In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 547–551, 2015.
@article{Hutchison2015,
title = {A systematic video analysis of National Hockey League (NHL) concussions, part I: who, when, where and what?},
author = {Hutchison, M G and Comper, P and Meeuwisse, W H and Echemendia, R J},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
number = {8},
pages = {547--551},
abstract = {BACKGROUND: Although there is a growing understanding of the consequences of concussions in hockey, very little is known about the precipitating factors associated with this type of injury. AIM: To describe player characteristics and situational factors associated with concussions in the National Hockey League (NHL). METHODS: Case series of medically diagnosed concussions for regular season games over a 3.5-year period during the 2006-2010 seasons using an inclusive cohort of professional hockey players. Digital video records were coded and analysed using the Heads Up Checklist. RESULTS: Of 197 medically diagnosed concussions, 88% involved contact with an opponent. Forwards accounted for more concussions than expected compared with on-ice proportional representation (95% CI 60 to 73; p=0.04). Significantly more concussions occurred in the first period (47%) compared with the second and third periods (p=0.047), with the majority of concussions occurring in the defensive zone (45%). Approximately 47% of the concussions occurred in open ice, 53% occurred in the perimeter. Finally, 37% of the concussions involved injured players' heads contacting the boards or glass. CONCLUSIONS: This study describes several specific factors associated with concussions in the NHL, including period of the game, player position, body size, and specific locations on the ice and particular situations based on a player's position.Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Utecht, B
Concussed Journal Article
In: Neurology, vol. 83, no. 13, pp. 1126–1127, 2014.
@article{Utecht2014,
title = {Concussed},
author = {Utecht, B},
year = {2014},
date = {2014-01-01},
journal = {Neurology},
volume = {83},
number = {13},
pages = {1126--1127},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Anonymous,
Concussion in sport: fair play for young people Journal Article
In: Lancet, vol. 382, no. 9904, pp. 1536, 2013.
@article{Anonymous2013,
title = {Concussion in sport: fair play for young people},
author = {Anonymous},
year = {2013},
date = {2013-01-01},
journal = {Lancet},
volume = {382},
number = {9904},
pages = {1536},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Duenas, M J; Hsu, S N; Jandial, R
Visual screening test for rapid sideline determination of concussive and sub-concussive events Journal Article
In: Neurosurgery, vol. 73, no. 4, pp. N17–8, 2013.
@article{Duenas2013,
title = {Visual screening test for rapid sideline determination of concussive and sub-concussive events},
author = {Duenas, M J and Hsu, S N and Jandial, R},
year = {2013},
date = {2013-01-01},
journal = {Neurosurgery},
volume = {73},
number = {4},
pages = {N17--8},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Matthews, S; Simmons, A; Strigo, I
The effects of loss versus alteration of consciousness on inhibition-related brain activity among individuals with a history of blast-related concussion.[Erratum appears in Psychiatry Res. 2011 May 31;192(2):131] Journal Article
In: Psychiatry Research, vol. 191, no. 1, pp. 76–79, 2011.
@article{Matthews2011a,
title = {The effects of loss versus alteration of consciousness on inhibition-related brain activity among individuals with a history of blast-related concussion.[Erratum appears in Psychiatry Res. 2011 May 31;192(2):131]},
author = {Matthews, S and Simmons, A and Strigo, I},
year = {2011},
date = {2011-01-01},
journal = {Psychiatry Research},
volume = {191},
number = {1},
pages = {76--79},
abstract = {In this investigation, 27 individuals who experienced blast-related concussion, i.e., brief loss (LOC) or alteration (AOC) of consciousness, performed a stop task during functional magnetic resonance imaging. LOC versus AOC subjects displayed altered ventromedial prefrontal cortex activity, which correlated with somatic symptom severity-findings which may suggest a neural correlate of impaired self awareness after LOC. Copyright Published by Elsevier Ireland Ltd.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Falconer, E K; Geffen, G M; Olsen, S L; McFarland, K
The rapid screen of concussion: an evaluation of the non-word repetition test for use in mTBI research Journal Article
In: Brain Injury, vol. 20, no. 12, pp. 1251–1263, 2006.
@article{Falconer2006,
title = {The rapid screen of concussion: an evaluation of the non-word repetition test for use in mTBI research},
author = {Falconer, E K and Geffen, G M and Olsen, S L and McFarland, K},
year = {2006},
date = {2006-01-01},
journal = {Brain Injury},
volume = {20},
number = {12},
pages = {1251--1263},
abstract = {PRIMARY OBJECTIVES: (1) To investigate the Nonword Repetition test (NWR) as an index of sub-vocal rehearsal deficits after mild traumatic brain injury (mTBI); (2) to assess the reliability, validity and sensitivity of the NWR; and (3) to compare the NWR to more sensitive tests of verbal memory. RESEARCH DESIGN: An independent groups design. METHODS AND PROCEDURES: Study 1 administered the NWR to 46 mTBI and 61 uninjured controls with the Rapid Screen of Concussion (RSC). Study 2 compared mTBI, orthopaedic and uninjured participants on the NWR and the Hopkins Verbal Learning Test (HVLT-R). MAIN OUTCOMES AND RESULTS: The NWR did not improve the diagnostic accuracy of the RSC. However, it is reliable and indexes sub-vocal rehearsal speed. These findings provide evidence that although the current form of the NWR lacks sensitivity to the impact of mTBI, the development of a more sensitive test of sub-vocal rehearsal deficits following mTBI is warranted.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Horner, A; VanDemark, M; Jensen, G A
The challenge of assessing a patient with dementia and head injury Journal Article
In: AACN Clinical Issues, vol. 13, no. 1, pp. 73–83, 2002.
