scholarly journals Pediatric headache incidence and outcomes after sports-related concussion: Findings from the North Texas ConcussionRegistry (ConTex)

Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S11.3-S12
Author(s):  
Bert B. Vargas ◽  
Elida Godbey ◽  
Stephen Bunt ◽  
Ali Shah Tejani ◽  
Munro Cullum
Keyword(s):  
Common Symptom ◽  
North Texas ◽  
Recurrent Headache ◽  
Symptom Resolution ◽  
The North ◽  
Pediatric Headache ◽  
History Of ◽  
Time Since Injury ◽  
Mean Time

IntroductionHeadache is the most common symptom reported after concussion; however, little is known about the incidence of headache and the clinical course over 3 months in pediatric patients with sports-related concussion (SRC) presenting within 30 days of injury.MethodsFour hundred twenty-five patients met inclusion criteria (patients under 18 years old limited to SRC within 30 days of injury and who also completed a 3 months follow up evaluation) and were enrolled from any 1 of 5 ConTex clinic sites.ResultsMean age was 14.3 years (range = 7–18, SD 2.2) and mean time since injury at presentation to clinic was 8.1 days (range = 0–30, SD = 6.7). Only 13.7% (n = 56) had a history of headache before their concussion. 96.5% (n = 410) of patients recalled having headache at time of injury. At initial presentation, 77.3% (n = 317) reported headache; 38.2% (n = 121) mild, 48.6% (n = 154) moderate, 13.2% (n = 42) severe (on a scale from 0-6). At 3 months follow up, 19.8% (n = 81) reported headache; 76.6% (n = 62) mild, 18.5% (n = 15) moderate, 4.9% (n = 4) severe. Among 264 that were treated with headache abortive medications, 97.7% (n = 258) used simple analgesics (NSAIDs or acetaminophen); 0.8% (n = 2) used opioids; 10.2% (n = 27) used triptans; and 5.7% (n = 15) used other non-specified treatments. 66.5% of children reported symptom resolution within 29 days (range 0–90 days, mode 17–29, n = 71, 20.2%).ConclusionsThe incidence of headache at the time of concussion is high and remains high within 30 days after injury, the majority of which were moderate in severity. By 3 months, only a minority of patients report headache, the majority of which were mild. For 86.3% of children, their first experience with recurrent headache occurred in the context of SRC. Outcomes were generally good at 3 months despite an overwhelming majority of children being treated with non-specific, simple analgesics. Most children reported symptom resolution within 29 days of injury.

Do Learning Disorders Impact Clinical Measures Following Concussion?

Neurology ◽  
2020 ◽  
Vol 95 (20 Supplement 1) ◽  
pp. S16.3-S17
Author(s):  
Mathew Stokes ◽  
Aaron J. Zynda ◽  
Jane Chung ◽  
Cheryl Silver ◽  
Munro Cullum ◽  
...  
Keyword(s):  
Impulse Control ◽  
Clinical Findings ◽  
Learning Disorders ◽  
Adhd Group ◽  
North Texas ◽  
The North ◽  
Patient Health ◽  
History Of ◽  
Clinical Measures ◽  
Time Since Injury

