scholarly journals Post-Concussion Syndrome

Concussion ◽  
2019 ◽  
pp. 89-92
Author(s):  
Brian Hainline ◽  
Lindsey J. Gurin ◽  
Daniel M. Torres
Keyword(s):  
Brain Injury ◽  
Homogeneous Process ◽  
Post Concussion Syndrome ◽  
Domain Specific ◽  
Persistent Symptoms ◽  
Medical Term ◽  
Emotional Issues

Post-concussion syndrome is no longer an accepted medical term and has been replaced by the phrase “persistent post-concussive symptoms” or simply “persistent symptoms.” Post-concussion syndrome had been used to identify individuals with prolonged symptoms following concussion, but the term assumed that concussion is a homogeneous process and that persistent symptoms were always a manifestation of the original brain injury. Concussion often manifests in different clinical domains, and it is important that these domains be managed more specifically. Domain-specific interventions seek to address the somatic, cognitive, and emotional issues that are common following concussion. Such specific interventions mitigate the development of persistent symptoms.

Neuro-Optometric Rehabilitation Accelerates Post-Concussion Syndrome Recovery in a Professional Athlete – A Case Report Presenting a New Paradigm

2017 ◽  
pp. 167-178
Keyword(s):  
Case Report ◽  
Brain Injury ◽  
Medical Staff ◽  
Clinical Findings ◽  
Return To Play ◽  
Top Down ◽  
Post Concussion Syndrome ◽  
Persistent Symptoms ◽  
Professional Soccer ◽  
Medicine Physician

Background: Optometrists are becoming increasingly instrumental in the care of brain injured patients. Within the profession of optometry, a segment of optometrists has become highly trained and skilled in rehabilitation of vision dysfunctions and therefore is integral in the interdisciplinary management of a patient’s overall recovery from acquired brain injury. No system provides more neurosensory input to the brain than vision. Therefore, optometry has an obligation to and is best prepared to provide this area of care referred to as neuro-optometric rehabilitation. Case Report: A professional soccer player suffered a head injury during competition. He was diagnosed with a mild traumatic brain injury (concussion) and was unable to obtain complete resolution of symptoms despite current standard return-to-play protocol administered by the team medical staff. Symptoms included intermittent blurred vision during movement, mild photophobia, and feeling somewhat “not present”. The team medical staff included a sports medicine physician, head athletic trainer/physical therapist, and a neuropsychologist. Neurooptometric consultation was requested for the athlete by the team physician to determine if vision dysfunction was contributing to the athlete’s persistent symptoms. He was diagnosed with vision dysfunctions presumably associated with the concussion and neurooptometric rehabilitation was prescribed. Conclusion: The clinical findings and treatment in a case of post-concussion syndrome involving associated vision dysfunctions are described. Neuro-optometric rehabilitation utilizing a unique paradigm remediated the vision dysfunctions of the athlete and eliminated his post-concussion symptoms. This in turn facilitated his return-to-play process. The paradigm applied began with passive, inputbased, bottom-up therapy accompanied by gradual introduction of active, output-based, top-down techniques. In recent years, this author has found this paradigm to be more effective than a top-down approach when non-oculomotor based vision dysfunctions are included in the post-concussion patient clinical findings.

scholarly journals Cervicovestibular rehabilitation in adult with mild traumatic brain injury: a randomised controlled trial protocol

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Pierre Langevin ◽  
Philippe Fait ◽  
Pierre Frémont ◽  
Jean-Sébastien Roy
Keyword(s):  
Traumatic Brain Injury ◽  
Cervical Spine ◽  
Brain Injury ◽  
Neck Pain ◽  
Mild Traumatic Brain Injury ◽  
Controlled Trial ◽  
Rehabilitation Program ◽  
Conventional Approach ◽  
Persistent Symptoms ◽  
Link Type

