Today s topic areas. We Keep Forgetting Our Topic: New Thinking on Concussion Exam and Management
|
|
- Edmund Welch
- 6 years ago
- Views:
Transcription
1 We Keep Forgetting Our Topic: New Thinking on Concussion Exam and Management Stephanie N. Aldret, DO, CAQSM Louisiana Orthopaedic Specialists, Lafayette, LA Team Physician, University of Louisiana at Lafayette President-Elect, Louisiana Osteopathic Medical Association Randy L. Aldret, EdD, ATC, LAT Assistant Professor and Director, Athletic Training Program University of Louisiana at Lafayette Director of Continuing Education, Louisiana Athletic Trainers Association Today s topic areas Acute examination Sidelines and in the office Treatment innovations What is making a difference in our patients What does the science say? The search for the Magic Bullet Next frontiers in research Research for a reason. 1
2 Today s topic areas Acute examination Sidelines and in the office Treatment innovations What is making a difference in our patients What does the science say? The search for the Magic Bullet Next frontiers in research Research for a reason. History Symptoms Neurological Exam Neurocognitive Testing Balance Assessment Exertional Testing Acute Evaluation Our Ragin Cajun spirit goes beyond athletics. 2
3 Clinic Evaluation History Symptom Scale Neurocognitive Testing SCAT3, ImPACT, C3Logix Neurological Exam Balance Assessment Focused Musculoskeletal Exam Osteopathic Exam We re eager to share what we re learning. 3
4 Today s topic areas Acute examination Sidelines and in the office Treatment innovations What is making a difference in our patients What does the science say? The search for the Magic Bullet Next frontiers in research Research for a reason. 4
5 Progress in Concussion Treatment Education Active Behavioral Management Academic Adjustments/Accomodations/Modifications Targeted Therapies Vestibular Therapy Vision Therapy We re eager to share what we re learning. Today s topic areas Acute examination Sidelines and in the office Treatment innovations What is making a difference in our patients What does the science say? The search for the Magic Bullet Next frontiers in research Research for a reason. 5
6 We All Want The Magic Bullet Research for a reason. But the reality of exam and care requires buckshot We have a gift of bringing people together. 6
7 The headlines are inadvertently accurate We re eager to share what we re learning. that a single blood biomarker Neurofilament Light (NF L) Intra axonal structural protein in large caliber axons Tau Intra axonal structure protein in thin, unmyelinated axons Spectrin N terminal Fragment (SNTF) Axonal injury marker generated by the calpain family of calcium activated proteases Neuro specific Enolase (NSE) Protein highly expressed in the neuronal soma, but also in RBC s Ubiquitin C terminal hydrolase L1 (UCHL 1) Deubiquitinating enzyme highly expressed in neurons but also in the gonads, lungs S100 Astroglial protein which is CNS enriched but not CNS specific Glial fibrillary acidic protein (GFAP) Astroglial protein which is CNS specific Interleukins (IL family) This is our time, and we re determined to make the most of it. 7
8 is not sufficient for diagnosis Our pilot study Professional Hockey So TONS of concussions, right? TONS of turnover 2 great case studies but no generalizable data This is our time, and we re determined to make the most of it. Our Pilot Study Outcomes Some good Both subjects demonstrated a significant spike in IL 6, 8 & 10 in the post 72 hr and 1 week follow up, then returned to near baseline at postseason Best data reinforced what we believed about VOMS: One of the subjects NPC spiked to 12.67cm at the 5 week mark before leveling at 4cm at post season measure (baseline was 3.67cm) Other subject did not spike significantly but saw a large increase (1 to 3.67cm) over the course of the season some not so good We did not run ELISA on SNTF, which has gained some steam recently Siman et al (2015) GFAP, UCH L1, NF L, NF M all had slight increases in the immediate measures post injury, but return to at or near baseline by the post season blood draw Interestingly, we had elevated levels of NF L & NF M at BASELINE, but did not increase significantly over the course of the season If it is detectable in the athletes already, are they damaged already from the trauma of previous season? We re eager to share what we re learning. 8