ObjectiveEvaluate differences in clinical testing following concussion between adolescents with no history of learning disorder (LD) and those with a history of dyslexia and/or ADD/ADHD.BackgroundLearning disorders, such as ADHD, can affect ImPACT® baseline neurocognitive testing. The effect that ADHD has on other clinical measures is less well understood. Additionally, limited data exists on the effect of dyslexia on these measures.Design/MethodsData were prospectively collected from participants enrolled in the North Texas Concussion Registry (ConTex). Participants ages 10–18 years old, diagnosed with a concussion sustained within 30 days of enrollment were included and assessed for self-reported history of LD type (dyslexia and/or ADD/ADHD). Clinical findings examined included symptom scores (derived from SCAT5™), ImPACT®, King-Devick (KD) test, patient health questionnaire 8(PHQ-8) scores, and generalized anxiety disorder 7(GAD-7) scores. Mann-Whitney tests were used to compare groups.ResultsIn total, 1,298 participants were included: 58 with dyslexia, 158 with ADD/ADHD, 35 with both (dyslexia and ADD/ADHD), and 1,047 with no LD. There was no difference in age, sex, time since injury, or history of concussion apart from the ADD/ADHD group, which had more males (p < 0.001). The dyslexia group had slower mean KD time (p = 0.011) and increased error scores (p = 0.028). In those with ADD/ADHD, impulse control scores on ImPACT® were significantly higher (p = 0.007), but no other ImPACT® score differences reached significance. PHQ-8 and GAD-7 scores were significantly higher in those with ADD/ADHD (p < 0.001). Participants with both dyslexia and ADHD demonstrated slower KD times (p = 0.009) and had higher PHQ-8 (p < 0.001) and GAD-7 (p = 0.001) scores.ConclusionsParticipants with dyslexia and/or ADD/ADHD had worse scores on commonly used concussion clinical measures including ImPACT® impulse control, KD testing, and depression and anxiety screenings. Understanding the differences in these groups will aid providers in their evaluation and assist in counseling families regarding the injury.

Impact of Playing Surface on Concussion Symptoms in Young American Football Players

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S12.2-S12
Author(s):  
Morgan Michelle Heinzelmann ◽  
Mathew Stokes ◽  
Stephen Bunt ◽  
Nyaz Didehbani ◽  
Shane Miller ◽  
...  
Keyword(s):  
American Football ◽  
Prior History ◽  
Football Players ◽  
Symptom Checklist ◽  
North Texas ◽  
Blurred Vision ◽  
The North ◽  
History Of ◽  
Modifiable Factor ◽  
Time Since Injury

ObjectiveTo identify differences in symptoms following sports-related concussion (SRC) on natural grass vs artificial turf in youth and adolescent football players.BackgroundThere is continued interest in reducing risk of SRC in football, with playing surface being one potentially modifiable factor. It is estimated that 15–30% of concussions result from helmet-to-ground contact, and some studies have suggested a higher incidence of SRC on grass in competitive contact sports compared to turf. To our knowledge, our study is the first to investigate reported post-concussive symptoms after SRC as they relate to playing surface.Design/MethodsData were prospectively collected from the North Texas Concussion Registry (ConTex), a longitudinal multi-institutional concussion database. We selected male football players between the ages of 10 and 24 who sustained a helmet-to-ground SRC (GCS 13–15) on either grass or turf. Pre-injury information and post-concussive symptoms (Graded Symptom Checklist from the SCAT-5) were collected at an initial in-person visit within 2 weeks of injury and via electronic follow up at 3 months.ResultsFifty-eight participants were included (grass = 32, turf = 26), and groups were similar in age (p = 0.089), time since injury (p = 0.500), history of headache (χ2 = 0.167), and prior history of concussion (χ2 = 0.868). Athletes who sustained SRC on grass reported significantly higher scores on the Graded Symptom Checklist (p = 0.018, mean 26.0 vs 11.4) and higher numbers of distinct symptoms (p = 0.013, mean 10.2 vs 5.5) compared to those who sustained SRC on turf. Symptoms that were rated significantly higher after SRC on grass included headache (p = 0.010), phonophobia (p = 0.014), dizziness (p = 0.001), fatigue (p = 0.021), blurred vision (p = 0.001), feeling “in a fog” (p = 0.014), difficulty remembering (p = 0.004), and feeling emotional (p = 0.041).ConclusionsYouth and adolescent football players who sustain SRC on grass report higher post-concussive symptom severity and burden. Elucidating differential effects of SRC on grass vs turf is important, as competitive playing surface is a modifiable risk factor.