Abstract Background Mild traumatic brain injury (mTBI) is an acknowledged public health problem. Up to 25% of adult with mTBI present persistent symptoms. Headache, dizziness, nausea and neck pain are the most commonly reported symptoms and are frequently associated with cervical spine and vestibular impairments. The most recent international consensus statement (2017 Berlin consensus) recommends the addition of an individualized rehabilitation approach for mTBI with persistent symptoms. The addition of an individualized rehabilitation approach including the evaluation and treatment of cervical and vestibular impairments leading to symptoms such as neck pain, headache and dizziness is, however, recommended based only on limited scientific evidence. The benefit of such intervention should therefore be further investigated. Objective To compare the addition of a 6-week individualized cervicovestibular rehabilitation program to a conventional approach of gradual sub-threshold physical activation (SPA) alone in adults with persistent headache, neck pain and/or dizziness-related following a mTBI on the severity of symptoms and on other indicators of clinical recovery. We hypothesize that such a program will improve all outcomes faster than a conventional approach (between-group differences at 6-week and 12-week). Methods In this single-blind, parallel-group randomized controlled trial, 46 adults with subacute (3 to12 weeks post-injury) persistent mTBI symptoms will be randomly assigned to: 1) a 6-week SPA program or 2) SPA combined with a cervicovestibular rehabilitation program. The cervicovestibular rehabilitation program will include education, cervical spine manual therapy and exercises, vestibular rehabilitation and home exercises. All participants will take part in 4 evaluation sessions (baseline, week 6, 12 and 26) performed by a blinded evaluator. The primary outcome will be the Post-Concussion Symptoms Scale. The secondary outcomes will be time to clearance to return to function, number of recurrent episodes, Global Rating of Change, Numerical Pain Rating Scale, Neck Disability Index, Headache Disability Inventory and Dizziness Handicap Inventory. A 2-way ANOVA and an intention-to-treat analysis will be used. Discussion Controlled trials are needed to determine the best rehabilitation approach for mTBI with persistent symptoms such as neck pain, headache and dizziness. This RCT will be crucial to guide future clinical management recommendations. Trial registration ClinicalTrials.gov Identifier - NCT03677661, Registered on September, 15th 2018.

scholarly journals Case report: Manual therapies promote resolution of persistent post-concussion symptoms in a 24-year-old athlete

2021 ◽  
Vol 9 ◽  
pp. 2050313X2095222
Author(s):  
Susan Vaughan Kratz
Keyword(s):  
Case Report ◽  
Symptom Severity ◽  
Impact Test ◽  
Manual Therapies ◽  
Symptom Checklist ◽  
Post Concussion Syndrome ◽  
Persistent Symptoms ◽  
Short Period ◽  
History Of ◽  
Headache Impact

This case report illustrates the treatment outcomes of a collegiate athlete presenting with an 18-month history of post-concussion syndrome who received a series of mixed manual therapies in isolation of other therapy. Persistent symptoms were self-reported as debilitating, contributing to self-removal from participation in school, work, and leisure activities. Patient and parent interviews captured the history of multiple concussions and other sports-related injuries. Neurological screening and activities of daily living were baseline measured. Post-Concussion Symptom Checklist and Headache Impact Test-6™ were utilized to track symptom severity. Treatments applied included craniosacral therapy, manual lymphatic drainage, and glymphatic techniques. Eleven treatment sessions were administered over 3 months. Results indicated restoration of oxygen saturation, normalized pupil reactivity, and satisfactory sleep. Post-concussion syndrome symptom severity was reduced by 87% as reflected by accumulative Post-Concussion Symptom Checklist scores. Relief from chronic headaches was achieved, reflected by Headache Impact Test-6 scores. Restoration of mood and quality of life were reported. A 6-month follow-up revealed symptoms remained abated with full re-engagement of daily activities. The author hypothesized that post-concussion syndrome symptoms were related to compression of craniosacral system structures and lymphatic fluid stagnation that contributed to head pressure pain, severe sleep deprivation, and multiple neurological and psychological symptoms. Positive outcomes over a relatively short period of time without adverse effects suggest these therapies may offer viable options for the treatment of post-concussion syndrome.

scholarly journals Myelin water fraction decrease in individuals with chronic mild traumatic brain injury and persistent symptoms

Heliyon ◽  
2021 ◽  
Vol 7 (4) ◽  
pp. e06709
Author(s):  
Bretta Russell-Schulz ◽  
Irene M. Vavasour ◽  
Jing Zhang ◽  
Alex L. MacKay ◽  
Victoria Purcell ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Water Fraction ◽  
Persistent Symptoms ◽  
Myelin Water Fraction

Prognostic Factors for Persistent Symptoms in Adults With Mild Traumatic Brain Injury: an Overview of Systematic Reviews

2021 ◽  
Author(s):  
Julien Déry ◽  
Béatrice Ouellet ◽  
Élaine de Guise ◽  
Ève-Line Bussières ◽  
Marie-Eve Lamontagne
Keyword(s):  
Traumatic Brain Injury ◽  
Prognostic Factors ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Systematic Reviews ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Persistent Symptoms ◽  
Wide Range ◽  
Overview Of Systematic Reviews

