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21. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Vestibular (Balance/ Dizziness) & Vision Dysfunction

Guideline for concussion/mild traumatic brain injury & persistent symptoms - Vestibular (Balance/ Dizziness) & Vision Dysfunction Vestibular (Balance/ Dizziness) & Vision Dysfunction // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age Vestibular (Balance/ Dizziness) & Vision Dysfunction Vestibular (Balance/Dizziness) Dysfunction (...) Persistent vertigo, dizziness, imbalance and visual disturbance are common symptoms of patients with concussion/mTBI and are often associated with objective impairments of the vestibular system. 1,2 Vestibular impairments can occur peripherally in the inner ear, or centrally in nuclei that integrate vestibular signals in order to maintain balance and posture. The vestibular system also affects eye movement through a variety of mechanisms including the vestibulo-occular reflex (VOR). The most common cause

2018 Ontario Neurotrauma Foundation

22. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Fatigue

Guideline for concussion/mild traumatic brain injury & persistent symptoms - Fatigue Fatigue // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age Fatigue Fatigue has been conceptualized as an experience of weariness or tiredness following mental or physical exertion, often resulting in a reduced capacity for work and limited efficiency (...) to respond to stimuli. Fatigue can be caused by psychological or physiological forces 1 and can be central or peripheral, which in lay terms is experienced as cognitive fatigue and physical fatigue or weariness. 2-4 Fatigue is one of the most pervasive symptoms following concussion/mTBI, with 27.8% of individuals experiencing persistent fatigue at 3 months post-injury. 5 The perception of fatigue can be out of proportion to exertion or may even occur without any exertion. 6 One study reported a level

2018 Ontario Neurotrauma Foundation

23. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Post-Traumatic Headache

Guideline for concussion/mild traumatic brain injury & persistent symptoms - Post-Traumatic Headache Post-Traumatic Headache // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age Post-Traumatic Headache Headache is the most common and among the most prevalent persistent symptoms following mTBI. 1-4 Studies to date have documented (...) that anywhere from 30-90% of individuals who sustain a mTBI develop post-traumatic headache. 2,5 Interestingly, several researchers have reported that post-traumatic headache is more common after concussion/mTBI than after severe TBI. 5-17 Notably, post-traumatic headache is associated with a high degree of disability 1 and is more chronic and persistent than previously thought. 18 The vast majority of people with post-traumatic headache improve within days or weeks; however, for some individuals, headaches

2018 Ontario Neurotrauma Foundation

24. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Sleep-Wake Disturbances

Guideline for concussion/mild traumatic brain injury & persistent symptoms - Sleep-Wake Disturbances Sleep-Wake Disturbances // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age Sleep-Wake Disturbances More than 50% of patients report sleep disturbances following mTBI, specifically insomnia, hypersomnia, obstructive sleep apnea, poor (...) and reassured about the fact that sleep alterations are very common in the acute stages of concussion/mTBI. 7.2 C Patients who have identified sleep alterations should be monitored for sleep/wake disturbances. Patients who have persisting sleep disturbances should be monitored for sleep-wake disorders (e.g., insomnia, excessive daytime sleepiness). (see Appendices and ). 7.3 C Screen for pre-existing sleep disturbances/ disorders, medical conditions, current medication use, comorbid psychopathology and risk

2018 Ontario Neurotrauma Foundation

25. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Mental Health Disorders

Guideline for concussion/mild traumatic brain injury & persistent symptoms - Mental Health Disorders Mental Health Disorders // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age Mental Health Disorders General considerations Mental health disorders are common following mTBI, and appear to be major determinants of post-mTBI wellness (...) and functional recovery. This includes disorders of mood which consist of symptoms related to depression and anxiety. The etiology of mTBI/concussive mood disorders may be related to reactive or environmental factors such as the experience of the trauma resulting in the injury (e.g., manifesting in post-traumatic stress symptoms, phobias and related anxieties) or to the negative outcomes following the injury (i.e., depression related to not participating in important roles such as work or school, sports, etc

2018 Ontario Neurotrauma Foundation

26. Guideline for concussion/mild traumatic brain injury & persistent symptoms - General Recommendations Regarding Management of Persistent Symptoms

Guideline for concussion/mild traumatic brain injury & persistent symptoms - General Recommendations Regarding Management of Persistent Symptoms General Recommendations Regarding Management of Persistent Symptoms // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age General Recommendations Regarding Management of Persistent Symptoms (...) Consistent with general expectations of both patients and healthcare professionals, symptoms following mTBI are anticipated to resolve in a timely fashion in the majority of cases; evidence is emerging that some people (15% or greater) continue to have persistent symptoms. 1-3 There is wide variation in how people recover after concussion/mTBI 4 even when experiencing similar injuries. 2 This guideline has been developed to assist in managing those individuals who continue to have persistent symptoms

