Rehabilitation from postconcussion syndrome: nonpharmacological treatment.
This report offers strategies for nonpharmacological treatment of PCS during the acute, subacute, and chronic stages of recovery following mTBI. The treatment strategies are supported by clinical consensus and the limited evidence-based research wherever possible. Core treatment strategies emphasize (1) education about mTBI, PCS, and the natural recovery course, (2) reassurance of a good outcome, (3) reduction in activity level and refrain from hazardous behaviors during the acute phase, (4) gradual return to lifestyle activities as symptoms permit, (5) careful monitoring and early intervention for adverse emotional respon...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Concussion in ice hockey.
In this report we review the incidence, evaluation, treatment, return-to-play protocol, and prevention efforts related to concussion in ice hockey.
PMID: 24923401 [PubMed - indexed for MEDLINE] (Source: Progress in Neurological Surgery)
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Management of concussion in the professional football player.
Authors: Pieroth EM, Hanks C
Abstract
There is no other sport that has come under greater scrutiny surrounding the incidence and treatment of concussion than football, and there is no other professional sports league that has experienced more intense focus of its handling of concussions than the National Football League (NFL). The NFL has received significant criticism of their management of concussion in players from both the popular press and the medical community. However, those working with active NFL players have changed their assessment and treatment of these injuries as the knowledge of concussions ...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Developing an interdisciplinary community-based sports concussion management program.
In this report we provide practical and user-friendly information regarding several important factors to consider when developing a sports concussion program, including how to select relevant team members, assess community needs and available resources, provide concussion education, secure and nurture partnerships with athletic programs, implement management strategies that align with current practice standards, and cater to athletes' unique needs in terms of program accessibility. It is hoped that the knowledge shared and proposed recommendations will be beneficial for guiding both newly developing and established concuss...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
The multidisciplinary concussion management program.
Authors: Panczykowski DM, Pardini JE
Abstract
Over the past decade, research has increased scientific and public knowledge about the importance of identification and proper management of concussion. These concerns have prompted many state, regional, and private organizations to mandate the creation of, and strict adherence to, concussion management protocols, particularly with regard to sport-related concussion and subsequent return to play. Because of the individualized nature of the concussive injury and its recovery, a multidisciplinary approach provides comprehensive patient care that best addresses tr...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Vulnerability in speed of visuomotor ability.
Authors: Shuttleworth-Edwards AB, Radloff SE, Whitefield-Alexander VJ
Abstract
The aim of this report is to illustrate the utility of neurocognitive testing as an investigative method to establish the presence of persistent effects of concussive brain injury amongst players of a contact sport with high risk of such injury. The report reviews the outcomes of three previously published neuropsychological studies on South African Rugby Union (hereafter 'rugby') from school through to the national adult level. The diagnostic utility of differential effects per se, as well as differential practice effects on vi...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Detecting eye movement abnormalities from concussion.
Authors: Maruta J, Ghajar J
Abstract
An attention-based biomarker may be useful for concussion screening. A key role of attention is to generate time-based expectancies of specific sensory information, and it is postulated that postconcussion cognitive impairments and symptoms may stem from a primary deficit in this predictive timing mechanism. There is a close relationship between gaze and attention, but in addressing predictive timing, there is a need for an appropriate testing paradigm and methods to quantify oculomotor anomalies. We have utilized a continuous predictive visual tracking paradigm because...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Neurodegenerative changes after mild traumatic brain injury.
Authors: Fakhran S, Alhilali L
Abstract
A link between mild traumatic brain injury (mTBI) and neurodegenerative diseases, specifically Alzheimer's disease and chronic traumatic encephalopathy (CTE), has long been suspected. Shared clinical symptomology - most notably the prominent role of central auditory dysfunction and sleep-wake disturbances in both disease states - and similar findings on postmortem pathological examination has further reinforced suspected commonality between these seemingly disparate entities. However, conventional imaging techniques, including computed tomography and anatomic magneti...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Future directions in brain injury research.
