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.

Improvements in Cognition, Graded Symptom Checklist Score, Balance and Memory Following Neurological Rehabilitation for a 58-year-old Male Patient with Post-Concussion Syndrome: Case Report

Neurology ◽  
2020 ◽  
Vol 95 (20 Supplement 1) ◽  
pp. S10.1-S10
Author(s):  
Brittany Forrester ◽  
Emily Kalambaheti ◽  
Mia Cozart ◽  
Matthew Michael Antonucci
Keyword(s):  
Cognitive Impairment ◽  
Male Patient ◽  
Symptom Severity ◽  
Severity Score ◽  
Standardized Assessment ◽  
Symptom Checklist ◽  
Post Concussion Syndrome ◽  
Persistent Symptoms ◽  
Symptom Severity Score ◽  
Stability Score

ObjectiveTo suggest the efficacy of multi-modal, intensive, neurologic rehabilitation approaches to improve cognition, balance, and cognitive impairment in patients with post-concussion syndrome.BackgroundA 58-year-old male patient presented to Plasticity Brain Centers for evaluation and treatment of persistent symptoms following a previously diagnosed concussion. His symptoms followed rapidly after injury and included headaches, neck pain, and difficulty with sleeping. Upon intake, he reported on the graded symptom checklist (GSC) a symptom severity score of 59. A Comprehensive Assessment of Postural Systems (CAPS ®) was performed assessing balance and stability on both a solid and foamed surface with eyes opened, eyes closed, and multiple head positions. An average stability score upon intake was calculated as 53.9% overall. Neurocognitive testing utilizing C3 Logix Neurocognitive Assessment Suite, Trails A time was 28.6 and standardized assessment of cognition (SAC) score was a 28/30 with specific difficulty in delayed memory.Design/MethodsA 5-day, intensive, multi-modal program of neurologic exercises was administered in 10 one-hour treatment sessions. Each session consisted of repetitive peripheral somatosensory stimuli, cognitive exercises, neuromuscular reeducation, vestibular rehabilitation, orthoptic exercises, and off-vertical axis rotation utilizing a multi-axis rotational chair.ResultsUpon exit, symptom severity score decreased to 35 (−40.6%); Trails A time decreased to 19.7 (−31.1%); balance improved from an average stability score of 75.5%–79.6% (+5.4%); and standardized assessment of cognition (SAC) score increased to an overall score of 30/10 (+7.1%) with an improvement in delayed memory.ConclusionsThe authors suggest further investigation into multi-modal, intensive approaches to improve cognition, balance, and cognitive impairment in patients with post-concussion syndrome.

scholarly journals Workers’ recovery from concussions presenting to the emergency department

2019 ◽  
Vol 69 (6) ◽  
pp. 419-427 ◽  
Author(s):  
L A Gaudet ◽  
L Eliyahu ◽  
J Beach ◽  
M Mrazik ◽  
G Cummings ◽  
...  
Keyword(s):  
Emergency Department ◽  
Return To Work ◽  
Patient Adherence ◽  
Point Of Care ◽  
Post Concussion Syndrome ◽  
Work Related ◽  
Hyperactivity Disorder ◽  
Persistent Symptoms ◽  
Modifiable Factors ◽  
History Of

AbstractBackgroundThe emergency department (ED) is the first point of care for many patients with concussion, and post-concussion syndrome can impact vocational outcomes like successful return to work. Evaluation of concussion in general adult populations is needed.AimsTo document the occurrence and outcomes of work-related concussion presenting to the ED for treatment.MethodsThis study enrolled adults presenting with concussion to three urban Canadian EDs. Baseline ED interviews, physician questionnaires and patient phone interviews at 30 and 90 days documented work-related events, ED management, discharge advice, patient adherence and symptom severity. Work-related injury and return to work were modelled using logistic or linear regression, as appropriate.ResultsOverall, 172 enrolled workers completed at least one follow-up. Work-related concussions were uncommon (n = 28). Most employees (80%) missed at least 1 day of work (median = 7; interquartile range: 3–14). Most (91%) employees returned to work within 90 days, while 41% reported persistent symptoms. Manual labour and self-reported history of attention deficit hyperactivity disorder were associated with work-related concussion, while days of missed work increased with marital status (divorced), history of sleep disorder and physician’s advice to avoid work.ConclusionWork-related concussions are infrequent; however, most workers who sustain a concussion will miss work, and many return while still experiencing symptoms. Work-related concussion and days of missed work are mainly affected by non-modifiable factors. Workers, employers and the workers’ compensation system should take necessary precautions to ensure that workers return to work safely and successfully following a concussion.