2018 Ontario Neurotrauma Foundation

27. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Return-to-Activity / Work / School Considerations

Guideline for concussion/mild traumatic brain injury & persistent symptoms - Return-to-Activity / Work / School Considerations Return-to-Activity / Work / School Considerations // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age Return-to-Activity / Work / School Considerations Returning to usual activities after a concussion/mTBI can (...) -aged children physical activity within 7 days of acute injury compared with no physical activity was associated with reduced risk of persistent post-concussive symptoms. 3 For workers, the literature demonstrates brain injury patients who are employed report better health status, improved sense of well-being, greater social integration within the community, less usage of health services and a better quality of life than do those who are not employed. 4 In order to facilitate early and safe

2018 Ontario Neurotrauma Foundation

28. Guideline for concussion/mild traumatic brain injury & persistent symptoms - General Recommendations Regarding Diagnosis/Assessment of Persistent Symptoms

Guideline for concussion/mild traumatic brain injury & persistent symptoms - General Recommendations Regarding Diagnosis/Assessment of Persistent Symptoms General Recommendations Regarding Diagnosis/Assessment of Persistent Symptoms // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age General Recommendations Regarding Diagnosis/Assessment (...) of Persistent Symptoms While full recovery is expected within 3 months after concussion/mTBI, 1,2, not all patients experience such rapid recovery, with minimally 15% or more experiencing persistent symptoms. 3,4 A more recent study showed 20 – 48% of veterans had persistent symptoms up to 60 months post-concussion. 5 A number of factors influence the rate of recovery, including the mechanism and setting for the initial injury; for example, concussion/mTBI due to non-sport-related causes can be unexpected

2018 Ontario Neurotrauma Foundation

29. Australian Institute of Sport and Australian Medical Association position statement on concussion in sport

Australian Institute of Sport and Australian Medical Association position statement on concussion in sport Australian Institute of Sport and Australian Medical Association position statement on concussion in sport | The Medical Journal of Australia mja-search search Use the for more specific terms. Title contains Body contains Date range from Date range to Article type Author's surname Volume First page doi: 10.5694/mja__.______ Search Reset  close Individual Login Purchase options Connect (...) person_outline Login keyboard_arrow_down Individual Login Purchase options menu search Advertisement close Australian Institute of Sport and Australian Medical Association position statement on concussion in sport Lisa J Elkington and David C Hughes Med J Aust 2017; 206 (1): . || doi: 10.5694/mja16.00741 Published online: 16 January 2017 Topics Summary Sport-related concussion is a growing health concern in Australia. Public concern is focused on the incidence and potential long term consequences

2017 MJA Clinical Guidelines

30. Bruising

in developing and updating this topic. Further details on the full process can be found in the section and on the website. Search strategy Scope of search A literature search was conducted for guidelines, systematic reviews and randomized controlled trials on primary care management of bruising and purpura. Search dates November 2010 - March 2016 Key search terms Various combinations of searches were carried out. The terms listed below are the core search terms that were used for Medline. exp Contusions (...) Bruising Prodigy Toggle navigation Topics Specialities A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Allergies Cancer Cardiovascular Child health Drugs and devices Ear, nose and throat Endocrine and metabolic Eyes Gastroenterology Gastrointestinal Haematology Immunizations Infections and infestations Injuries Kidney disease and urology Men's health Mental health Musculoskeletal Neurological Oral health Palliative care Poisoning Pregnancy Preventative medicine Respiratory Sexual health

2017 Prodigy

31. Bone contusion progression from traumatic knee injury: association of rate of contusion resolution with injury severity (Full text)

Bone contusion progression from traumatic knee injury: association of rate of contusion resolution with injury severity Bone contusions are frequently encountered in magnetic resonance imaging (MRI) evaluation of knee anterior cruciate ligament (ACL) injuries. Their role as indicators of injury severity remains unclear, primarily due to indeterminate levels of joint injury forces and to a lack of preinjury imaging.The purpose of this study was to 1) quantify bone contusion pathogenesis (...) following traumatic joint injuries using fixed imaging follow-ups, and 2) assess the feasibility of using longitudinal bone contusion volumes as an indicator of knee injury severity.Prospective sequential MRI follow-ups of a goat cohort exposed to controlled stifle trauma in vivo were compared to parallel clinical MRI follow-ups of a human ACL tear patient series.Reproducible cartilage impact damage of various energy magnitudes was applied in a survival goat model, coupled with partial resection