9 Current Research Confirms This Research does not support diagnosis by blood for now Posti et al. (2016): Px w/ortho trauma & high levels of UCHL1 or GFAP may be falsely diagnosed as having concomitant mtbi Same with Puvenna et al (2012), but could correlate s100, which gives it traction but Babcock et al (2013) found s100 had no ability to predict post concussion syndrome in children tested within 6 hrs post injury Our Ragin Cajun spirit goes beyond athletics. Today s topic areas Acute examination Sidelines and in the office Treatment innovations What is making a difference in our patients What does the science say? The search for the Magic Bullet Next frontiers in research Research for a reason. 9
10 So Where Do We Go From Here?!? Blood, but not just inflammtory markers Exosomes, Genetic markers Baseline/Exam/Rehab with vestibular and oculomotor components Nothing will ever replace a good H&P, but need the baselines More research = normative data Advancing diagnostic into new arenas Sleep as medicine, tying quality to markers, symptoms This is our time, and we re determined to make the most of it. Not your typical blood markers Literature to follow Alzheimer's/HIV E/FT Dementia PINCH me! (treatment) Inhibition of TAU proliferation Claudin 3, 5 (diagnosis) Axonal damage, blood brain barrier Exosome (diagnosis) Neurogranin, GFAP within the exosome not free in blood Will this ever be practical on field or in the clinic?!? Research for a reason. 10
11 The Eyes Have It Near Point Convergence Statistical power of Near Point Convergence (P <.001) when it extended past 6 cm When combined, NPC, Visual Motion Sensitivity (VMS) & Vestibular Ocular Reflex (hvor) accurately identified a concussion 89% of the time Mucha A et al (2014) EYE SYNC/Stanford Using VR technology, isolating oculomotor system Specifically dynamic foveation/visuomotor synchronization via predictive timing that accounts for the constraint of the sensorimotor processing delay Maruat & Ghajar (2014) We have a gift of bringing people together. Yolk not Shell: Using DTI/fMRI/MRS Alterations in CBF Children yrs, w/src, no other evidence of trauma White Matter/Corpus Callosum Posterior aspect is more vulnerable than the anterior Minimal fiber disruption but multiple regions of fractional anisotropy, specifically in the splenium and mildly in the midbody, and no significant change in the genu Increasing levels of Choline, Creatine with subsequent mtbi Implication for acute diagnosis, monitoring through recovery Do we ever get back to normal? We re eager to share what we re learning. 11
12 Recommendations Maintain a multi faceted approach in all aspects Conduct Baseline Testing, Assessment, Care, R T L/R T P Longitudinal tracking of patients Fleminger (2012): mtbi represents a substantial risk factor for development of Alzheimer s particularly in males and individuals who have a genetic predisposition to the disorder Education with good information This involves a large number of kids, so it involves an even larger number of parents. This is our time, and we re determined to make the most of it. References Giza CC, Hovda DA. The New Neurometabolic Cascade of Concussion. Neurosurgery [Internet] Oct [cited 2017 Apr 11];75(0 4):S Available from: Rutgers DR, Toulgoat F, Cazejust J, Fillard P, Lasjaunias P, Ducreux D. White Matter Abnormalities in Mild Traumatic Brain Injury: A Diffusion Tensor Imaging Study. American Journal of Neuroradiology [Internet] Mar 1 [cited 2017 Apr 11];29(3): Available from: Maugans TA, Farley C, Altaye M, Leach J, Cecil KM. Pediatric Sports Related Concussion Produces Cerebral Blood Flow Alterations. Pediatrics [Internet] Jan 1 [cited 2017 Apr 11];129(1): Available from: Doherty CP, O Keefe E, Wallace E, Loftus T, Keaney J, Kealy J, et al. Blood Brain Barrier Dysfunction as a Hallmark Pathology in Chronic Traumatic Encephalopathy. J Neuropathol Exp Neurol Jul;75(7): Johnson B, Gay M, Zhang K, Neuburger T, Horovitz S, Hallett M, Sebastianelli W, Slobounov S. The Use of Magnetic Resonance Spectroscopy in the Subacute Evaluation of Athletes Recovering from Single and Multiple Mile Traumatic Brain Injury. J of Neurotrauma Aug; 29(13): Available from: Posti JP, Hossain I, Takala RSK, Liedes H, Newcombe V, Outtrim J, et al. Glial Fibrillary Acidic Protein and Ubiquitin C Terminal Hydrolase L1 Are Not Specific Biomarkers for Mild CT Negative Traumatic Brain Injury. J Neurotrauma Jan 27; Roozenbeek B, Maas AIR, Menon DK. Changing patterns in the epidemiology of traumatic brain injury. Nat Rev Neurol ;9(4): Shetty T, Raince A, Manning E, Tsiouris AJ. Imaging in Chronic Traumatic Encephalopathy and Traumatic Brain Injury. Sports Health [Internet] Jan 1 [cited 2017 Apr 13];8(1): Available from: 12