@article{Horner2002,
title = {The challenge of assessing a patient with dementia and head injury},
author = {Horner, A and VanDemark, M and Jensen, G A},
year = {2002},
date = {2002-01-01},
journal = {AACN Clinical Issues},
volume = {13},
number = {1},
pages = {73--83},
abstract = {Alzheimer's disease is emerging as a major health challenge for the 21st century. The reported case study discusses a 74-year-old woman with dementia of the Alzheimer type who sustained a head injury when she fell down the basement stairs. Differentiating the head injury from the preexisting dementia was complicated and required creative and astute assessment. Objective assessment tools discussed include the Mini-Mental State Examination, a delirium guide, and the Tinetti assessment tool. Predisposition to delirium is significant because of the comorbidities associated with cognitive impairment and head injury. Interventions to prevent delirium are recommended.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Jordan, B D
Neurologic aspects of boxing Journal Article
In: Archives of Neurology, vol. 44, no. 4, pp. 453–459, 1987.
@article{Jordan1987,
title = {Neurologic aspects of boxing},
author = {Jordan, B D},
year = {1987},
date = {1987-01-01},
journal = {Archives of Neurology},
volume = {44},
number = {4},
pages = {453--459},
abstract = {The assessment and prevention of potentially adverse neurologic consequences of boxing requires two important considerations. Acute neurologic injuries should be distinguished from chronic brain injuries and the level of competitive boxing (ie, amateur vs professional) must also be taken into account. Acute neurologic injuries such as concussion, post-concussion syndrome, intracranial hemorrhage, and brain contusion are more readily identified than chronic neurologic injuries because of their immediate devastation of the nervous system. In contrast, chronic neurologic injuries differ in their pathophysiologic mechanisms that are exemplified by an insidious onset and progression after the cessation of boxing. Accordingly, the chronic traumatic encephalopathy of boxing poses the most serious neurologic threat of boxing. Amateur boxing differs from professional boxing in the duration of fights, rules and regulatory policies, medical evaluation, and protective devices. These factors could produce a differential effect on the risk of injury to the brain. The prevention of neurologic injuries in boxing requires the integration of proper neurologic evaluation by qualified ring-side physicians, the design and utilization of effective protective devices, and the establishment of national regulatory agencies.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Auerbach, P S; Waggoner 2nd, W H
It's Time to Change the Rules Journal Article
In: JAMA, vol. 316, no. 12, pp. 1260–1261, 2016.
BibTeX | Tags: *Brain Concussion/co [Complications], *Football/in [Injuries], adult, Brain Concussion/et [Etiology], Brain Concussion/pc [Prevention & Control], Football/st [Standards], Humans, Male, Safety/st [Standards], UNITED States
@article{Auerbach2016,
title = {It's Time to Change the Rules},
author = {Auerbach, P S and {Waggoner 2nd}, W H},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {316},
number = {12},
pages = {1260--1261},
keywords = {*Brain Concussion/co [Complications], *Football/in [Injuries], adult, Brain Concussion/et [Etiology], Brain Concussion/pc [Prevention \& Control], Football/st [Standards], Humans, Male, Safety/st [Standards], UNITED States},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
Abstract | BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics & Numerical Data
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
O'Kane, J W
Is Heading in Youth Soccer Dangerous Play? Journal Article
In: Physician & Sportsmedicine, vol. 44, no. 2, pp. 190–194, 2016.
