Article

Video analysis of acute motor and convulsive manifestations in sport-related concussion.

University of Melbourne, Department of Neurology, Austin & Repatriation Medical Centre, Heidelberg, Victoria, Australia.
Neurology (Impact Factor: 8.3). 05/2000; 54(7):1488-91. DOI: 10.1212/WNL.54.7.1488
Source: PubMed

ABSTRACT To describe the motor and convulsive manifestations in acute sports-related head injury.
A total of 234 cases of concussive injuries during the 1995 through 1997 football seasons were obtained from the Australian Football League Medical Officers Association injury survey. Of these, 102 cases were recorded adequately on television videotape and were analyzed by two independent observers using a standardized recording form detailing injury mechanics and clinical features of the episodes. Motor and convulsive features were correlated with mechanical variables and with duration of loss of consciousness using linear modeling techniques.
Tonic posturing occurred in 25 subjects, clonic movements in 6, righting movement in 40, and gait unsteadiness in 42. In one subject the tonic and clonic features were sufficiently prolonged to be deemed a concussive convulsion. The only risk factor for tonic posturing using logistic regression was the presence of loss of consciousness (p = 0.0001). There was a trend toward facial impact being an independent predictor of tonic posturing but this did not reach significance. No other independent variable predicted the development of clonic movements, righting movements, or gait unsteadiness.
Subtle motor manifestations such as tonic posturing and clonic movements commonly occur in concussion; the main predictive factor for tonic posturing is the presence of loss of consciousness. The authors speculate that these clinical features are due to brainstem dysfunction secondary to biomechanical forces inducing a transient functional decerebration.

Download full-text

Full-text

Available from: Paul McCrory, Apr 27, 2014
0 Followers
 · 
87 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Several domains such as sports, surgery, dance etc. are characterized by a significant influence of expertise of the performer on the motion pattern and style. The retrieval of expertise level of the performer through automated motion analysis is the subject of this paper. We employ a novel neuropsychologically inspired algorithm that employs a dynamic hierarchical layered structure to represent the human anatomy, and low-level parameters to characterize motion in the layers of this hierarchy which correspond to different segments of the human body. This characterization is representative of the expertise of the performer of the motion. These motion profiles are then compared using dynamic time warping to generate a similarity matrix. We employ isomap to reduce dimensionality and the cluster the data into different expertise classes. This algorithm was tested on a library of surgical movements that contained 3D hand motion data of common surgical laparoscopic procedures. Linearly separable clusters were obtained between novice, intermediate and expert performances. Test sequences were projected into manifold spaces. A recognition percentage of 98.56% was obtained for classifying the test sequences into correct expertise clusters.
    Pattern Recognition, 2008. ICPR 2008. 19th International Conference on; 01/2009
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper overviews the current status of neuroimaging in neuropsychological outcome in traumatic brain injury (TBI). The pathophysiology of TBI is reviewed and integrated with expected neuroimaging and neuropsychological findings. The integration of clinical and quantitative magnetic resonance (QMR) imaging is the main topic of review, but these findings are integrated with single photon emission computed tomography (SPECT) and magnetoencephalography (MEG). Various clinical caveats are offered for the clinician.
    Archives of Clinical Neuropsychology 03/2001; 16(2):95-131. · 1.92 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Sports-related injuries represent approximately 20% of the estimated 1.54 million head injuries that occur yearly in the United States. With as many as 216,000 sports-related concussions occurring each year in the United States alone, and between 2% and 10% of all athletes at risk for sustaining a concussion it is reasonable to say that sports-related concussion is a public health concern. While the literature is replete with writings about how to define concussion, understand the mechanisms of concussion and appropriately assess concussed individuals for neurocognitive deficits, there are several areas that necessitate further scientific inquiry. Issues compounding concussive injuries can include a history of multiple concussions, neurocognitive deficits, learning disabilities, age and gender. All of these issues have the potential of facilitating a concussive injury or exacerbating residual deficits following one. The ever-expanding area of athletic team evaluations, which can be costly, time consuming, and restricted to expert knowledge, is worthy of exploration. Typically, an assessment paradigm, which includes baseline and serial post-concussion testing, is favored in order to allow each athlete to act as his or her own experimental control. There has been much debate, however, as to the ideal timeline for serial post-concussion testing that would allow for neurocognitive deficits to be effectively captured. Overall, the current study proposes to examine several areas of sports-related concussion including the type of assessment paradigm utilizing computerized assessment at baseline and several serial post-concussion intervals, the prevalence of sports-related concussion among collegiate varsity and club athletes, the severity of sports-related concussive injuries and recovery trajectories. Lastly, the extent to which gender differences exist in the prevalence and severity of concussions and recovery trajectories following sports-related concussions will be explored.