Authors: Gennarelli TA
Abstract
This paper reviews the potential future directions that are important for brain injury research, especially with regard to concussion. The avenues of proposed research are categorized according to current concepts of concussion, types of concussion, and a global schema for globally reducing the burden of concussion.
PMID: 24923408 [PubMed - indexed for MEDLINE] (Source: Progress in Neurological Surgery)
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Occipital Nerve Stimulation for Migraine: Update from Recent Multicenter Trials.
Authors: Schwedt TJ, Green AL, Dodick DW
Abstract
Occipital nerve stimulation (ONS) continues to be investigated for the treatment of refractory chronic migraine. Results from case series and from prospective, sham-controlled clinical trials remain inconclusive regarding the efficacy of ONS for migraine treatment. Safety and implantation techniques require improvements since rates of lead migration, infection, and persistent stimulator-related pain continue to be high. Existing data justify further ONS trials with carefully chosen primary outcome(s), adequate statistical power, and improved surgical techni...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Theoretical Basis of Vagus Nerve Stimulation.
Authors: Attenello F, Amar AP, Liu C, Apuzzo ML
Abstract
Despite a myriad of medical and surgical treatments for epilepsy developed over the past few decades, a large subset of patients remains refractory to treatment. Over this time period, vagus nerve stimulation (VNS) has become an accepted and viable treatment modality for this population. Since the earliest report of VNS implantation in 1988, tens of thousands of patients worldwide have received VNS therapy, and >100,000 patient-years of experience have been accrued. The mechanisms underlying the response to VNS therapy continue to be elucidated. A...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Vagus Nerve Stimulation: Surgical Technique and Complications.
Authors: Tronnier VM
Abstract
Chronic stimulation of the left vagus nerve (VNS) is commonly performed for different clinical conditions such as refractory epilepsy in children and adults, and major and bipolar depression. Despite more than 20 years of cumulative experience with VNS implantation, various surgery- and modality-related complications continue to occur in a sizable percentage of patients. A clear understanding of surgical anatomy and following standard operating protocol may, at least theoretically, reduce the number of complications. Here we present our way to perform VNS implantation and disc...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Peripheral Nerve Stimulation for Back Pain.
Authors: Verrills P, Russo M
Abstract
Peripheral nerve stimulation (PNS) generally refers to stimulation of a named nerve via direct placement of a lead next to the nerve either via a percutaneous or open approach; in peripheral nerve field stimulation (PNFS), leads are subcutaneously placed to stimulate the region of affected nerves, cutaneous afferents, or the dermatomal distribution of the nerves which converge back to the spinal cord. Recently, there has been a renewed interest in using the PNS approach for many otherwise refractory pain conditions; however, PNFS appears to be more effective for the ma...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Vagus Nerve Stimulation for Epilepsy: An Evidence-Based Approach.
Authors: Cukiert A
Abstract
Medical treatment of seizures yields a satisfactory response in 75-80% of the patients; resective epilepsy surgery is a therapeutic option for those patients who are refractory to drug therapy, but there is still a considerable portion (20-30%) of patients who are ineligible for surgery or failed surgery. Vagus nerve stimulation (VNS) might be an option for these very refractory patients. We carried out an evidence-based search to identify the best evidence presently available related to the use of VNS. We used multiple searchable databases (primary: PubMed-MEDLINE, EMBASE, LILA...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Peripheral Nerve Stimulation for Pain in Extremities: An Update.
Authors: Pope JE, Carlson JD, Rosenberg WS, Slavin KV, Deer TR
Abstract
Pain in extremities may occur in a variety of central and peripheral neuropathic and nociceptive syndromes, some of which may respond to central neuromodulation procedures. Peripheral neuromodulation techniques, either as a stand-alone therapy or as an adjuvant to spinal cord stimulation, may be particularly effective when the pain is localized to a part of a single extremity or when the source of the pain is related to the malfunction of a known peripheral nerve. Further, peripheral neuromodulation is used to treat disorders in which ...
Source: Progress in Neurological Surgery - November 20, 2015 Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