13 References GBabcock L, Byczkowski T, Wade SL, Ho M, Bazarian JJ. Inability of S100B to Predict Post Concussion Syndrome in Children who Present to the Emergency Department with Mild Traumatic Brain Injury: A Brief Report. Pediatr Emerg Care [Internet] Apr [cited 2017 Apr 11];29(4): Available from: Puvenna V, Brennan C, Shaw G, Yang C, Marchi N, Bazarian JJ, et al. Significance of Ubiquitin Carboxy Terminal Hydrolase L1 Elevations in Athletes after Sub Concussive Head Hits. PLOS ONE [Internet] May 7 [cited 2017 Apr 11];9(5):e Available from: LaDuca H, Farwell KD, Vuong H, Lu H M, Mu W, Shahmirzadi L, et al. Exome sequencing covers >98% of mutations identified on targeted next generation sequencing panels. PLOS ONE [Internet] Feb 2 [cited 2017 Apr 12];12(2):e Available from: Ozdemir AY, Rom I, Kovalevich J, Yen W, Adiga R, Dave RS, et al. PINCH in the Cellular Stress Response to Tau Hyperphosphorylation. PLOS ONE [Internet] Mar 12 [cited 2017 Apr 12];8(3):e Available from: Maruta J, Ghajar J. Detecting Eye Movement Abnormalities from Concussion [cited 2017 Apr 13];28: Available from: Siman R, Shahim P, Tegner Y, Blennow K, Zetterberg H, Smith DH. Serum SNTF Increases in Concussed Professional Ice Hockey Players and Relates to the Severity of Postconcussion Symptoms. Journal of Neurotrauma [Internet] Nov 24 [cited 2017 Apr 13];32(17): Aoki Y, Inokuchi R, Gunshin M, Yahagi N, Suwa H. Diffusion tensor imaging studies of mild traumatic brain injury: a meta analysis. J Neurol Neurosurg Psychiatry [Internet] Sep 1 [cited 2017 Apr 13];83(9): Johnson B, Zhang K, Gay M, Neuberger T, Horovitz S, Hallett M, et al. Metabolic alterations in corpus callosum may compromise brain functional connectivity in MTBI patients: An 1H MRS study. Neuroscience Letters [Internet] Feb 10 [cited 2017 Apr 13];509(1):5 8. Any Questions? snaldret@gmail.com raldret@louisiana.edu 13
14 Thank You For Having Us Back In Oklahoma! 14
Blood Biomarkers for Brain Injury. Dianne Langford Associate Professor Department of Neuroscience Lewis Katz School of Medicine at Temple University
Blood Biomarkers for Brain Injury Dianne Langford Associate Professor Department of Neuroscience Lewis Katz School of Medicine at Temple University TOPICS COVERED What are we measuring? How do markers
More informationSeth Smith MD, PharmD. Thank You!
Seth Smith MD, PharmD Thank You! Concussion Headlines!!! Concussion Headlines!!! Concussion rules put kids health before winning games The Miami Herald 8/21/12 FHSAA's implementation of legislation goes
More informationConcussion Management
Concussion Management Jennifer Gray, DO Medical Co-Director, ThinkSMART! Concussion Management Program Department of Physical Medicine and Rehabilitation St. Charles Hospital Residency Program Director,
More informationTreatments = 0 10/19/2018. Concussion is not a diagnosis!!! Multiple Clinical Trials for Traumatic Brain Injury (TBI) Treatment
Penn Center for Brain Injury and Repair Blood Biomarkers for Concussion Promises and Pitfalls Douglas H. Smith Center for Brain Injury and Repair, Dept. of Neurosurgery University of Pennsylvania Multiple
More informationJam Ghajar MD PhD Director, Stanford Concussion and Brain Performance Center Founder, SyncThink President, Brain Trauma Foundation
The Concussion Conundrum: an opportunity to explore the last frontier, TIME Jam Ghajar MD PhD Director, Stanford Concussion and Brain Performance Center Founder, SyncThink President, Brain Trauma Foundation
More informationConcussion: A Treatable Injury MELISSA N. WOMBLE, PHD NEUROPSYCHOLOGIST, DIRECTOR INOVA SPORTS MEDICINE CONCUSSION PROGRAM
Concussion: A Treatable Injury MELISSA N. WOMBLE, PHD NEUROPSYCHOLOGIST, DIRECTOR INOVA SPORTS MEDICINE CONCUSSION PROGRAM THE CURRENT PROBLEM 1. WHAT IS A CONCUSSION? 2. ACUTE/SIDELINE EVALUATION 3. AT
More informationClinical Practice of a Vision Based Concussion Tool MATT FRANTZ, M.ED., LAT, ATC LAFAYETTE COLLEGE
Clinical Practice of a Vision Based Concussion Tool MATT FRANTZ, M.ED., LAT, ATC LAFAYETTE COLLEGE Disclosure No financial COI No non-financial COI No corporate bias or sponsorship Your Concussion Toolbag
More information5/19/2017. Concussion: Advancement in Diagnostic & Management Practices
Concussion: Advancement in Diagnostic & Practices Jacob E. Resch, Ph.D., AT Exercise Sport and Injury Laboratory Department of Kinesiology The University of Virginia If it has become cheaper to produce
More informationSports Related Concussions. The King-Devick Test: the Science & Implementation
Sports Related Concussions The King-Devick Test: the Science & Implementation King-Devick Test: the Today Show CLICK HERE for Video: King-Devick Test on the Today Show Concussion by the Numbers Highest
More informationConcussion. Concussions in Sports Medicine
Concussion Concussions in Sports Medicine Britt Marcussen, MD Primary Care Sports Medicine Department of Family Medicine University of Iowa Hospitals and Clinics Disclosures I have no financial or personal
More informationConcussion. Concussion is a disturbance of brain function caused by a direct or indirect force to the head.
