Changing the Culture of Concussion: Education Meets Legislation

Executive Board, Brain Injury Association of Washington, Seattle, WA, USA.
PM&R (Impact Factor: 1.53). 10/2011; 3(10 Suppl 2):S468-70. DOI: 10.1016/j.pmrj.2011.08.006
Source: PubMed
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    ABSTRACT: Mild traumatic brain injury (mTBI) is a common public health concern that affects millions of people each year. The available epidemiology of mTBI may contain insights that can guide future identification, prevention, and treatment efforts. This article discusses epidemiology of both non-sports-related mTBI and sports-related concussion. Specific occupational factors, emergency department data, and meta-analysis regarding mTBI are reviewed and discussed. With regard to sports concussion, the article will discuss data related to the sport played, the individual's position, level of play, and gender differences. Although males make up a larger percentage of cases than do females throughout the majority of reviewed non-sports-related mTBI data, the sports literature indicates that rates are higher in women when similar sports are compared. Identifiable risk factors within sports include female gender, sport, and position played. Emerging trends across mTBI include increased incidence and decreased rate of hospitalization for mTBI.
    PM&R 10/2011; 3(10 Suppl 2):S354-8. DOI:10.1016/j.pmrj.2011.07.017 · 1.53 Impact Factor
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    ABSTRACT: Object: Sports-related concussions (SRCs) represent a significant and growing public health concern. The vast majority of SRCs produce mild symptoms that resolve within 1-2 weeks and are not associated with imaging-documented changes. On occasion, however, structural brain injury occurs, and neurosurgical management and intervention is appropriate. Methods: A literature review was performed to address the epidemiology of SRC with a targeted focus on structural brain injury in the last half decade. MEDLINE and PubMed databases were searched to identify all studies pertaining to structural head injury in sports-related head injuries. Results: The literature review yielded a variety of case reports, several small series, and no prospective cohort studies. Conclusions: The authors conclude that reliable incidence and prevalence data related to structural brain injuries in SRC cannot be offered at present. A prospective registry collecting incidence, management, and follow-up data after structural brain injuries in the setting of SRC would be of great benefit to the neurosurgical community.
    Neurosurgical FOCUS 12/2012; 33(6):E6. DOI:10.3171/2012.10.FOCUS12279 · 2.11 Impact Factor
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    ABSTRACT: PURPOSE OF THE STATEMENT: To provide an evidence-based, best practises summary to assist physicians with the evaluation and management of sports concussion. To establish the level of evidence, knowledge gaps and areas requiring additional research. Concussion is defined as a traumatically induced transient disturbance of brain function and involves a complex pathophysiological process. Concussion is a subset of mild traumatic brain injury (MTBI) which is generally self-limited and at the less-severe end of the brain injury spectrum. Animal and human studies support the concept of postconcussive vulnerability, showing that a second blow before the brain has recovered results in worsening metabolic changes within the cell. Experimental evidence suggests the concussed brain is less responsive to usual neural activation and when premature cognitive or physical activity occurs before complete recovery the brain may be vulnerable to prolonged dysfunction. INCIDENCE: It is estimated that as many as 3.8 million concussions occur in the USA per year during attention-deficit disorders (ADD/ADHD) and migraine headaches complicate checklists provide an objective tool for assessing a variety of symptoms related to concussions, while also tracking the severity of those symptoms over serial evaluations. Standardised assessment tools provide a helpful structure for the evaluation of concussion, although limited validation of these assessment tools is available. SIDELINE Additional research is needed to validate current assessment tools, delineate the role of NP testing and improve identification of those at risk of prolonged post-concussive symptoms or other long-term complications. Evolving technologies for the diagnosis of concussion, such as newer neuroimaging techniques or biological markers, may provide new insights into the evaluation and management of sports concussion.
    British Journal of Sports Medicine 01/2013; 47(1):15-26. DOI:10.1136/bjsports-2012-091941 · 5.03 Impact Factor
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