2017 Open access journal of sports medicine PubMed abstract

32. Dermorphin [D-Arg2, Lys4] (1-4) amide inhibits below-level heat hypersensitivity in mice after contusive thoracic spinal cord injury. (Abstract)

Dermorphin [D-Arg2, Lys4] (1-4) amide inhibits below-level heat hypersensitivity in mice after contusive thoracic spinal cord injury. Opioid use for chronic pain is limited by severe central adverse effects. We examined whether activating mu-opioid receptors (MORs) in the peripheral nervous system attenuates spinal cord injury (SCI) pain-like behavior in mice. We produced a contusive SCI at the T10 vertebral level and examined motor and sensory dysfunction for 6 weeks. At 6 weeks, we tested

2019 Pain

33. It was not a hip fracture - you were lucky this time - or perhaps not! A prospective study of clinical outcomes in patients with low-energy pelvic fractures and hip contusions. (Abstract)

It was not a hip fracture - you were lucky this time - or perhaps not! A prospective study of clinical outcomes in patients with low-energy pelvic fractures and hip contusions. Prehospital and hospital emergency care guidelines have been developed for patients with suspected hip fracture. Initial radiography can identify a number of patients with other injuries, generally pelvic fractures and hip contusions. Little is known about the prognosis for these patients. The aim of this study (...) , repeated prehospital emergency care and mortality were made between verified HF and OHI cases.449 patients were included, 400 in the HF and 149 in the OHI group (86 hip contusions, 46 pelvic fractures and 17 other injuries/diseases). The HF group had a significantly longer hospital stay (9.5 days vs. 6.3 for the OHI group; p < 0.001) and more adverse events while in hospital (34% vs. 19%; p < 0.001). We found no evidence that the groups differed with regard to other outcomes: mortality during hospital

2019 Injury

34. Increased lateral meniscal slope is associated with greater incidence of lateral bone contusions in noncontact ACL injury. (Abstract)

Increased lateral meniscal slope is associated with greater incidence of lateral bone contusions in noncontact ACL injury. (1) To investigate whether an increased lateral meniscal slope measured on magnetic resonance image (MRI) would be associated with greater risk of bone contusions in noncontact anterior cruciate ligament injury, and (2) to measure the relationship between the occurrence of bone contusions and associated findings observed in ACL deficient knees such as cartilage damage (...) , anterolateral complex injury and concomitant meniscal tears.Patients who underwent ACL reconstruction surgery between 2013 and 2018 were retrospectively reviewed. Sixty-three patients were included in the study group (ACL + bone contusions group), 56 participants were in the control group (isolated ACL group). The presence and severity of bone contusions were determined from preoperative MRIs. The lateral meniscal slope and lateral posterior tibial slope were measured on the MRIs in a blinded fashion

2019 Knee Surgery, Sports Traumatology, Arthroscopy

35. Iodine-based Dual-Energy CT of Traumatic Hemorrhagic Contusions: Relationship to In-Hospital Mortality and Short-term Outcome. (Abstract)

Iodine-based Dual-Energy CT of Traumatic Hemorrhagic Contusions: Relationship to In-Hospital Mortality and Short-term Outcome. BackgroundTraumatic hemorrhagic contusions are associated with iodine leak; however, quantification of leakage and its importance to outcome is unclear.PurposeTo identify iodine-based dual-energy CT variables that correlate with in-hospital mortality and short-term outcomes for contusions at hospital discharge.Materials and MethodsIn this retrospective study (...) , consecutive patients with contusions from May 2016 through January 2017 were analyzed. Two radiologists evaluated CT variables from unenhanced admission head CT and follow-up head dual-energy CT scans obtained after contrast material-enhanced whole-body CT. The outcomes evaluated were in-hospital mortality, Rancho Los Amigos scale (RLAS) score, and disability rating scale (DRS) score. Logistic regression and linear regression were used to develop prediction models for categorical and continuous outcomes

2019 Radiology

36. The Effect of Hyperbaric Oxygen Treatment on Myoblasts and Muscles After Contusion Injury. (Abstract)

The Effect of Hyperbaric Oxygen Treatment on Myoblasts and Muscles After Contusion Injury. The recommended treatment varies depending on the severity of muscle injuries. The aim of this study was to evaluate the in vitro myoblast proliferation and the in vivo histologic and physiologic effects of hyperbaric oxygen treatment on muscle healing after contusion. Cells from the C2C12 myoblast cell line were exposed to 100% O2 for 25 min then to air for 5 min at 2.5 atmospheres absolute (...) in a hyperbaric chamber for a total treatment duration of 90 min per 48 h at intervals of 2, 4, 6 and 8 days. Cell growth measurements and western blot analysis of myogenin and actin were performed. Then, 18 mice aged 8-10 weeks were used in the muscle contusion model. The histologic and physiologic effects and muscle regeneration after hyperbaric oxygen treatment were evaluated. The myoblast growth rate was significantly higher (p < 0.05) after hyperbaric oxygen treatment. Densitometric evaluation