Concussion Concussion is a disturbance of brain function caused by a direct or indirect force to the head. Disturbances of brain tissue is largely related to neurometabolic dysfunction rather then structural
More informationClinical Profile and Active Treatment Approach to Concussion Management Micky Collins, PhD
Clinical Profile and Active Treatment Approach to Concussion Management Micky Collins, PhD University of Pittsburgh Medical Center Associate Professor Department of Orthopaedic Surgery Department of Neurological
More informationVestibular Oculomotor Screening (VOMS) and Concussion Challenge
Vestibular Oculomotor Screening (VOMS) and Concussion Challenge Keely Battaglini, PT, SCS, ATC Courage Kenny Sports and PT Eagan Erin Baldridge, DPT, OCS, CLT Courage Kenny Sports and PT Mercy Specialty
More informationElevated markers of brain injury as a result of clinically asymptomatic high-acceleration head impacts in high-school football athletes
CLINICAL ARTICLE Elevated markers of brain injury as a result of clinically asymptomatic high-acceleration head impacts in high-school football athletes Jacob R. Joseph, MD, 1 Jennylee S. Swallow, BS,
More informationImaging Biomarkers Significance S100B NSE. Admitted within 6 hours of injury and CT scan occurred after initial examination. N = 1,064 CT+ N = 50 4.
Concussion Guidelines Step 1: Systematic Review of Prevalent Indicators Supplemental Content 7 Evidence Table. Included Studies For Key Question 4 Imaging and Biomarker Publications Medium Potential for
More informationMild TBI (Concussion) Not Just Less Severe But Different
Mild TBI (Concussion) Not Just Less Severe But Different Disclosures Funded research: 1. NIH: RO1 Physiology of concussion 2016-2021, Co-PI, $2,000,000 2. American Medical Society of Sports Medicine: RCT
More informationNeurological Effects of Sports-Related Injury
Neurological Effects of Sports-Related Injury DAVID RUBIN, MD Disclosures Neither I nor my spouse/partner has a relevant financial relationship with a commercial interest to disclose Epidemiology 1.6 3.8
More informationCONCUSSION UPDATE 2017
CONCUSSION UPDATE 2017 Shannon Woods MD Medical Director CoxHealth Sports Medicine Team Physician Evangel University Team Physician Drury University 1 Cognitive Fogginess Difficulty concentrating Memory
More informationThe Changing Landscape of Sports Concussions
The Changing Landscape of Sports Concussions Anthony G. Alessi MD, FAAN Director, UConn NeuroSport Sports Medicine Symposium August 2, 2016 Overview Significance Diagnosis Sideline diagnosis v Management
More informationUniversity of Louisiana at Lafayette
University of Louisiana at Lafayette College of Education Faculty Curriculum Vitae Information Randy L. Aldret, EdD, ATC, LAT Title Department Office Number Extension Email Address Education Teaching Philosophy
More informationSerum biomarkers for predicting outcome after TBI
Józef Opara, Andrzej Małecki, Elżbieta Małecka Serum biomarkers for predicting outcome after TBI Jerzy Kukuczka Academy of Physical Education in Katowice TBI biomarkers A biomarker, or biological marker,
More informationApril 28, Katie Barnes Wood, PT, DPT Orthotennessee Therapy. Concussion Therapy. How and Why Physical Therapy Can Help Concussions
April 28, 2018 Katie Barnes Wood, PT, DPT Orthotennessee Therapy Concussion Therapy How and Why Physical Therapy Can Help Concussions Background Concussion Rehab at KOC Our Care Team Athletic Trainers
More informationSports-related concussion is defined as a complex
Neurosurg Focus 33 (6):E4, 2012 A prospective study of physician-observed concussion during a varsity university hockey season: metabolic changes in ice hockey players. Part 4 of 4 Emilie Chamard, B.Sc.,
More informationActive Intervention in Concussion: Results from TEAM (Targeted Evaluation and Active Management)
Active Intervention in Concussion: Results from TEAM (Targeted Evaluation and Active Management) Erin Reynolds, Psy.D Fellowship Director UPMC Sports Medicine Concussion Program Assistant Professor Department
More informationConcussions: Diagnosis, Management and the world of known unknowns
Concussions: Diagnosis, Management and the world of known unknowns Alexander Rogers, MD Associate Professor Michigan Medicine 1 Disclosures I have no Financial Conflicts of Interest to Declare I will discuss
More informationSport-Related Concussion. Daniel Seidman DO 6 August 2016
Sport-Related Concussion Daniel Seidman DO 6 August 2016 My Pertinent Qualifications - Current Fellow, PCSM - Henry Ford Hospital - Recent Graduate, FM - St. John Macomb-Oakland Hospital - Involved in
More informationEmerging CSF and serum biomarkers in atypical dementia. Laksanun Cheewakriengkrai, MD. Phramongkutklao Hospital March 7 th, 2018
Emerging CSF and serum biomarkers in atypical dementia Laksanun Cheewakriengkrai, MD. Phramongkutklao Hospital March 7 th, 2018 Biomarkers A characteristic that is objectively measured and evaluated as
More informationFORENSIC SCIENCE NEWSLETTER Forensic Pathology and Neuropathology. William A. Cox, M.D., FCAP.
