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Available from: Paul McCrory, Apr 27, 2014
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    • "A concussion is a mTBI induced by an impulsive force transmitted to the head resulting from a direct or indirect impact to the head, face, neck, or elsewhere [21] [22]. In the combat setting, most concussions occur as a result of blunt trauma associated with blasts from explosive devices, such as hitting the head against the interior of a vehicle [23]. "
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    ABSTRACT: Mild traumatic brain injury (mTBI) includes concussion, subconcussion, and most exposures to explosive blast from improvised explosive devices. mTBI is the most common traumatic brain injury affecting military personnel; however, it is the most difficult to diagnose and the least well understood. It is also recognized that some mTBIs have persistent, and sometimes progressive, long-term debilitating effects. Increasing evidence suggests that a single traumatic brain injury can produce long-term gray and white matter atrophy, precipitate or accelerate age-related neurodegeneration, and increase the risk of developing Alzheimer's disease, Parkinson's disease, and motor neuron disease. In addition, repetitive mTBIs can provoke the development of a tauopathy, chronic traumatic encephalopathy. We found early changes of chronic traumatic encephalopathy in four young veterans of the Iraq and Afghanistan conflict who were exposed to explosive blast and in another young veteran who was repetitively concussed. Four of the five veterans with early-stage chronic traumatic encephalopathy were also diagnosed with posttraumatic stress disorder. Advanced chronic traumatic encephalopathy has been found in veterans who experienced repetitive neurotrauma while in service and in others who were accomplished athletes. Clinically, chronic traumatic encephalopathy is associated with behavioral changes, executive dysfunction, memory loss, and cognitive impairments that begin insidiously and progress slowly over decades. Pathologically, chronic traumatic encephalopathy produces atrophy of the frontal and temporal lobes, thalamus, and hypothalamus; septal abnormalities; and abnormal deposits of hyperphosphorylated tau as neurofibrillary tangles and disordered neurites throughout the brain. The incidence and prevalence of chronic traumatic encephalopathy and the genetic risk factors critical to its development are currently unknown. Chronic traumatic encephalopathy has clinical and pathological features that overlap with postconcussion syndrome and posttraumatic stress disorder, suggesting that the three disorders might share some biological underpinnings.
    Alzheimer's and Dementia 06/2014; 10(3):S242–S253. DOI:10.1016/j.jalz.2014.04.003 · 12.41 Impact Factor
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    ABSTRACT: Basketball is a popular sport in North America and worldwide. Most injuries are lower extremity injuries to the ankle and knee. In this article, injuries common to basketball and, from our experience, injuries that escape injury surveillance systems are discussed from the physician and athletic trainer's perspective. Both treatment and prevention of injuries are discussed.
    Current Sports Medicine Reports 09/2013; 12(5):321-8. DOI:10.1097/ · 1.55 Impact Factor
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    ABSTRACT: Concussion is a physiologic brain injury that produces systemic and cognitive symptoms. The metabolic and physiologic changes of concussion result in altered autonomic function and control of cerebral blood flow. Evaluation and treatment approaches based upon the physiology of concussion may therefore add a new dimension to concussion care. In this article, we discuss the use of a standard treadmill test, the Buffalo Concussion Treadmill Test (BCTT), in acute concussion and in postconcussion syndrome (PCS). The BCTT has been shown to diagnose physiologic dysfunction in concussion safely and reliably, differentiate it from other diagnoses (e.g., cervical injury), and quantify the clinical severity and exercise capacity of concussed patients. It is used in PCS to establish a safe aerobic exercise treatment program to help speed recovery and return to activity. The use of a provocative exercise test is consistent with world expert consensus opinion on establishing physiologic recovery from concussion.
    Current Sports Medicine Reports 11/2013; 12(6):370-6. DOI:10.1249/JSR.0000000000000008 · 1.55 Impact Factor
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