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Results for “Post-Concussion Syndrome”

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At least 199 records · Page 11Linked to original sources
PubMed2002

Brain atrophy in mild or moderate traumatic brain injury: a longitudinal quantitative analysis.

BACKGROUND AND PURPOSE: Although mild or moderate traumatic brain injury (TBI) is known to cause persistent neurologic sequelae, the underlying structural changes remain elusive. Our purpose was to assess decreases in the volume of brain parenchyma (VBP) in patients with TBI and to determine if clinical parameters are predictors of the extent of atrophy. METHODS: We retrospectively assessed the total VBP in 14 patients with mild or moderate TBI at more than 3 months after injury and in seven patients at two time points more than 3 months apart. VBP was calculated from whole-brain MR images and then normalized by calculating the percent VBP (%VBP) to correct for intraindividual variations in cranial size. Clinical parameters at the time of trauma were evaluated for potential predictors of atrophy. Findings were compared with those of control subjects of similar ages. RESULTS: In the single time-point analysis, brain volumes, CSF volumes, and %VBP were not significantly different between patients and control subjects. In the longitudinal analysis, the rate of decline in %VBP (0.02 versus 0.0064 U/day, P =.05) and the change in %VBP between the first and second time points (-4.16 +/- 1.68 versus -1.49 +/- 1.7, P =.022 [mean +/-SD]) were significantly greater in patients. Change in %VBP was significantly greater in patients with loss of consciousness (LOC) than in those without LOC (P =.023). CONCLUSION: Whole-brain atrophy occurs after mild or moderate TBI and is evident at an average of 11 months after trauma. Injury that produces LOC leads to more atrophy. These findings may help elucidate an etiology for the persistent or new neurologic deficits that occur months after injury.

Adult↗
PubMed2004

Post-traumatic vertigo.

The vestibular-like symptoms that commonly follow head injury are most often due to one of a number of specific pathologies affecting vestibular, CNS or cervical structures. These pathologies can be readily identified in the majority of cases by appropriate testing in the examining room, and in vestibular function or neurodiagnosic laboratories. Whereas vestibular suppressants have a roll, they often delay recovery and have been supplanted as the mainstay of treatment in most cases by vestibular rehabilitation techniques. Given the large number of patients requiring outpatient management following head injury, it is appropriate that most generalists and many subspecialists should be aware of the differential diagnosis, workup and treatment options for post-traumatic vertigo.

Ambulatory Care↗
PubMed2001

Attentional deficits in patients with post-concussion symptoms: a componential perspective.

Attentional deficits are frequently reported by patients suffering from closed head injuries. The majority will develop a group of clinical symptoms known as post-concussion symptoms or syndromes (PCS), which are characterized by a range of subjectively experienced symptoms including headaches, dizziness, fatigue, irritability, slowed thinking, and memory dysfunction. It is posited that attentional deficit is the crucial factor for the apparent failures of memory and higher cognitive functioning, and may contribute largely to difficulty in re-integrating back into the community and resuming independent daily living. It also appears that there are large variations within these patients, in terms of both presented symptoms and neuropsychological performances. However, these variations in terms of attentional deficits have not been systematically differentiated and examined. This article aims to build up a theoretical framework to guide the investigation of the varieties of attentional deficits in patients with PCS. Current theories on attention from cognitive psychology, neuropsychology, cognitive neuroscience and clinical rehabilitation will be reviewed and integrated. It is hoped that a better understanding of the underlying mechanism of such defects will foster and guide the development of intervention.

Adhesives↗
PubMed1998

Return to play guidelines after a head injury.

Presently there are no universally accepted definitions of the grades of concussion or criteria for when to allow the athlete to return to competition after a head injury. What is agreed upon is that in order to avoid cumulative brain damage and the second impact syndrome, no athlete still suffering post-concussion symptoms should return to competition. This article is meant to serve only as a guideline as the final decision in every instance is a clinical judgement.

Biomechanical Phenomena↗
PubMed1989

The perilymph fistula syndrome defined in mild head trauma.