NEUROPATHOLOGY FORENSIC SCIENCE NEWSLETTER Forensic Pathology and Neuropathology William A. Cox, M.D., FCAP www.forensicjournals.cm May 15, 2016 This issue of the Forensic Science Newsletter will address
More informationConcussion is a brain injury. Like any injury it needs to be diagnosed and treated. About this talk. Why Am I Giving This Talk?
Concussion is a brain injury. Like any injury it needs to be diagnosed and treated. Joseph F. Clark, Ph.D. ATC Department of Neurology and Rehabilitation Medicine University of Cincinnati About this talk
More informationCompleting the Loop: Management of the Adolescent Sports Injury. Marisa Frank PT, DPT, CSCS
: Management of the Adolescent Sports Injury Marisa Frank PT, DPT, CSCS OBJECTIVES Describe patients who are appropriate for physical therapy. Demonstrate an understanding of the phases of concussion rehabilitation.
More informationConcussion: Research Overview
Concussion: Research Overview September 30, 2013 Hugh J.L. Garton, M.D.,M.HSc. Dept. of Neurosurgery University of Michigan No Disclosures Overview Anatomy / Definitions Biomechanics Cerebral Blood Flow
More informationHead Injury Testing & Management Protocol Boston University Athletic Training Services
Policy # Head Injury Testing & Management Protocol Title: Head Injury Testing and Management Protocol Distribution: Athletic Department, All clinical staff Effective date: 05/2010 Revision date: 06/2015
More informationConcussion 101. Natalie Stork, MD
Concussion 101 Natalie Stork, MD Assistant Professor University of Missouri-Kansas City School of Medicine, Department of Orthopaedic Surgery and Department of Pediatrics Children s Mercy Kansas City,
More informationConcussion update 2010
Concussion update 2010 UCSF 5 th Annual Primary Care Sports Medicine Conference December 4, 2010 Carlin Senter, M.D. Assistant Clinical Professor Primary Care Sports Medicine UCSF Orthopaedic Surgery and
More informationNew Frontiers in Sports Concussion
New Frontiers in Sports Concussion Sports Medicine and Performance Summit 22 October2016 William Haug, Jr., MD, CAQSM Advanced Orthopedics Altru Health System Disclosures No Disclosures to report Objectives
More informationPhysiotherapy management of concussion
Physiotherapy management of concussion Ms. Mairead Daly, Senior Physiotherapist, Bon Secours Health System Saturday November 17 th Silver Springs Hotel Cork Concussion Physiotherapy Assessment and Management
More informationConcussion Information
What is a Concussion? Concussion Information Information taken from the Sports Concussion Institute http://www.concussiontreatment.com A concussion is defined as a complex pathophysiological process that
More informationJohnson, V. E., and Stewart, W. (2015) Traumatic brain injury: Age at injury influences dementia risk after TBI. Nature Reviews Neurology, 11(3), pp. 128-130. (doi:10.1038/nrneurol.2014.241) There may
More informationCommon Modifying Factors for Baseline VOMS Performance 2018 Big Sky Athletic Training Sports Medicine Conference. Disclosure. Objectives 2/13/18
Common Modifying Factors for Baseline VOMS Performance 2018 Big Sky Athletic Training Sports Medicine Conference Ryan N. Moran, PhD, ATC Disclosure I have no actual or potential conflict of interest in
More informationmtbi/concussion in Children, Adolescents & Young Adults: What it is and Why we should be Concerned Ronald C. Savage, Ed.D.
