Management of Cerebral Concussion in the War Fighter: Lessons Learned from Sports Medicine
- Authors: Lovell MR, Collins MW, Pardini J, Parodi A, Yates T.
- Publication: Operative Techniques in Sports Medicine
- Date: Jun 06, 2006
Abstract:
Amateur athletes with a history of three or more concussions were carefully matched (gender, age, education, and sport) with athletes with no prior concussions. ALl completed computerized neuropsychological test battery at preseason and then within 5 days of sustaining a concussion. There were differences between groups in symptom reporting and memory performance. At baseline, athletes with multiple concussions reported more symptoms than athletes with no history of concussion. At approximately 2 days post-injury, athletes with multiple concussions scored significantly lower on memory testing than athletes with a single concussion. Athletes with multiple concussions were 7.7 times more likely to demonstrate a major drop in memory performance than athletes with no previous concussions.
Abstract:
The purpose of this study was to examine the validity of ImPACT, a computerized neuropsychological test battery, for measuring attention and processing speed in athletes with concussions. This was accomplished by comparing the computerized testing to a traditional neuropsychological measure, the Symbol Digit Modalities Test. Participants were 72 amateur athletes who were seen within 21 days of sustaining a sports-related concussion. As predicted, the SDMT correlated most highly with the Processing Speed and Reaction Time composites from ImPACT.
Abstract:
Neurocogntive testing has been endorsed as a 'cornerstone' of concussion management by recent Vienna and Prague meetings of the Concussion In Sport Group. Neurocognitive testing is important given the potential unreliability of athlete self-report after injury. Relying only on athletes' reports of symptoms may result in premature return of athletes to contact sport, potentially exposing them to additional injury.
Abstract:
Normative Data for the ImPACT Composite Scores
A sample of 205 elementary, junior high, and high school students was initially used for this project. Three of these subjects had incomplete test data and were subsequently dropped from the normative sample. The current normative sample consists of 102 boys and 100 girls between the ages of 11 and 14. Multiple analysis of variance (MANOVA) was performed to allow an analysis of performance differences between gender and age across multiple neuropsychological domains.
Abstract:
Neuropsychological testing is a variable tool in concussion diagnosis and management. ImPACT, a computerized neuropsychological testing program, consists of eight cognitive tasks and a 21-item symptom inventory. ImPACT was used to examine the cognitive performance of 104 concussed athletes at baseline, 2, 7, and 14 days post-injury. Dependent measures included composite scores from the ImPACT computerized test battery, as well as a total symptom score from the Post-Concussion Symptom Scale.
Abstract:
This study explored the diagnostic utility of the composite scores of Immediate Post-Concussion Assessment and Cognitive Testing and Post Concussion Symptom Scale scores. Recently concussed high school athletes were tested within 72h of sustaining a concussion, and data were compared to non-concussed high school athletes with no history of concussion.
Abstract:
Recent concussion management guidelines have suggested that athletes with mild (grade 1) concussions may be returned to play if asymptomatic for 15 minutes. The purpose of this study was to assess the utility of a current concussion management guideline in classifying and managing mild concussion. Forty-three high school athletes completed neuropsychological test performance and symptom ratings prior to the season and at two times during the 1st week following mild concussion.
Abstract:
The effectiveness of a concussion management education programme (CMEP) in rugby in reducing the number and
cost of concussion/brain injury (CBI) moderate to serious claims (MSC) was assessed.
Abstract:
Carbon monoxide (CO) is well known as a nonirritating,
colorless, tasteless and odorless gas. It mixes
readily with air and is found wherever organic material
is burned under conditions of incomplete combustion,
such as exhaust gas from internal combustion engines1.
Abstract:
During the past thirty years, over twenty concussion management guidelines have been published with the intent of providing guidance and direction for the sports-medicine practitioner in making complex return to play decisions. The authors of each of these guidelines also provided an accompanying grading sclae designed to reflect and characterize the severity of the injury. Although these guidelines have no-doubt resulted in improved care of the athlete, these multiple directives also created significant confusion and sparked almost continuous debate.
Abstract:
The object of this study was to compare symptom status and neurocognitive functioning in athletes with no headache, athletes complaining of headache, and athletes with characteristics of posttraumatic migraine group. Neurocognitive tests were undertaken by 261 high-school and collegiate athletes with a a mean age of 16.36 +/- 2.6 years.
Abstract:
The Heads-Up on Sport Concussion is a concise introductory book on sport concussion for professionals who work with athletes. It provides a comprehensive review of current literature on sport concussion, and it guides professionals in communicating with athletes, parents, and coaches regarding assessment, treatment, and other issues surrounding sport concussion.
In The Heads-Up on Sport Concussion, the authors detail
• what happens when the brain is injured;
• appropriate assessment and evaluation tools;
• sport-specific issues;
• how medical organizations are addressing the issue of sport concussion;
• medical and nonmedical treatment and rehabilitation strategies;
• recent research on a variety of topics in sport concussion; and
• essential information for coaches, athletes, and parents.