Abstract | BibTeX | Tags: *Brain Injuries/et [Etiology], *Brain Injury, *Soccer/in [Injuries], Adolescent, Brain Concussion/et [Etiology], Brain Concussion/pc [Prevention & Control], Brain Injuries/pc [Prevention & Control], Brain Injury, Child, Chronic/et [Etiology], Chronic/pc [Prevention & Control], Humans, Risk Factors, UNITED States
@article{OKane2016,
title = {Is Heading in Youth Soccer Dangerous Play?},
author = {O'Kane, J W},
year = {2016},
date = {2016-01-01},
journal = {Physician \& Sportsmedicine},
volume = {44},
number = {2},
pages = {190--194},
abstract = {BACKGROUND: Soccer is among the most popular youth sports with over 3 million youth players registered in the U.S. Soccer is unique in that players intentionally use their head to strike the ball, leading to concerns that heading could cause acute or chronic brain injury, especially in the immature brains of children. METHODS: Pub Med search without date restriction was conducted in November 2014 and August 2015 using the terms soccer and concussion, heading and concussion, and youth soccer and concussion. 310 articles were identified and reviewed for applicable content specifically relating to youth athletes, heading, and/or acute or chronic brain injury from soccer. RESULTS: Soccer is a low-risk sport for catastrophic head injury, but concussions are relatively common and heading often plays a role. At all levels of play, concussions are more likely to occur in the act of heading than with other facets of the game. While concussion from heading the ball without other contact to the head appears rare in adult players, some data suggests children are more susceptible to concussion from heading primarily in game situations. Contributing factors include biomechanical forces, less developed technique, and the immature brain's susceptibility to injury. CONCLUSIONS: There is no evidence that heading in youth soccer causes any permanent brain injury and there is limited evidence that heading in youth soccer can cause concussion. A reasonable approach based on U.S. Youth Soccer recommendations is to teach heading after age 10 in controlled settings, and heading in games should be delayed until skill acquisition and physical maturity allow the youth player to head correctly with confidence.},
keywords = {*Brain Injuries/et [Etiology], *Brain Injury, *Soccer/in [Injuries], Adolescent, Brain Concussion/et [Etiology], Brain Concussion/pc [Prevention \& Control], Brain Injuries/pc [Prevention \& Control], Brain Injury, Child, Chronic/et [Etiology], Chronic/pc [Prevention \& Control], Humans, Risk Factors, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Bachynski, K E
Tolerable Risks? Physicians and Youth Tackle Football Journal Article
In: New England Journal of Medicine, vol. 374, no. 5, pp. 405–407, 2016.
BibTeX | Tags: *Athletic Injuries/pc [Prevention & Control], *Brain Concussion/pc [Prevention & Control], *Football/in [Injuries], *Guidelines as Topic, *Physician's Role, *SPORTS medicine, Adolescent, Brain Concussion/et [Etiology], Child, Craniocerebral Trauma/et [Etiology], Craniocerebral Trauma/pc [Prevention & Control], Head Protective Devices, Humans, Medical, pediatrics, Societies, UNITED States
@article{Bachynski2016,
title = {Tolerable Risks? Physicians and Youth Tackle Football},
author = {Bachynski, K E},
year = {2016},
date = {2016-01-01},
journal = {New England Journal of Medicine},
volume = {374},
number = {5},
pages = {405--407},
keywords = {*Athletic Injuries/pc [Prevention \& Control], *Brain Concussion/pc [Prevention \& Control], *Football/in [Injuries], *Guidelines as Topic, *Physician's Role, *SPORTS medicine, Adolescent, Brain Concussion/et [Etiology], Child, Craniocerebral Trauma/et [Etiology], Craniocerebral Trauma/pc [Prevention \& Control], Head Protective Devices, Humans, Medical, pediatrics, Societies, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Miller, J H; Gill, C; Kuhn, E N; Rocque, B G; Menendez, J Y; O'Neill, J A; Agee, B S; Brown, S T; Crowther, M; Davis, R D; Ferguson, D; Johnston, J M
Predictors of delayed recovery following pediatric sports-related concussion: a case-control study Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 17, no. 4, pp. 491–496, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors
@article{Miller2016,
title = {Predictors of delayed recovery following pediatric sports-related concussion: a case-control study},
author = {Miller, J H and Gill, C and Kuhn, E N and Rocque, B G and Menendez, J Y and O'Neill, J A and Agee, B S and Brown, S T and Crowther, M and Davis, R D and Ferguson, D and Johnston, J M},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {17},
number = {4},
pages = {491--496},
abstract = {OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (\> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score \< 80 (aOR 5.58, 95% CI 2.61-11.93), and female sex (aOR 3.48, 95% CI 1.43-8.49) were all associated with a higher risk for postconcussive symptoms lasting more than 28 days. For patients without SCAT2 scores, female sex and reporting a history of ADHD significantly increased the odds of prolonged recovery (aOR 4.41, 95% CI 1.93-10.07 and aOR 3.87, 95% CI 1.13-13.24, respectively). Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in patients with and without SCAT2 scores (OR 2.59, 95% CI 1.28-5.26 and OR 2.17, 95% CI 0.99-7.73, respectively). Amnesia, balance abnormalities, and a history of migraines were not associated with symptoms lasting longer than 28 days. CONCLUSIONS This case-control study suggests candidate risk factors for predicting prolonged recovery following sports-related concussion. Large prospective cohort studies of youth athletes examined and treated with standardized protocols will be needed to definitively establish these associations and confirm which children are at highest risk for delayed recovery.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Outcome Assessment (Health Care)/mt [Methods], Adolescent, Athletic Injuries/co [Complications], Athletic Injuries/ep [Epidemiology], Brain Concussion/ep [Epidemiology], Brain Concussion/et [Etiology], Case-Control Studies, Child, Female, Humans, Male, Post-Concussion Syndrome/di [Diagnosis], Post-Concussion Syndrome/ep [Epidemiology], Post-Concussion Syndrome/et [Etiology], Prognosis, Recovery of Function, Risk Factors},
pubstate = {published},
tppubtype = {article}
}
Davis, J; Canty, G
Are Sports-Related Concussions Giving You a Headache? Journal Article
In: Missouri Medicine, vol. 112, no. 3, pp. 187–191, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/co [Complications], *Brain Concussion/di [Diagnosis], *Brain Concussion/th [Therapy], Adolescent, Brain Concussion/et [Etiology], Child, DIAGNOSTIC imaging, Emergency Medicine, Humans, Neuropsychological Tests, Patient Education as Topic
@article{Davis2015,
title = {Are Sports-Related Concussions Giving You a Headache?},
author = {Davis, J and Canty, G},
year = {2015},
date = {2015-01-01},
journal = {Missouri Medicine},
volume = {112},
number = {3},
pages = {187--191},
abstract = {Acute care visits for sports-related concussion (SRC) are increasing dramatically in adolescents. This review summarizes current concepts in the evaluation and management of pediatric SRC by health care providers in the acute care setting.},
keywords = {*Athletic Injuries/co [Complications], *Brain Concussion/di [Diagnosis], *Brain Concussion/th [Therapy], Adolescent, Brain Concussion/et [Etiology], Child, DIAGNOSTIC imaging, Emergency Medicine, Humans, Neuropsychological Tests, Patient Education as Topic},
pubstate = {published},
tppubtype = {article}
}
Hernandez, F; Shull, P B; Camarillo, D B
Evaluation of a laboratory model of human head impact biomechanics Journal Article
In: Journal of Biomechanics, vol. 48, no. 12, pp. 3469–3477, 2015.