mtbi/concussion in Children, Adolescents & Young Adults: What it is and Why we should be Concerned Ronald C. Savage, Ed.D. rcsavage@comcast.net 1 How Common Are mtbi/concussions? CDC reports indicate that
More informationOMEGA-3 FATTY ACIDS FOR NEUROTRAUMA
OMEGA-3 FATTY ACIDS FOR NEUROTRAUMA ADINA MICHAEL-TITUS PROFESSOR OF NEUROSCIENCE CENTRE LEAD Centre for Neuroscience and Trauma Blizard Institute Queen Mary University of London WHY ARE WE INTERESTED
More informationNew Frontiers in the Science of Concussion
New Frontiers in the Science of Concussion Mark R. Lovell, Ph.D., FACPN Chairman and Chief Scientific Officer Founding Director and Professor University of Pittsburgh Sports Concussion Program Copyright
More informationSUPPLEMENTARY FIG. S2. (A) Risk of bias and applicability concerns graph by marker. Review authors judgments about each domain presented as
Supplementary Data SUPPLEMENTARY FIG. S1. Graphical depiction of (A) influence and (B) outlier detection analyses of S100 calcium binding protein B (S100B) 0.10 0.11lg/L cutoff value studies. (C) Summary
More informationNew Developments in the Management of Concussions. David Marshall, MD Medical Director Sports Medicine Program Children s Healthcare of Atlanta
New Developments in the Management of Concussions David Marshall, MD Medical Director Sports Medicine Program Children s Healthcare of Atlanta Concussions in the News June 7, 2009 New Guidelines on Young
More informationConcussions: Diagnosis, Management and the World of Known Unknowns
Concussions: Diagnosis, Management and the World of Known Unknowns Alexander Rogers, MD Associate Professor Emergency Medicine and Pediatrics Michigan Medicine 1 Disclosures I have no Financial Conflicts
More informationCurrent Concepts in Sports Concussion: Opportunities for the Physical Therapist. Concussion in Sport
Current Concepts in Sports Concussion: Opportunities for the Physical Therapist Concussion in Sport Current Concepts in Sports Concussion: Opportunities for the Physical Therapist Concussion Management:
More informationNeuroimaging of TBI: Current Clinical Guidelines and Future Direction Brain Injury Alliance of Colorado 2017
Neuroimaging of TBI: Current Clinical Guidelines and Future Direction Brain Injury Alliance of Colorado 2017 Peter E. Ricci, M.D. Staff Neuroradiologist Radiology Imaging Associates OBJECTIVES 1. Understand
More informationConcussions in Sport Definitions, Mechanisms, and Current Issues
Concussions in Sport Definitions, Mechanisms, and Current Issues Concussions are Everyone s Responsibility! If you do not LOOK FOR IT you will not FIND IT! Paul Echlin MD CCFP, Dip. ABFM, Dip. SM, CAQSM
More informationSports Concussion Data, Gender and Concussion Treatment Paths
Sports Concussion Data, Gender and Concussion Treatment Paths R. Dawn Comstock, PhD Associate Professor, Epidemiology Colorado School of Public Health, Dept. of Epidemiology University of Colorado School
More informationMELISSA N. WOMBLE, PHD NEUROPSYCHOLOGIST/DIRECTOR INOVA SPORTS MEDICINE COMPREHENSIVE CONCUSSION PROGRAM
MELISSA N. WOMBLE, PHD NEUROPSYCHOLOGIST/DIRECTOR INOVA SPORTS MEDICINE COMPREHENSIVE CONCUSSION PROGRAM THE CURRENT PROBLEM 1. PATHOPHYSIOLOGY OF CONCUSSION 2. SIGNS AND SYMPTOMS OF CONCUSSION 3. TYPICAL
More informationClinical Profiles and Recovery Trajectories Concussion Management
Disclosures and Recovery Trajectories Concussion Management I have no disclosures Aimee Custer, PsyD, LP Clinical Sports Neuropsychologist The following slides are property of Aimee Custer, PsyD. Do not
More informationSports Concussions: Return to Learn
Sports Concussions: Return to Learn Jonathan Santana, DO Adolescent & Sports Medicine Objectives Be able to perform a brief cognitive assessment in the athlete with a head injury Be able to prescribe return
More informationFrom postseason injury analysis through pre-season screening risk management in the team setting
From postseason injury analysis through pre-season screening risk management in the team setting Roald Bahr MD PhD Professor & Chair Oslo Sports Trauma Research Center Norwegian School of Sport Sciences
More informationMichelle L. Gutierrez, PT, DSc CURRICULUM VITAE
Michelle L. Gutierrez, PT, DSc CURRICULUM VITAE January 2016 BUSINESS ADDRESS: The University of Texas at El Paso (UTEP) College of Health Sciences Doctor of Physical Therapy Program 1101 N Campbell (physical
More informationPT/MR evaluation of athletes with postconcussion syndrome
PT/MR evaluation of athletes with postconcussion syndrome Niklas Marklund Professor@Dept. of Clinical Sciences Lund, Neurosurgery, Lund University, Sweden Sports-related concussions- basic facts Recovery
More informationConcussion Management Plan
Purpose: The purpose of the concussion protocol administered by CC Sports Medicine is to provide a plan to effectively and safely manage and prevent concussions suffered by CC athletes. This protocol aims