2019 Journal of Orthopaedic Research

37. Multidisciplinary Concussion Management: A Model for Outpatient Concussion Management in the Acute and Post-Acute Settings. (Abstract)

Multidisciplinary Concussion Management: A Model for Outpatient Concussion Management in the Acute and Post-Acute Settings. To describe a model of multidisciplinary concussion management and explore management methods in the acute and post-acute settings.A multidisciplinary concussion management program within a large health system.Patients with sports and non-sports-related concussions aged 14 to 18 years with persisting concussion symptoms at 4 weeks postinjury or beyond.Pilot randomized (...) controlled trial comparing a subsymptom threshold exercise program with standard-of-care treatment in the post-acute setting.Beck Depression Inventory-II and the Post-Concussion Scale-Revised.Across groups, 60% improvement in concussion symptoms was noted. After removing the influence of depression, the intervention showed a large effect on symptom reduction, with participants in the intervention group improving more than those in the control group. There was no difference in response to the intervention

2019 The Journal of head trauma rehabilitation Controlled trial quality: uncertain

38. Rest Evaluation for Active Concussion Treatment (ReAct) Protocol: a prospective cohort study of levels of physical and cognitive rest after youth sports-related concussion. (Full text)

Rest Evaluation for Active Concussion Treatment (ReAct) Protocol: a prospective cohort study of levels of physical and cognitive rest after youth sports-related concussion. Although current guidelines for the early clinical management of sports-related concussion (SRC) call for a gradual return-to-activity, the optimal level of rest needed to promote recovery remains unknown. This paper describes the protocol of the Rest Evaluation for Active Concussion Treatment (ReAct) study which objectively (...) measures physical and cognitive rest following SRC and its relation to recovery among youth athletes.Youth athletes aged 11-17 years are recruited preinjury and enrolled within 72 hours following a physician-diagnosed concussion. Injury information and acute clinical presentation are assessed at the time of injury. Youth participants are prospectively followed to objectively monitor daily physical and cognitive rest using two electronic devices: ActiGraph (to measure physical rest and sleep

2019 BMJ open PubMed abstract

39. Demographics, presentation, and clinical outcomes after traumatic bifrontal contusions: a systematic review. (Full text)

Demographics, presentation, and clinical outcomes after traumatic bifrontal contusions: a systematic review. Traumatic bifrontal contusions (TBC) form a recognised clinical entity among patients with traumatic brain injury (TBI). This study aims to systematically review current literature on demographics, management, and predictors of outcomes of patients with TBC. A multi-database literature search (PubMed, Cochrane, OVID Medline/Embase) was performed using PRISMA as a search strategy. Studies (...) with an average presentation GCS of 9.2 (n = 3, 119 patients). GCS on admission of ≤ 13.1 and contusion volume at day 2 post-injury of ≥ 62.9cm3 were associated with increased risk of deterioration needing surgical interventions (n = 1, 7 patients). The majority of patients underwent surgery; the average GOS was 4, at an average follow-up duration of 11.7 months (n = 6, 356 patients). The currently available evidence on the management of TBC is scarce. Larger multicentre well-designed studies are needed

2019 Neurosurgical review PubMed abstract

40. Sports-related concussion (SRC) assessment in road cycling: a systematic review and call to action. (Full text)

Sports-related concussion (SRC) assessment in road cycling: a systematic review and call to action. Sports-related concussion (SRC) is a recognised risk in road cycling and can have serious health consequences. Recent high-profile cases of professional road cyclists continuing to participate in races despite suffering obvious SRC have highlighted the difficulties in assessing SRC within road cycling.To undertake a systematic review of the literature on SRC assessment in road cycling.Systematic (...) review.Literature describing SRC assessment in road cycling was identified by searching MEDLINE, EMBASE, PsycINFO and Web of Science. Two reviewers independently screened titles and abstracts for eligibility and a qualitative analysis was undertaken of included studies.From 94 studies identified, two were included for review. Gordon et al describe the presentation of a single case of paediatric concussion following a cycling crash. They highlight the utility of SRC evaluation using the Sport Concussion

2020 BMJ open sport & exercise medicine PubMed abstract

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