Abstract 14134: The Impact of Ablation for Atrial Fibrillation on Dementia Incidence in Patients With and Without Depression

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Heidi T May ◽  
Tami L Bair ◽  
Stacey Knight ◽  
Jeffrey L Anderson ◽  
Joseph B Muhlestein ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Treatment Strategies ◽  
Brain Perfusion ◽  
Cardiovascular Comorbidities ◽  
Incident Dementia ◽  
History Of ◽  
The Impact ◽  
Mean Time ◽  
History Of Depression

Introduction: Studies have previously shown that atrial fibrillation (AF) is associated with dementia. The mechanisms are likely multifactorial, but may involve treatment strategies that include anticoagulation use and rhythm management, particularly when used early. Patients that have earlier-life depression are at risk of dementia. However, depression diagnosis in AF patients may indicate a patient at higher risk of developing dementia and whether treatments ameliorate that risk is unknown. Methods: A total of 132,703 AF patients without a history of dementia were studied. History of depression was determined at the time of AF diagnosis. Patients were deemed as having a follow-up ablation if it occurred prior to a dementia diagnosis. Patients were stratified into 4 groups based on depression history and follow-up ablation status: no depression, ablation (n=5,960); no depression, no ablation (n=106,986); depression, ablation (n=923); and depression, no ablation (n=18,834). Patients were followed for 5-year incidence of dementia. Results: A total of 14.9% (n=19,757) pts had a history of depression at the time of AF diagnosis. The mean time between depression and AF diagnoses was 4.9±4.8 years. Patients with depression were younger (68±15 vs. 71±14 years), more likely to be female (62% vs. 44%), and had more cardiovascular comorbidities. Mean time to ablation was 1.3±1.4 days (median: 7.7 months) from AF diagnosis. Frequencies of 5-year dementia were: no depression, ablation=1.6%; no depression, no ablation=5.2%; depression, ablation=4.7%; and depression, no ablation=9.7%, p<0.0001. Multivariable comparisons between the groups are shown in the Figure. Conclusion: In AF patients with and without depression, ablation was associated with a lower risk of incident dementia. Rhythm control approaches that improve long-term brain perfusion may represent a means to impact cognitive declines in patients at higher risk because of earlier-life depression.

scholarly journals A-147 Post-Concussive Symptoms in Adolescent Athletes with Premorbid Psychiatric History: A Matched Case–Control Study

2020 ◽  
Vol 35 (6) ◽  
pp. 941-941
Author(s):  
Presley C ◽  
Caze T ◽  
Tarkenton T ◽  
Stokes M ◽  
Miller S ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Control Sample ◽  
Psychiatric History ◽  
Adolescent Athletes ◽  
Symptom Scale ◽  
North Texas ◽  
The North ◽  
Matched Case ◽  
Domain Scores

Abstract Objective To examine sport-related concussion (SRC) symptoms in adolescent athletes with premorbid psychiatric history (PPH+) compared to a matched control sample without such history (PPH-). It was hypothesized that adolescents with PPH+ would report higher symptom severity both initially and at 3-month follow-up. Method Participants aged 13–18 (M age = 14.9) who reported a psychiatric history (N = 29) presented to clinic within 7 days of sustaining a SRC. Subjects were matched to those without premorbid psychiatric history (N = 29) by age, sex, race, sport, and time to clinic ( 1 day). All participants (N = 58) completed the Post-Concussion Symptom Scale (PCSS) at initial visit and 3-month follow-up as part of the North Texas Concussion Registry (ConTex). Independent sample T tests compared PCSS total and cognitive/fatigue, vestibular, ocular, posttraumatic migraine, and anxiety/mood domain scores between groups across time points. Results Consistent with our hypothesis, the PPH+ group reported significantly higher PCSS total (M = 41.0/132 vs. M = 27.7/132; p = .02), posttraumatic migraine domain (M = 3.5/6 vs. M = 2.5/6; p = .03), and anxiety domain (M = 1.1/6 vs. M = 0.4/6; p = .002) severity at the initial evaluation. However, there were no significant differences in PCSS total (PPH+ M = 4.1/132 vs. PPH- M = 3.3/132) or domain scores at 3-month follow-up. Conclusion(s) After matching by age, sex, race, sport, and time to clinic, adolescents with self-endorsed PPH+ reported higher total symptom, posttraumatic migraine, and anxiety domain symptom severity immediately following SRC but not at 3-month follow-up. Findings suggest that adolescents with PPH+ may experience higher subjective levels of distress following SRC, although further research is needed to understand the role of recovery in this population.