More informationFrom Research to Recovery
From Research to Recovery Oregon Health & Science University September 16-17, 2016 John Leddy MD FACSM FACP Professor of Clinical Orthopaedics and Rehabilitation Sciences Medical Director, University at
More informationCommunity Partnerships for Youth Concussion Care: Power of the Medical Neighborhood
Community Partnerships for Youth Concussion Care: Power of the Medical Neighborhood Gerard A. Gioia, Ph.D. Pediatric Neuropsychologist Chief, Division of Pediatric Neuropsychology Director, Safe Concussion
More informationValutazione dei disturbi neurocognitivi e invecchiamento: non solo HAND. Workshop Nazionale CISAI Lecco 20 Marzo 2015
Valutazione dei disturbi neurocognitivi e invecchiamento: non solo HAND Workshop Nazionale CISAI Lecco 20 Marzo 2015 Paola Cinque Dipartimento di Malattie Infettive Istituto Scientifico San Raffaele, Milano
More informationThe Need for Baseline Concussion Testing. Brandie Messer, DNP, RN DNP Coordinator Assistant Professor Saint Anthony College of Nursing
Traumatic Head Injuries: The Need for Baseline Concussion Testing Brandie Messer, DNP, RN DNP Coordinator Assistant Professor Saint Anthony College of Nursing TRAUMATIC BRAIN INJURIES PROBLEM STATEMENT
More informationBrain Concussion: A Stealth Injury. Christine Schulman, RN, MS, CNS, CCRN Trauma & Critical Care CNS Legacy Health, Portland, Oregon Director, AACN
Brain Concussion: A Stealth Injury Christine Schulman, RN, MS, CNS, CCRN Trauma & Critical Care CNS Legacy Health, Portland, Oregon Director, AACN Legacy Emanuel Medical Center Portland, Oregon Disclosures
More informationNeurochemical aftermath of repetitive mild traumatic brain injury
Neurochemical aftermath of repetitive mild traumatic brain injury Pashtun Shahim 1, MD, PhD, Yelverton Tegner 2, MD, PhD, Bengt Gustafsson 3, MD, Magnus Gren 1, MD, Johan Ärlig 1, MD, Martin Olsson 1,
More informationBeyond the Basics, Bringing Concussion Out of the Dark
Beyond the Basics, Bringing Concussion Out of the Dark Objectives Recognize different types of concussion based on symptomatology Identify risk factors for prolonged recovery after a concussion Predict
More informationConcussions and Mild Traumatic Brain Injury
Concussions and Mild Traumatic Brain Injury Nancy Mann, MD, Paradigm Medical Director Fellow, American Academy of Physical Medicine and Rehabilitation Nancy Mann, MD Specializes in traumatic brain injury
More informationTRAUMATIC BRAIN INJURY
Psychiatry and Addictions Case Conference UW Medicine Psychiatry and Behavioral Sciences TRAUMATIC BRAIN INJURY GARY STOBBE, MD UNIVERSITY OF WASHINGTON GENERAL DISCLOSURES The University of Washington
More informationMulti-disciplinary TBI evaluation
Multi-disciplinary TBI evaluation Date: September 16, 2017 Ryan Rockwood, ATC Jennifer Wilhelm, PT, DPT, NCS Kyla Laraway, OT, DOT Haley Landau, M.S., CCC- SLP Adapted from Collins MW et al; Knee Surg
More informationPEDIATRIC SPORTS RELATED CONCUSSIONS
Anna Mazur, PhD PEDIATRIC SPORTS RELATED CONCUSSIONS Disclosure No financial interests or funding 1 Presentation Outline Prevalence Predicting recovery: Post Traumatic Amnesia and Loss of Consciousness
More informationIntroduction To Mild TBI. Not Just Less Severe But Different
Introduction To Mild TBI Not Just Less Severe But Different Purpose Provide a discussion of issues related to diagnostic criteria for mild brain injury and concussion To present incidence data on MTBI
More informationSport Concussion Updates:
Sport Concussion Updates: Engaging research to improve prevention & clinical care Johna K. Register-Mihalik, PhD, LAT, ATC Asst. Professor Department of Exercise and Sport Science Kevin Guskiewicz, PhD,
More informationUpdate of Concussion Management 2013 SC School Nurses Meeting
Update of Concussion Management 2013 SC School Nurses Meeting Craig M Burnworth, M.D. Primary Care Sports Medicine Moore Orthopaedics Sports Concussion Center Disclosures I, Craig Burnworth, MD, or family
More informationThe Role of Sports in Long-Term Brain Health
July 21, 2017 Bronson Sports Medicine Symposium The Role of Sports in Long-Term Brain Health Jeffrey Kutcher, MD, FAAN National Director, The Sports Neurology Clinic Team Neurologist, USSA @JeffKutcherMD
More informationFlawless. Mike Cendoma, MS, ATC. Athletic Trainer. Sports Medicine Concepts. Get Your Coffee and Get Comfy. We ll Start in Just A Few!
Sports Medicine Concepts Get Your Coffee and Get Comfy. We ll Start in Just A Few! Mike Cendoma, MS, ATC Sports Medicine Concepts, Inc Suite of Services Since 1995 Founder, Program Director In 2Min or
More informationSportsMed Update. Nov 2007: Issue 4
SportsMed Update Nov 27: Issue 4 Contents: 1. In a controlled filed study, repeated low-severity head impacts due to heading in soccer were not associated with any neurochemical changes (serum and cerebrospinal
More informationIT S ALL IN YOUR HEAD!