Abstract | BibTeX | Tags: *HEAD, *Laboratories, *Mechanical Phenomena, *Models, Acceleration, Biological, Biomechanical Phenomena, Brain Concussion/et [Etiology], Football/in [Injuries], Head Protective Devices, Humans, Male, Neck/ph [Physiology], Rotation, SAFETY
@article{Hernandez2015,
title = {Evaluation of a laboratory model of human head impact biomechanics},
author = {Hernandez, F and Shull, P B and Camarillo, D B},
year = {2015},
date = {2015-01-01},
journal = {Journal of Biomechanics},
volume = {48},
number = {12},
pages = {3469--3477},
abstract = {This work describes methodology for evaluating laboratory models of head impact biomechanics. Using this methodology, we investigated: how closely does twin-wire drop testing model head rotation in American football impacts? Head rotation is believed to cause mild traumatic brain injury (mTBI) but helmet safety standards only model head translations believed to cause severe TBI. It is unknown whether laboratory head impact models in safety standards, like twin-wire drop testing, reproduce six degree-of-freedom (6DOF) head impact biomechanics that may cause mTBI. We compared 6DOF measurements of 421 American football head impacts to twin-wire drop tests at impact sites and velocities weighted to represent typical field exposure. The highest rotational velocities produced by drop testing were the 74th percentile of non-injury field impacts. For a given translational acceleration level, drop testing underestimated field rotational acceleration by 46% and rotational velocity by 72%. Primary rotational acceleration frequencies were much larger in drop tests ($sim$100 Hz) than field impacts ($sim$10 Hz). Drop testing was physically unable to produce acceleration directions common in field impacts. Initial conditions of a single field impact were highly resolved in stereo high-speed video and reconstructed in a drop test. Reconstruction results reflected aggregate trends of lower amplitude rotational velocity and higher frequency rotational acceleration in drop testing, apparently due to twin-wire constraints and the absence of a neck. These results suggest twin-wire drop testing is limited in modeling head rotation during impact, and motivate continued evaluation of head impact models to ensure helmets are tested under conditions that may cause mTBI. Copyright © 2015 Elsevier Ltd. All rights reserved.},
keywords = {*HEAD, *Laboratories, *Mechanical Phenomena, *Models, Acceleration, Biological, Biomechanical Phenomena, Brain Concussion/et [Etiology], Football/in [Injuries], Head Protective Devices, Humans, Male, Neck/ph [Physiology], Rotation, SAFETY},
pubstate = {published},
tppubtype = {article}
}
Neselius, S; Brisby, H; Granholm, F; Zetterberg, H; Blennow, K
Monitoring concussion in a knocked-out boxer by CSF biomarker analysis Journal Article
In: Knee Surgery, Sports Traumatology, Arthroscopy, vol. 23, no. 9, pp. 2536–2539, 2015.