Abstract Background: Mild traumatic brain injury (mTBI) is an increasing public health problem, because of its persistent symptoms and several functional consequences. Understanding the prognosis of a condition is an important component of clinical decision-making and can help to guide prevention of persistent symptoms following mTBI. Prognosis of mTBI has stimulated several empirical primary research papers and many systematic reviews leading to the identification of a wide range of factors. We aim to synthesize these factors to get a better understanding of their breadth and scope.Methods: We conducted an overview of systematic reviews. We searched in databases systematic reviews synthesizing evidence about prognosis of persistent symptoms after mTBI in the adult population. Two reviewers independently screened all references and selected eligible reviews based on eligibility criteria. They extracted relevant information using an extraction grid. They also rated independently the risk of bias using the ROBIS tool. We synthesized evidence into a comprehensive conceptual map to facilitate the understanding of prognostic factors that have an impact on persistent post-concussion symptoms.Results: From the 3857 references retrieved in database search, we included 25 systematic reviews integrating the results of 312 primary articles published between 1957 and 2019. We examined 35 prognostic factors from the systematics reviews. No single prognostic factor demonstrated convincing and conclusive results. However, age, sex and multiple concussions showed an affirmatory association with persistent post-concussion outcomes in systematic reviews.Conclusion: We highlighted the need of a comprehensive picture of prognostic factors related to persistent post-concussion symptoms. We believe that these prognostic factors would guide clinical decision and research related to prevention and intervention regarding persistent post-concussion symptoms.Systematic review registration: PROSPERO CRD42020176676

Domain-specific deficits in self-awareness and relationship to psychosocial outcomes after severe traumatic brain injury

2018 ◽  
Vol 42 (5) ◽  
pp. 651-659 ◽  
Author(s):  
Felicity G. Hurst ◽  
Tamara Ownsworth ◽  
Elizabeth Beadle ◽  
David H. K. Shum ◽  
Jennifer Fleming
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Psychosocial Outcomes ◽  
Self Awareness ◽  
Domain Specific

scholarly journals Neuromodulation for Mild Traumatic Brain Injury Rehabilitation: A Systematic Review

2020 ◽  
Vol 14 ◽  
Author(s):  
Francesca Buhagiar ◽  
Melinda Fitzgerald ◽  
Jason Bell ◽  
Fiona Allanson ◽  
Carmela Pestell
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Post Intervention ◽  
Persistent Symptoms ◽  
Positive Effects ◽  
The Brain

Background: Mild traumatic brain injury (mTBI) results from an external force to the head or body causing neurophysiological changes within the brain. The number and severity of symptoms can vary, with some individuals experiencing rapid recovery, and others having persistent symptoms for months to years, impacting their quality of life. Current rehabilitation is limited in its ability to treat persistent symptoms and novel approaches are being sought to improve outcomes following mTBI. Neuromodulation is one technique used to encourage adaptive neuroplasticity within the brain.Objective: To systematically review the literature on the efficacy of neuromodulation in the mTBI population.Method: A systematic review was conducted using Medline, Embase, PsycINFO, PsycARTICLES and EBM Review. Preferred Reporting Items for Systematic Reviews and the Synthesis Without Meta-analysis reporting guidelines were used and a narrative review of the selected studies was completed. Fourteen articles fulfilled the inclusion criteria which were published in English, investigating an adult sample and using a pre- and post-intervention design. Studies were excluded if they included non-mild TBI severities, pediatric or older adult populations.Results: Thirteen of fourteen studies reported positive reductions in mTBI symptomatology following neuromodulation. Specifically, improvements were reported in post-concussion symptom ratings, headaches, dizziness, depression, anxiety, sleep disturbance, general disability, cognition, return to work and quality of life. Normalization of working memory activation patterns, vestibular field potentials, hemodynamics of the dorsolateral prefrontal cortex and excessive delta wave activity were also seen. The studies reviewed had several methodological limitations including small, heterogenous samples and varied intervention protocols, limiting generalisability. Further research is required to understand the context in which neuromodulation may be beneficial.Conclusions: While these positive effects are observed, limitations included unequal representation of neuromodulation modalities in the literature, and lack of literature describing the efficacy of neuromodulation on the development or duration of persistent mTBI symptoms. Better clarity regarding neuromodulation efficacy could have a significant impact on mTBI patients, researchers, clinicians, and policy makers, facilitating a more productive post-mTBI population. Despite the limitations, the literature indicates that neuromodulation warrants further investigation. PROSPERO registration number: CRD42020161279.

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