Post-concussion syndrome and pre-existing mood disorder: A case report

2018 ◽  
Vol 54 (3) ◽  
pp. 163-171 ◽  
Author(s):  
S Tucker Price ◽  
Alexei O DeCastro ◽  
Clive D Brock
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Family History ◽  
Mood Disorder ◽  
Attention Deficit ◽  
Anxiety And Depression ◽  
Duration Of Symptoms ◽  
Post Concussion Syndrome ◽  
Hyperactivity Disorder ◽  
Persistent Symptoms ◽  
History Of

Sport-related concussions in youth and adolescent athletes most commonly resolve within one week without residual symptoms, with athletes resuming full participation following return to play guidelines. A small percentage of athletes have persistent symptoms that cause significant morbidity, some of whom are ultimately diagnosed with post-concussion syndrome. In these athletes, symptoms in the emotional domain can be more prolonged than other domains, with athletes reporting anxiety and depression months to years following injury. A prior personal or family history of pre-existing mood disorder or attention-deficit/hyperactivity disorder increases the risk of a prolonged duration of symptoms. In this case series, we discuss two cases of post-concussion syndrome in adolescent athletes with a past personal or family history of attention-deficit/hyperactivity disorder, anxiety, and depression treated by a combination of cognitive behavioral therapy and medication with ongoing persistent symptoms. There is increased need for mental health screening in all athletes to identify individuals at risk for post-concussion syndrome. Early identification of at-risk individuals allows the interdisciplinary care team to discuss expectations for the athlete and family regarding duration of symptoms.

scholarly journals Group a streptococcal cellulitis in the early puerperium

2011 ◽  
Vol 68 (7) ◽  
pp. 607-610
Author(s):  
Branka Nikolic ◽  
Ana Mitrovic ◽  
Svetlana Dragojevic-Dikic ◽  
Snezana Rakic ◽  
Zlatica Cakic ◽  
...  
Keyword(s):  
Case Report ◽  
Toxic Shock Syndrome ◽  
Early Recognition ◽  
Healthy Woman ◽  
Supportive Therapy ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Short Period ◽  
History Of ◽  
Group A

Introduction. Infectious diseases caused by Streptococcus pyogenes, a member of the group A Streptococci (GAS) are among the most common life threatening ones. Patients with GAS infections have a poor survival rate. Cellulitis is a severe invasive GAS infection and the most common clinical presentation of the disease associated with more deaths than it can be seen in other GAS infections. According to the literature data, most cases of GAS toxic shock syndrome are developed in the puerperium. However, there are two main problems with GAS infection in early puerperium and this case report is aimed at reminding on them. The first problem is an absence of awareness that it can be postpartal invasive GAS infection before the microbiology laboratory confirms it, and the second one is that we have little knowledge about GAS infection, in general. Case report. A 32- year-old healthy woman, gravida 1, para 1, was hospitalized three days after vaginal delivery with a 38-hour history of fever, pain in the left leg (under the knee), and head injury after short period of conscious lost. Clinical picture of GAS infection was cellulites. Group A Streptoccocus pyogenes was isolated in vaginal culture. Rapid antibiotic and supportive treatment stopped development of streptococcal toxic shock syndrome (STSS) and potential multiorganic failure. Signs and symptoms of the infection lasted 25 days, and complete recovery of the patient almost 50 days. Conclusion. In all women in childbed with a history of fever early after delivery, vaginal and cervical culture specimens should be taken as soon as possible. Early recognition of GAS infection in early puerperium and prompt initiation of antimicrobial drug and supportive therapy can prevent development of STSS and lethal outcome.

scholarly journals Diagnostic Dilemma in Groove Pancreatitis: A Case Report

2020 ◽  
Vol 58 (231) ◽  
Author(s):  
Uttam Laudari ◽  
Roshan Ghimire ◽  
Rosi Pradhan ◽  
Dhiresh Kumar Maharjan ◽  
Prabin Bikram Thapa
Keyword(s):  
Case Report ◽  
Chronic Pancreatitis ◽  
Ductal Adenocarcinoma ◽  
Diagnostic Dilemma ◽  
Perioperative Morbidity ◽  
Persistent Symptoms ◽  
Groove Pancreatitis ◽  
History Of ◽  
High Index Of Suspicion

Groove pancreatitis is uncommon form of chronic pancreatitis common in patients with history of smoking and alcohol abuse. High index of suspicion is required as it may masquerade pancreatic ductal adenocarcinoma and both of these conditions are difficult to differentiate preoperatively. Pancreaticoduodenectomy has good outcome in patient with Groove pancreatitis. Hence, we are reporting a case report of Groove pancreatitis in 40 years gentleman, who was being managed by multiple endoscopic dilatations, later underwent pancreaticoduodenectomy for persistent symptoms. He had no perioperative morbidity and doing well in 24 months follow up.

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.