SARS-CoV-2 Infection in a Spanish Cohort of CKD-5D Patients: Prevalence, Clinical Presentation, Outcomes, and De-Isolation Results

2020 ◽  
pp. 1-8
Author(s):  
José Jesús Broseta ◽  
Diana Rodríguez-Espinosa ◽  
Elena Cuadrado ◽  
Elena Guillén-Olmos ◽  
Evelyn Hermida ◽  
...  
Keyword(s):  
Health Resources ◽  
Maintenance Hemodialysis ◽  
Common Symptom ◽  
Time To Death ◽  
Reactive Protein ◽  
Increased Risk ◽  
Discharged Patients ◽  
History Of ◽  
The Mean ◽  
Mean Time

<b><i>Introduction:</i></b> COVID-19 is a highly contagious disease that has easily spread worldwide. Outpatient maintenance hemodialysis seems to entail an increased risk of contagion, and previous reports inform of increased mortality among this population. <b><i>Methods:</i></b> We retrospectively analyzed clinical and laboratory parameters, outcomes, and management once discharged of CKD-5D patients infected with SARS-CoV-2 from our health area. <b><i>Results:</i></b> Out of the 429 CKD-5D population, 36 were diagnosed with SARS-CoV-2 infection (8%): 34 on in-center hemodialysis and 2 on peritoneal dialysis. Five were asymptomatic. The most common symptom was fever (70%), followed by dyspnea and cough. History of cardiovascular disease and elevation of LDH and C-reactive protein during admission were associated with higher mortality. Thirteen patients died (36%), 8 patients were admitted to an ICU, and survival was low (38%) among the latter. The mean time to death was 12 days. Most discharged patients got negative rRT-PCR in nasopharyngeal swabs within 26 days of diagnosis. However, there is a portion of cured patients that continue to have positive results even more than 2 months after the initial presentation. <b><i>Conclusions:</i></b> Patients on dialysis have an increased mortality risk if infected with SARS-CoV-2. Preventive measures have proven useful. Thus, proper ones, such as universal screening of the population and isolation when required, need to be generalized. Better de-isolation criteria are necessary to ensure an appropriate use of public health resources.

scholarly journals Intravitreal Bevacizumab to Treat Retinopathy of Prematurity in 865 Eyes: a Study to Determine Predictors of Primary Treatment Failure and Recurrence

2021 ◽  
Author(s):  
Kaveh Fadakar ◽  
Mohammadreza Mehrabi Bahar ◽  
Hamid Riazi-Esfahani ◽  
Afsaneh Azarkish ◽  
Afsar Dastjani Farahani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Treatment Failure ◽  
Retinopathy Of Prematurity ◽  
Intravitreal Bevacizumab ◽  
Primary Treatment ◽  
Anti Vegf ◽  
History Of ◽  
Mean Time

Abstract Purpose: This study aimed To evaluate the rate and risk factors for primary failure and recurrence after intravitreal anti-VEGF injection in retinopathy of prematurity (ROP).Methods: This retrospective study was performed on 865 eyes from 441 patients with retinopathy of prematurity receiving intravitreal Bevacizumab from 2012 to 2019. Medical records of patients were evaluated.Results: Mean gestational age (GA) and birth weight of patients were 28±2 weeks and 1121±312 g, respectively. Thirty-five eyes (4.04%) had a primary failure, including 18 eyes from 187 eyes in zone 1 (9.6%) and 17 eyes from 678 eyes in zone 2 (2.5%). The mean time of retreatment was 16.64±13.68 days in eyes without regression ROP. The remaining 830 eyes (95.95%) were included in recurrence analysis. The recurrence occurred in 33 eyes (3.97 %) of them in 20 patients, with the meantime of 77.52 days after the first treatment (IVB). Presence of plus disease, history of oxygen therapy or phototherapy, and GA less than 32 were associated with significantly increased prevalence of treatment failure. The risk factor predicting recurrence are lower birth weight, zone 1 pretreatment, history of intubation, anemia, and sepsis.Conclusion: Intravitreal anti-VEGF is a successful treatment for ROP with a low rate of primary failure and recurrence. Attention to risk factors accompanied by special care to patterns of treatment failure and recurrence helps to achieve early detection of treatment failure and vigilant follow up for recurrence.