Neurological and neuro-otological studies were carried out on 102 adults with mild cranio-cervical trauma productive of positional vertigo and perilymph fistula as confirmed by laboratory tests, and by the finding of perilymph fistula at tympanotomy in the surgically managed group. In this patient group, all other neurological and neuro-otological diagnoses were excluded, e.g. epilepsy, cerebral palsy, multiple sclerosis, retardation; and for the neuro-otological group those with a history of ototoxicity, labyrinthitis, Meniere's disease, chronic ear infections, or developmental or familial disorders. Emphasis in this study was on mild trauma: fewer than half of the sample had been rendered unconscious in the injury of record, and a third of the cases were of whiplash type, with no loss of consciousness (LOC) and no remembered headstrike. These concomitant lesions comprise the perilymph fistula syndrome (PLFS) with a unique profile of neurological, perceptual, and cognitive deficits resembling a post-concussion injury. A complete description of the clinical picture is given, including psychological, cognitive and diagnostic tests, and the outcome of bedrest vs. surgical management. PLFS can arise from minor trauma, fistula are frequently bilateral (71/102), a mild sensorineural hearing loss is of variable occurrence (53%), secondary hydrops is not uncommon, and women appear more vulnerable than men for developing the syndrome. As based upon combined laboratory techniques and clinical symptomology, fistula were correctly predicted in 61 of 65 laser-operated ears. The positional vertigo component of PLFS was in all cases managed according to a special physical therapy program utilizing exercises for vestibular symptom habituation. Even when diagnosed late, a good-to-excellent outcome was achieved in 70% of treated patients.

Adult↗
PubMed2003

Symptoms and cognitive dysfunction in patients with the late whiplash syndrome.

The aim of the study was to record the severity of symptoms in patients with the late whiplash syndrome and to assess how the symptom load affected the performance on a simple psychometric test. The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) with an additional question on neck pain, modified RPQ (mRPQ), and the Short Test of Mental Status (STMS) were applied on 40 chronic whiplash patients. Symptoms reported by the whiplash group were compared to those of 50 normal controls. The patients scored significantly higher than the controls on all symptoms listed in the mRPQ. The most frequent symptoms reported.

Adult↗
PubMed2004

Elevated serum S-100B protein as a predictor of failure to short-term return to work or activities after mild head injury.

Protein S-100B is an established serum marker of primary and secondary brain damage and stroke. A group of patients after mild head injury (MHI) develop post-concussion symptoms that interfere with the ability in the short-term to return to work or undertake certain activities. The aim of this study was to examine the correlation of serum S-100B with short-term outcome after MHI. We studied 100 subjects who were referred to the Emergency Department (ED) after a MHI. All subjects had a GCS of 15 either with or without loss of consciousness (LOC) and/or post-traumatic amnesia (PTA). Serum S-100B was collected within 3 h from the injury and a value of > or = 0.15 microg/L was considered as abnormal. Subjects with other injuries, including scalp or cervical spine, were excluded, as well as those with alcohol/narcotic drug consumption or history of serious physical/mental illness. An independent observer measured the return to work/activities within one week. Thirty-two (32%) subjects had elevated S-100B. The failure to return to work/activities was significantly correlated with elevated S-100B: subjects with increased S-100B had a failure rate of 37.5% versus 4.9% of those with normal values (p = 0.0001). In MHI, the elevated S-100B seemed to correlate with an unfavorable short-term outcome. This might be useful in (1) selecting patients who need closer observation, hospitalization, and further investigations (such as CT scan or MRI), and (2) the prognosis of genuine post-concussion symptoms, that interfere with return to work or activities, versus other causes such as premorbid personality, labyrinthine dysfunction, whiplash syndrome, postinjury stress, occupational injury, litigation, and malingering.

Activities of Daily Living↗
PubMed1998

Second-impact syndrome.

Second impact syndrome (SIS) occurs when an athlete who has sustained an initial head injury, most often a concussion, sustains a second head injury before symptoms associated with the first have fully cleared. While most commonly reported in football, the SIS can occur during any sport that can produce head blows. Any athlete still complaining of post-concussion symptoms after a head injury must not be allowed to return to play.

Adolescent↗
PubMed1997

Does premorbid depression influence post-concussive symptoms and neuropsychological functioning?

We examined the contribution of premorbid affective disturbance to persistent post-concussive symptoms and neuropsychological functioning following a mild traumatic brain injury. No differences were observed on self-reported post-concussive symptoms, MMPI scales, or neuropsychological measures between two case-matched groups of patients with and without a history of pre-injury depression. Clinicians are urged to use caution in attributing post-concussive symptoms or neuropsychological deficits to the presence of a pre-existing affective disorder.

Adult↗
PubMed1994

Sequelae of minor head injury: the natural history of post-concussive symptoms and their relationship to loss of consciousness and follow-up.

The character and natural history of post-concussive symptoms were studied in two subject groups: patients admitted to hospital for observation following brief loss of consciousness (LOC) as a result of head injury and patients who attended the accident unit after head injury but not were not admitted. Follow-up data were obtained from the hospitalized group at standardized out-patient interview and from the non-hospitalized group by postal questionnaire. Two- and 12-week data are presented on 24 hospitalized and 58 non-hospitalized patients. The type and frequency of symptoms was similar in the two groups and rank ordering was significantly correlated. However, the reduction in symptom scores (number of symptoms) 12 weeks post-injury was significantly greater in the hospitalized than the non-hospitalized group. The possible significance of this is discussed.

Adolescent↗