Cricoid Chondronecrosis: Case Report and Review of Literature

2020 ◽  
Vol 129 (7) ◽  
pp. 662-668
Author(s):  
Mark M. Mims ◽  
Andree A. Leclerc ◽  
Libby J. Smith
Keyword(s):  
Case Report ◽  
Endotracheal Intubation ◽  
Surgical Techniques ◽  
Upper Airway ◽  
Signs And Symptoms ◽  
Rare Entity ◽  
Level Of Evidence ◽  
Radiologic Findings ◽  
Short Period ◽  
History Of

Objective: Cricoid chondronecrosis is a rare entity that has significant consequences for patients. Reports of its occurrence are scattered in the literature and currently there is no comprehensive review to help guide providers. Methods: A case report from our institution is presented. A review of available literature is then provided with assessment of risk factors, signs and symptoms at presentation, laryngeal exam findings, radiologic findings, and surgical techniques. Results: Twenty-four cases of cricoid chondronecrosis were reviewed from the literature. Patient age ranged from 8 months to 76 years. A history of endotracheal intubation for various reasons was present in all but two cases, and duration of intubation ranged from 6 hours to 28 days. Patients presented with airway compromise in all but two cases—one asymptomatic patient with prior tracheostomy and another with dysphagia after radiation. Dysphonia (n = 6) and dysphagia (n = 3) were less commonly present. Subglottic stenosis (n = 19) was the most common exam finding followed by vocal fold impairment (n = 11). When CT scan findings were reported, fragmentation of the cartilage and/or hypodensity of the central lamina were described in all but one case. Interventions ranged from observation on antibiotics and steroids to surgical therapies including tracheostomy, dilation, and posterior cricoid split, with or without stent placement. Conclusions: Cricoid chondronecrosis is a serious, rare entity that can occur even after a short period of endotracheal intubation. Providers must have a high level of suspicion in patients that present with upper airway dyspnea with a history of prior intubation. Level of evidence: Level 4

scholarly journals Migrated fish bone into the neck: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Vasanthika Sanjeewanie Thuduvage
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Asian Population ◽  
Fish Bone ◽  
Diagnosis Delay ◽  
Lateral Neck ◽  
Case Presentation ◽  
Persistent Symptoms ◽  
History Of ◽  
Nose And Throat

Abstract Background Impaction of foreign body is a common condition presented to ear, nose, and throat department among Asian population. The commonest foreign body seen among this population has been documented as fish bone. Fish bone can migrate to lateral neck space or related organs around the neck and chest. By presenting this case report, we aim to emphasize the importance of taking proper history and make clinicians aware of the possibility of a fish bone migrating into different spaces. This will help to prevent diagnosis delay leading to complications due to migrated fish bone. Case presentation A 50-year-old female Sinhalese patient presented to ear, nose, and throat department with right-sided neck pain for 2 days, who had a history of suspected fish bone impaction a few days ago that subsided without any investigations or treatments. She did not have any symptoms related to throat, and neck examination showed mild swelling and tenderness. Computer tomography revealed a migrated fish bone into the lateral neck close to carotid artery, and the fish bone was removed by neck exploration under general anesthesia without any complications. Conclusion In conclusion, migrated fish bone should be suspected if patient is having persistent symptoms mainly in the neck without having difficulty swallowing and who gives a history of fish bone impaction and having negative laryngoscopic examination. Proper history taking is very important in the assessment of these patients to prevent misdiagnosis of the condition. Clinicians should aware that migrated fish bones are not uncommon and that early suspicion can prevent later diagnosis and complications.

Popliteal artery thrombosis secondary to a tibial osteochondroma

VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Gruber-Szydlo ◽  
Poreba ◽  
Belowska-Bien ◽  
Derkacz ◽  
Badowski ◽  
...  
Keyword(s):  
Case Report ◽  
Magnetic Resonance Angiography ◽  
Popliteal Artery ◽  
Doppler Ultrasonography ◽  
Histopathological Examination ◽  
Previous History ◽  
Plain Radiography ◽  
Artery Thrombosis ◽  
History Of ◽  
The Right

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.

An unusual presentation of epigastric pain due to thrombophlebitis of a recanalised umbilical vein – case report

2019 ◽  
Vol 98 (8) ◽  
pp. 326-327 ◽  
Keyword(s):  
Liver Cirrhosis ◽  
Abdominal Pain ◽  
Case Report ◽  
Portal Hypertension ◽  
Liver Disease ◽  
Epigastric Pain ◽  
Umbilical Vein ◽  
History Of ◽  
Clinically Significant ◽  
Inflammatory Changes

Introduction: The umbilical vein can become recanalised due to portal hypertension in patients with liver cirrhosis but the condition is rarely clinically significant. Although bleeding from this enlarged vein is a known complication, the finding of thrombophlebitis has not been previously described. Case report: We report the case of a 62-year-old male with a history of liver cirrhosis due to alcoholic liver disease presenting to hospital with epigastric pain. A CT scan of the patient’s abdomen revealed a thrombus with surrounding inflammatory changes in a recanalised umbilical vein. The patient was managed conservatively and was discharged home the following day. Conclusion: Thrombophlebitis of a recanalised umbilical vein is a rare cause of abdominal pain in patients with liver cirrhosis.

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