scholarly journals Clinical Epidemiology and Paraclinical Findings in Tuberculosis Patients in North of Iran

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Farhang Babamahmoodi ◽  
Ahmad Alikhani ◽  
Jamshid Yazdani Charati ◽  
Amir Ghovvati ◽  
Fatemeh Ahangarkani ◽  
...  
Keyword(s):  
Clinical Epidemiology ◽  
Wide Spectrum ◽  
Cross Sectional Study ◽  
Common Symptom ◽  
Cross Sectional ◽  
Significant Difference ◽  
North Of Iran ◽  
History Of ◽  
The Mean ◽  
Mean Time

Background. Mycobacterium tuberculosis (M.TB) causes a wide spectrum of clinical diseases. The prevalence of TB is different in various parts of Iran and throughout the world. The present study aimed to determine the clinical epidemiology and paraclinical findings of TB. Methods. A cross-sectional study was conducted from 2008 to 2013. Patient demographic, clinical, and radiologic characteristics, picked up from the TB patient’s files, were collected using a standard questionnaire format. Data was entered and analyzed using the SPSS version 16 statistical software and P value < 0.05 was considered statistically significant. Results. Out of 212 patients enrolled in this study 62% were male and the mean age was about 50 years old. 98.6% were Iranian, and 46.2% were rural. Prevalence of smear-positive TB was 66.4%. Prevalence of positive PPD was 50.7% with no significant difference between HIV-positive and -negative patients (P = 0.8). Prevalence of diabetes mellitus was 17%. 36% of the patients had history of smoking and about 29.3% were addicted to narcotics. Cough was the most common symptom (94.5%) and 84% had sputum. 15 cases (7%) had extrapulmonary TB. The mean time between the onset of symptoms and admission was 46.5 days. The delay for admission between urban and rural populations was not significantly different (P = 0.68); but for those who were in prison, the delay was significant (P = 0.02). About 46% of the patients had cavitary lesions in CXRs. Conclusion. Timely diagnosis of TB especially in prisoners by understanding its most important epidemiologic characteristics and clinical features can help to make an early treatment and prevent spread of mycobacteria and their complications.

scholarly journals Outcomes of COVID-19 among Patients on In-Center Hemodialysis: An Experience from the Epicenter in South Korea

2020 ◽  
Vol 9 (6) ◽  
pp. 1688 ◽  
Author(s):  
Hee-Yeon Jung ◽  
Jeong-Hoon Lim ◽  
Seok Hui Kang ◽  
Seong Gyu Kim ◽  
Yong-Hoon Lee ◽  
...  
Keyword(s):  
South Korea ◽  
Antiviral Agents ◽  
Common Symptom ◽  
Advanced Chronic Kidney Disease ◽  
Reactive Protein ◽  
History Of ◽  
Pulmonary Infiltration ◽  
The Mean ◽  
Mean Time ◽  
Increased Susceptibility