Abstract | BibTeX | Tags: *Boxing/in [Injuries], *Brain Concussion/di [Diagnosis], *Neurofilament Proteins/cf [Cerebrospinal Fluid], 0 (Biomarkers), 0 (neurofilament protein L), 0 (Neurofilament Proteins), Biomarkers/cf [Cerebrospinal Fluid], Brain Concussion/cf [Cerebrospinal Fluid], Brain Concussion/et [Etiology], Humans, Male, Young Adult
@article{Neselius2015,
title = {Monitoring concussion in a knocked-out boxer by CSF biomarker analysis},
author = {Neselius, S and Brisby, H and Granholm, F and Zetterberg, H and Blennow, K},
year = {2015},
date = {2015-01-01},
journal = {Knee Surgery, Sports Traumatology, Arthroscopy},
volume = {23},
number = {9},
pages = {2536--2539},
abstract = {Concussion is common in many sports, and the incidence is increasing. The medical consequences after a sport-related concussion have received increased attention in recent years since it is known that concussions cause axonal and glial damage, which disturbs the cerebral physiology and makes the brain more vulnerable for additional concussions. This study reports on a knocked-out amateur boxer in whom cerebrospinal fluid (CSF) neurofilament light (NFL) protein, reflecting axonal damage, was used to identify and monitor brain damage. CSF NFL was markedly increased during 36 weeks, suggesting that neuronal injury persists longer than expected after a concussion. CSF biomarker analysis may be valuable in the medical counselling of concussed athletes and in return-to-play considerations.},
keywords = {*Boxing/in [Injuries], *Brain Concussion/di [Diagnosis], *Neurofilament Proteins/cf [Cerebrospinal Fluid], 0 (Biomarkers), 0 (neurofilament protein L), 0 (Neurofilament Proteins), Biomarkers/cf [Cerebrospinal Fluid], Brain Concussion/cf [Cerebrospinal Fluid], Brain Concussion/et [Etiology], Humans, Male, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Ritchie, L J; Koltek, M; Hosain, S; Cordingley, D; Chu, S; Selci, E; Leiter, J; Russell, K
Psychiatric outcomes after pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 16, no. 6, pp. 709–718, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/co [Complications], *Brain Concussion/ep [Epidemiology], *Brain Concussion/px [Psychology], *Emotions, *Post-Concussion Syndrome/ep [Epidemiology], *Post-Concussion Syndrome/px [Psychology], Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/et [Etiology], Child, Female, Humans, Male, Manitoba/ep [Epidemiology], MEDICAL records, Neuropsychological Tests, Patient Care Team, Post-Concussion Syndrome/et [Etiology], Prevalence, Retrospective Studies, Risk Factors, Sports
@article{Ellis2015ab,
title = {Psychiatric outcomes after pediatric sports-related concussion},
author = {Ellis, M J and Ritchie, L J and Koltek, M and Hosain, S and Cordingley, D and Chu, S and Selci, E and Leiter, J and Russell, K},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {16},
number = {6},
pages = {709--718},
abstract = {OBJECT: The objectives of this study were twofold: (1) to examine the prevalence of emotional symptoms among children and adolescents with a sports-related concussion (SRC) who were referred to a multidisciplinary pediatric concussion program and (2) to examine the prevalence, clinical features, risk factors, and management of postinjury psychiatric outcomes among those in this clinical population. METHODS: The authors conducted a retrospective chart review of all patients with SRC referred to a multidisciplinary pediatric concussion program between September 2013 and October 2014. Clinical assessments carried out by a single neurosurgeon included clinical history, physical examination, and Post-Concussion Symptom Scale (PCSS) scoring. Postinjury psychiatric outcomes were defined as a subjective worsening of symptoms of a preinjury psychiatric disorder or new and isolated suicidal ideation or diagnosis of a novel psychiatric disorder (NPD). An NPD was defined as a newly diagnosed psychiatric disorder that occurred in a patient with or without a lifetime preinjury psychiatric disorder after a concussion. Clinical resources, therapeutic interventions, and clinical and return-to-play outcomes are summarized. RESULTS: One hundred seventy-four patients (mean age 14.2 years, 61.5% male) were included in the study. At least 1 emotional symptom was reported in 49.4% of the patients, and the median emotional PCSS subscore was 4 (interquartile range 1-8) among those who reported at least 1 emotional symptom. Overall, 20 (11.5%) of the patients met the study criteria for a postinjury psychiatric outcome, including 14 patients with an NPD, 2 patients with isolated suicidal ideation, and 4 patients with worsening symptoms of a preinjury psychiatric disorder. Female sex, a higher initial PCSS score, a higher emotional PCSS subscore, presence of a preinjury psychiatric history, and presence of a family history of psychiatric illness were significantly associated with postinjury psychiatric outcomes. Interventions for patients with postinjury psychiatric outcomes included pharmacological therapy alone in 2 patients (10%), cognitive behavioral therapy alone in 4 (20%), multimodal therapy in 9 (45%), and no treatment in 5 (25%). Overall, 5 (25%) of the patients with postinjury psychiatric disorders were medically cleared to return to full sports participation, whereas 5 (25%) were lost to follow-up and 9 (45%) remained in treatment by the multidisciplinary concussion program at the end of the study period. One patient who was asymptomatic at the time of initial consultation committed suicide. CONCLUSIONS: Emotional symptoms were commonly reported among pediatric patients with SRC referred to a multidisciplinary pediatric concussion program. In some cases, these symptoms contributed to the development of an NPD, isolated suicidal ideation, and worsening symptoms of a preexisting psychiatric disorder. Future research is needed to clarify the prevalence, pathophysiology, risk factors, and evidence-based management of postinjury psychiatric outcomes after pediatric SRC. Successful management of these patients requires prompt recognition and multidisciplinary care by experts with clinical training and experience in concussion and psychiatry.},
keywords = {*Athletic Injuries/co [Complications], *Brain Concussion/ep [Epidemiology], *Brain Concussion/px [Psychology], *Emotions, *Post-Concussion Syndrome/ep [Epidemiology], *Post-Concussion Syndrome/px [Psychology], Adolescent, Athletic Injuries/ep [Epidemiology], Brain Concussion/et [Etiology], Child, Female, Humans, Male, Manitoba/ep [Epidemiology], MEDICAL records, Neuropsychological Tests, Patient Care Team, Post-Concussion Syndrome/et [Etiology], Prevalence, Retrospective Studies, Risk Factors, Sports},
pubstate = {published},
tppubtype = {article}
}
Hutchison, M G; Comper, P; Meeuwisse, W H; Echemendia, R J
A systematic video analysis of National Hockey League (NHL) concussions, part I: who, when, where and what? Journal Article
In: British Journal of Sports Medicine, vol. 49, no. 8, pp. 547–551, 2015.
Abstract | BibTeX | Tags: *Brain Concussion/ep [Epidemiology], *Hockey/in [Injuries], adult, Athletic Injuries/ep [Epidemiology], Athletic Injuries/et [Etiology], Body Height/ph [Physiology], Body Weight/ph [Physiology], Brain Concussion/et [Etiology], Canada/ep [Epidemiology], checklist, Head Protective Devices/sn [Statistics & Numerical, Hockey/sn [Statistics & Numerical Data], Humans, Male, Sports Equipment/sn [Statistics & Numerical Data], VIDEO recording, Young Adult
@article{Hutchison2015,
title = {A systematic video analysis of National Hockey League (NHL) concussions, part I: who, when, where and what?},
author = {Hutchison, M G and Comper, P and Meeuwisse, W H and Echemendia, R J},
year = {2015},
date = {2015-01-01},
journal = {British Journal of Sports Medicine},
volume = {49},
number = {8},
pages = {547--551},
abstract = {BACKGROUND: Although there is a growing understanding of the consequences of concussions in hockey, very little is known about the precipitating factors associated with this type of injury. AIM: To describe player characteristics and situational factors associated with concussions in the National Hockey League (NHL). METHODS: Case series of medically diagnosed concussions for regular season games over a 3.5-year period during the 2006-2010 seasons using an inclusive cohort of professional hockey players. Digital video records were coded and analysed using the Heads Up Checklist. RESULTS: Of 197 medically diagnosed concussions, 88% involved contact with an opponent. Forwards accounted for more concussions than expected compared with on-ice proportional representation (95% CI 60 to 73; p=0.04). Significantly more concussions occurred in the first period (47%) compared with the second and third periods (p=0.047), with the majority of concussions occurring in the defensive zone (45%). Approximately 47% of the concussions occurred in open ice, 53% occurred in the perimeter. Finally, 37% of the concussions involved injured players' heads contacting the boards or glass. CONCLUSIONS: This study describes several specific factors associated with concussions in the NHL, including period of the game, player position, body size, and specific locations on the ice and particular situations based on a player's position.Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.},
keywords = {*Brain Concussion/ep [Epidemiology], *Hockey/in [Injuries], adult, Athletic Injuries/ep [Epidemiology], Athletic Injuries/et [Etiology], Body Height/ph [Physiology], Body Weight/ph [Physiology], Brain Concussion/et [Etiology], Canada/ep [Epidemiology], checklist, Head Protective Devices/sn [Statistics \& Numerical, Hockey/sn [Statistics \& Numerical Data], Humans, Male, Sports Equipment/sn [Statistics \& Numerical Data], VIDEO recording, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Utecht, B
Concussed Journal Article
In: Neurology, vol. 83, no. 13, pp. 1126–1127, 2014.
BibTeX | Tags: *Athletic Injuries, *Brain Concussion, *Memory/ph [Physiology], Athletic Injuries/et [Etiology], Athletic Injuries/pp [Physiopathology], Brain Concussion/et [Etiology], Brain Concussion/pp [Physiopathology], Humans, Sports
@article{Utecht2014,
title = {Concussed},
author = {Utecht, B},
year = {2014},
date = {2014-01-01},
journal = {Neurology},
volume = {83},
number = {13},
pages = {1126--1127},
keywords = {*Athletic Injuries, *Brain Concussion, *Memory/ph [Physiology], Athletic Injuries/et [Etiology], Athletic Injuries/pp [Physiopathology], Brain Concussion/et [Etiology], Brain Concussion/pp [Physiopathology], Humans, Sports},
pubstate = {published},
tppubtype = {article}
}
Anonymous,
Concussion in sport: fair play for young people Journal Article
In: Lancet, vol. 382, no. 9904, pp. 1536, 2013.
BibTeX | Tags: *Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Adolescent, Athletic Injuries/et [Etiology], Brain Concussion/et [Etiology], Child, Humans, Preschool, Risk Factors, Sports, Young Adult
@article{Anonymous2013,
title = {Concussion in sport: fair play for young people},
author = {Anonymous},
year = {2013},
date = {2013-01-01},
journal = {Lancet},
volume = {382},
number = {9904},
pages = {1536},
keywords = {*Athletic Injuries/ep [Epidemiology], *Brain Concussion/ep [Epidemiology], Adolescent, Athletic Injuries/et [Etiology], Brain Concussion/et [Etiology], Child, Humans, Preschool, Risk Factors, Sports, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Duenas, M J; Hsu, S N; Jandial, R
Visual screening test for rapid sideline determination of concussive and sub-concussive events Journal Article
In: Neurosurgery, vol. 73, no. 4, pp. N17–8, 2013.
BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Vision Screening/mt [Methods], Athletic Injuries/co [Complications], Brain Concussion/et [Etiology], Humans
@article{Duenas2013,
title = {Visual screening test for rapid sideline determination of concussive and sub-concussive events},
author = {Duenas, M J and Hsu, S N and Jandial, R},
year = {2013},
date = {2013-01-01},
journal = {Neurosurgery},
volume = {73},
number = {4},
pages = {N17--8},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Vision Screening/mt [Methods], Athletic Injuries/co [Complications], Brain Concussion/et [Etiology], Humans},
pubstate = {published},
tppubtype = {article}
}
Matthews, S; Simmons, A; Strigo, I
The effects of loss versus alteration of consciousness on inhibition-related brain activity among individuals with a history of blast-related concussion.[Erratum appears in Psychiatry Res. 2011 May 31;192(2):131] Journal Article
In: Psychiatry Research, vol. 191, no. 1, pp. 76–79, 2011.
Abstract | BibTeX | Tags: *Brain Concussion/pa [Pathology], *Brain Mapping, *Brain/pp [Physiopathology], *Consciousness/ph [Physiology], *Inhibition (Psychology), *Unconsciousness/pp [Physiopathology], 0 (Peroxides), 31PZ2VAU81 (carbamide peroxide), 8W8T17847W (Urea), adult, Blast Injuries/co [Complications], Brain Concussion/et [Etiology], Brain/bs [Blood Supply], Computer-Assisted/mt [Methods], Humans, image processing, Magnetic Resonance Imaging/mt [Methods], Male, Monte Carlo Method, Peroxides/bl [Blood], Unconsciousness/pa [Pathology], Urea/aa [Analogs & Derivatives], Urea/bl [Blood], Young Adult
@article{Matthews2011a,
title = {The effects of loss versus alteration of consciousness on inhibition-related brain activity among individuals with a history of blast-related concussion.[Erratum appears in Psychiatry Res. 2011 May 31;192(2):131]},
author = {Matthews, S and Simmons, A and Strigo, I},
year = {2011},
date = {2011-01-01},
journal = {Psychiatry Research},
volume = {191},
number = {1},
pages = {76--79},
abstract = {In this investigation, 27 individuals who experienced blast-related concussion, i.e., brief loss (LOC) or alteration (AOC) of consciousness, performed a stop task during functional magnetic resonance imaging. LOC versus AOC subjects displayed altered ventromedial prefrontal cortex activity, which correlated with somatic symptom severity-findings which may suggest a neural correlate of impaired self awareness after LOC. Copyright Published by Elsevier Ireland Ltd.},
keywords = {*Brain Concussion/pa [Pathology], *Brain Mapping, *Brain/pp [Physiopathology], *Consciousness/ph [Physiology], *Inhibition (Psychology), *Unconsciousness/pp [Physiopathology], 0 (Peroxides), 31PZ2VAU81 (carbamide peroxide), 8W8T17847W (Urea), adult, Blast Injuries/co [Complications], Brain Concussion/et [Etiology], Brain/bs [Blood Supply], Computer-Assisted/mt [Methods], Humans, image processing, Magnetic Resonance Imaging/mt [Methods], Male, Monte Carlo Method, Peroxides/bl [Blood], Unconsciousness/pa [Pathology], Urea/aa [Analogs \& Derivatives], Urea/bl [Blood], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Falconer, E K; Geffen, G M; Olsen, S L; McFarland, K
The rapid screen of concussion: an evaluation of the non-word repetition test for use in mTBI research Journal Article
In: Brain Injury, vol. 20, no. 12, pp. 1251–1263, 2006.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Mass Screening/mt [Methods], *Neuropsychological Tests, Adolescent, adult, Brain Concussion/et [Etiology], Brain Concussion/px [Psychology], Brain Injuries/co [Complications], Brain Injuries/px [Psychology], Female, Humans, Male, Mental Recall, middle aged, Reproducibility of Results, Sensitivity and Specificity, Verbal Learning
@article{Falconer2006,
title = {The rapid screen of concussion: an evaluation of the non-word repetition test for use in mTBI research},
author = {Falconer, E K and Geffen, G M and Olsen, S L and McFarland, K},
year = {2006},
date = {2006-01-01},
journal = {Brain Injury},
volume = {20},
number = {12},
pages = {1251--1263},
abstract = {PRIMARY OBJECTIVES: (1) To investigate the Nonword Repetition test (NWR) as an index of sub-vocal rehearsal deficits after mild traumatic brain injury (mTBI); (2) to assess the reliability, validity and sensitivity of the NWR; and (3) to compare the NWR to more sensitive tests of verbal memory. RESEARCH DESIGN: An independent groups design. METHODS AND PROCEDURES: Study 1 administered the NWR to 46 mTBI and 61 uninjured controls with the Rapid Screen of Concussion (RSC). Study 2 compared mTBI, orthopaedic and uninjured participants on the NWR and the Hopkins Verbal Learning Test (HVLT-R). MAIN OUTCOMES AND RESULTS: The NWR did not improve the diagnostic accuracy of the RSC. However, it is reliable and indexes sub-vocal rehearsal speed. These findings provide evidence that although the current form of the NWR lacks sensitivity to the impact of mTBI, the development of a more sensitive test of sub-vocal rehearsal deficits following mTBI is warranted.},
keywords = {*Brain Concussion/di [Diagnosis], *Mass Screening/mt [Methods], *Neuropsychological Tests, Adolescent, adult, Brain Concussion/et [Etiology], Brain Concussion/px [Psychology], Brain Injuries/co [Complications], Brain Injuries/px [Psychology], Female, Humans, Male, Mental Recall, middle aged, Reproducibility of Results, Sensitivity and Specificity, Verbal Learning},
pubstate = {published},
tppubtype = {article}
}
Horner, A; VanDemark, M; Jensen, G A
The challenge of assessing a patient with dementia and head injury Journal Article
In: AACN Clinical Issues, vol. 13, no. 1, pp. 73–83, 2002.