Patients with advanced chronic kidney disease (CKD) or who are on hemodialysis (HD) could have increased susceptibility to the 2019 coronavirus disease (COVID-19) given their pre-existing comorbidities, older age, compromised immune system, and regular visits to populated outpatient dialysis centers. This study included 14 consecutive patients on HD or with advanced CKD who initiated HD after being diagnosed with laboratory-confirmed COVID-19 from February to April 2020 in hospitals throughout Daegu, South Korea. The included patients, 42.9% of whom were men, had a mean age of 63.5 years. Four patients had a history of contact with a patient suffering from COVID-19. The most common symptom was cough (50.0%), followed by dyspnea (35.7%). The mean time from symptom onset to diagnosis and admission was 2.6 and 3.5 days, respectively. Patients exhibited lymphopenia and elevated inflammatory markers, including C-reactive protein and ferritin. Chest radiography findings showed pulmonary infiltration in 10 patients. All patients underwent regular HD in a negative pressure room and received antiviral agents. Four patients received mechanical ventilation and continuous renal replacement therapy at a median duration of 14.0 and 8.5 days, respectively. One patient underwent extracorporeal membrane oxygenation for three days. Among the 14 patients included, two died due to acute respiratory distress syndrome, nine were discharged from the hospital, and three remained hospitalized. Despite the high-risk conditions associated with worse outcomes, patients on HD did not exhibit extremely poor overall COVID-19 outcomes perhaps due to early diagnosis, prompt hospitalization, and antiviral therapy.

scholarly journals Management of supratentorial epidural hematoma in children: report on 49 patients

2010 ◽  
Vol 68 (6) ◽  
pp. 888-892 ◽  
Author(s):  
Wellingson Silva Paiva ◽  
Almir Ferreira de Andrade ◽  
Luis Mathias Júnior ◽  
Vinicius Monteiro de Paula Guirado ◽  
Robson Luis Amorim ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Neurological Status ◽  
Neurological Impairment ◽  
Common Symptom ◽  
Traumatic Head Injury ◽  
Patients Âgés ◽  
Vehicle Accidents ◽  
Long Term Follow Up ◽  
History Of

Traumatic head injury is a common cause of mortality and acquired neurological impairment in children. However, pediatric epidural hematomas (EDHs) are not common and few series have studied the evolution of these patients. In this study, we present the results from a sample of patients with EDH with long-term follow-up. METHOD: Between January 2006 and December 2008, 49 patients with traumatic EDH were treated at our unit. Clinical course, radiological findings and outcomes were evaluated. Neurological status was assessed using the Glasgow Coma Scale (GCS). The patients' ages ranged from one day to 16 years. The mean follow-up was six months. RESULTS: On admission, most of the patients presented mild trauma and 57% had a GCS of 13-15. The most common symptom was irritability. The most frequent mechanisms of injury were: falling from a height in 29 cases and motor vehicle accidents in 16 cases. Three of these patients presented GCS 3, but only one died. We found a late neurological deficit in nine patients. CONCLUSION: These lesions may occur following mild head trauma and in alert children with nonfocal neurological examinations. However, in children presenting irritability with subgaleal hematomas and a history of loss of consciousness, skull computed tomography must be performed.

Association Between Sleep Quality and Recovery Following Sport-Related Concussion in Pediatrics

2019 ◽  
Vol 34 (11) ◽  
pp. 639-645 ◽  
Author(s):  
Jane S. Chung ◽  
Aaron J. Zynda ◽  
Nyaz Didehbani ◽  
Cason Hicks ◽  
Linda S. Hynan ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Symptom Severity ◽  
Early Recognition ◽  
Clinic Visit ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
North Texas ◽  
The North ◽  
Prolonged Recovery

Our objective was to determine the association between sleep quality, symptom severity, and recovery following sport-related concussion in pediatric athletes. A review of data from the North Texas Concussion Network Prospective Registry (ConTex) was performed. Participants were diagnosed with a sport-related concussion and were ≤18 years old. Participants were categorized based on their initial clinic visit Pittsburgh Sleep Quality Index composite score (0-21) into good sleep quality (GS≤5) and poor sleep quality (PS>5) groups. The PS group reported higher median total symptom scores at 3-month follow-up (3.0 vs 0.0, P < .01) and took more than a median of 2 weeks longer to recover compared to the GS group (35.0 days vs 20.0 days, P < .01). Poor sleep quality was strongly associated with greater symptom severity and longer time to recovery following sport-related concussion. Early recognition of concussed athletes with poor sleep quality at initial clinic visit may help predict prolonged recovery.

Sign in / Sign up

Export Citation Format

Share Document