Abstract | BibTeX | Tags: *Craniocerebral Trauma/co [Complications], *Dementia/co [Complications], Accidental Falls, Accidents, aged, Alzheimer Disease/di [Diagnosis], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Brain Concussion/pp [Physiopathology], Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/pp [Physiopathology], Delirium/di [Diagnosis], Delirium/et [Etiology], Home, Humans
@article{Horner2002,
title = {The challenge of assessing a patient with dementia and head injury},
author = {Horner, A and VanDemark, M and Jensen, G A},
year = {2002},
date = {2002-01-01},
journal = {AACN Clinical Issues},
volume = {13},
number = {1},
pages = {73--83},
abstract = {Alzheimer's disease is emerging as a major health challenge for the 21st century. The reported case study discusses a 74-year-old woman with dementia of the Alzheimer type who sustained a head injury when she fell down the basement stairs. Differentiating the head injury from the preexisting dementia was complicated and required creative and astute assessment. Objective assessment tools discussed include the Mini-Mental State Examination, a delirium guide, and the Tinetti assessment tool. Predisposition to delirium is significant because of the comorbidities associated with cognitive impairment and head injury. Interventions to prevent delirium are recommended.},
keywords = {*Craniocerebral Trauma/co [Complications], *Dementia/co [Complications], Accidental Falls, Accidents, aged, Alzheimer Disease/di [Diagnosis], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Brain Concussion/pp [Physiopathology], Craniocerebral Trauma/di [Diagnosis], Craniocerebral Trauma/pp [Physiopathology], Delirium/di [Diagnosis], Delirium/et [Etiology], Home, Humans},
pubstate = {published},
tppubtype = {article}
}
Jordan, B D
Neurologic aspects of boxing Journal Article
In: Archives of Neurology, vol. 44, no. 4, pp. 453–459, 1987.
Abstract | BibTeX | Tags: *Athletic Injuries, *Boxing, *Brain Injuries, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pa [Pathology], Athletic Injuries/pc [Prevention & Control], Athletic Injuries/pp [Physiopathology], Brain Concussion/et [Etiology], Brain Injuries/ep [Epidemiology], Brain Injuries/pa [Pathology], Brain Injuries/pc [Prevention & Control], Brain Injuries/pp [Physiopathology], Humans, Magnetic Resonance Spectroscopy, Tomography, X-Ray Computed
@article{Jordan1987,
title = {Neurologic aspects of boxing},
author = {Jordan, B D},
year = {1987},
date = {1987-01-01},
journal = {Archives of Neurology},
volume = {44},
number = {4},
pages = {453--459},
abstract = {The assessment and prevention of potentially adverse neurologic consequences of boxing requires two important considerations. Acute neurologic injuries should be distinguished from chronic brain injuries and the level of competitive boxing (ie, amateur vs professional) must also be taken into account. Acute neurologic injuries such as concussion, post-concussion syndrome, intracranial hemorrhage, and brain contusion are more readily identified than chronic neurologic injuries because of their immediate devastation of the nervous system. In contrast, chronic neurologic injuries differ in their pathophysiologic mechanisms that are exemplified by an insidious onset and progression after the cessation of boxing. Accordingly, the chronic traumatic encephalopathy of boxing poses the most serious neurologic threat of boxing. Amateur boxing differs from professional boxing in the duration of fights, rules and regulatory policies, medical evaluation, and protective devices. These factors could produce a differential effect on the risk of injury to the brain. The prevention of neurologic injuries in boxing requires the integration of proper neurologic evaluation by qualified ring-side physicians, the design and utilization of effective protective devices, and the establishment of national regulatory agencies.},
keywords = {*Athletic Injuries, *Boxing, *Brain Injuries, Athletic Injuries/ep [Epidemiology], Athletic Injuries/pa [Pathology], Athletic Injuries/pc [Prevention \& Control], Athletic Injuries/pp [Physiopathology], Brain Concussion/et [Etiology], Brain Injuries/ep [Epidemiology], Brain Injuries/pa [Pathology], Brain Injuries/pc [Prevention \& Control], Brain Injuries/pp [Physiopathology], Humans, Magnetic Resonance Spectroscopy, Tomography, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}