IT S ALL IN YOUR HEAD! CARING FOR CONCUSSIONS IN YOUR COMMUNITY Stephen K Stacey, DO CPT, MC, USA OUTLINE Definition Epidemiology Diagnosis Evaluation Recovery Sequelae Prevention Resources for providers
More informationKorebalance Concussion Management Program
Korebalance Concussion Management Program The comprehensive program that combines baseline assessment, proven strengthening regimen, and post injury assessment including both cerebrum (cognitive) and cerebellum
More informationClinical trial of brain-protective effect of nalmefene hydrochloride in patients with acute traumatic
DOI:10.16636/j.cnki.jinn.2014.02.006 Journal of International Neurology and Neurosurgery 1 2 2 1. 410004 2. 410008 β- β-ep DynA1-13 NSE 40 20 1 2 3 5 7 10 β-ep DynA1-13 NSE 3 GOS β-ep DynA1-13 NSE β-ep
More informationConcussion Update and Case Presentations
Concussion Update and Case Presentations Cayce Onks, DO, MS, ATC Associate Professor Primary Care Sports Medicine Penn State Concussion Program Departments of Family Medicine and Orthopaedics I have no
More informationDayna Geiger DPT Concussion Education Specialist January 2015
Dayna Geiger DPT Concussion Education Specialist January 2015 Understand and implement at least 2 balance assessments Capable of being done in any environment Require minimal equipment Implement at least
More informationHeads up! Tackling the Topic of Concussions
Heads up! Tackling the Topic of Concussions Irvin Sulapas MD, FAAFP Assistant Professor Sports Medicine Department of Family & Community Medicine Baylor College of Medicine Disclosure I have no actual
More informationConcussion Assessment and Management Update. Oluseun Olufade, MD and Lee Kneer, MD 1/12/19
Concussion Assessment and Management Update Oluseun Olufade, MD and Lee Kneer, MD 1/12/19 OBJECTIVES When to refer to a physician? When to sent to the ER? When to image? Update on sports related concussion
More informationSport Related Concussion Update 2017
Sport Related Concussion Update 2017 HAYLEY QUELLER, MD ST. CHARLES ORTHOPEDICS, SPORTS MEDICINE DIRECTOR THINKSMART! CONCUSSION MANAGEMENT, CO-DIRECTOR Consensus Statement: 5 th Annual Meeting, Berlin
More informationSports Concussion: What Do We Really Know?
Sports Concussion: What Do We Really Know? Anthony G. Alessi MD, FAAN Director, UConn NeuroSport October 17, 2018 Overview Significance Diagnosis Sideline diagnosis v Management Concussion Tools Return-to-Play
More informationCognitive Risk in High School. Football: A Pilot Study. By: Bernadette Darcy
Cognitive Risk in High School Football: A Pilot Study By: Bernadette Darcy 2 Abstract: To assess the cognitive risk football poses for high school players, a study was conducted which tested change in
More informationAn Update on the Physiology of Mild Traumatic Brain Injury. Barry Willer PhD Grand Rounds Psychiatry 2017
An Update on the Physiology of Mild Traumatic Brain Injury Barry Willer PhD Grand Rounds Psychiatry 2017 Disclosures The Buffalo Sabres Foundation Robert Rich Family Foundation PUCCS Foundation NFL Charities
More informationDr. Wyatt J. LaVigne, PT, DPT, ATC
Dr. Wyatt J. LaVigne, PT, DPT, ATC Physical Therapist and Athletic Trainer Director, Therapy & Wellness Rainy Lake Medical Center International Falls, MN To share my experience of developing a Concussion
More informationCONCUSSIONS: What You Really Need to Know Dr. Emily Dixon
CONCUSSIONS: What You Really Need to Know Dr. Emily Dixon TriHealth Heads Count Concussion Medical Director Emily Dixon, DO Born and raised north of Kansas City, Missouri. Earned her medical degree from
More informationSports Concussion: Questions Our Patients Are Asking and the Evidence-Based Responses
Sports Concussion: Questions Our Patients Are Asking and the Evidence-Based Responses Carlin Senter, MD Co-Director UCSF Sports Concussion Program Associate Professor Primary Care Sports Medicine UCSF
More information2018 CONCUSSION UPDATE WHAT S NEW? 4/12/2018. Michele LaBotz MD FAAP InterMed Sports Medicine AAP Council on Sports Medicine and Fitness
2018 CONCUSSION UPDATE Michele LaBotz MD FAAP InterMed Sports Medicine AAP Council on Sports Medicine and Fitness I have no relevant financial relationships with the manufacturers of any commercial products
More informationHIV Neurology Persistence of Cognitive Impairment Despite cart
HIV Neurology Persistence of Cognitive Impairment Despite cart Victor Valcour MD PhD Professor of Medicine Memory and Aging Center, Dept. of Neurology University of California San Francisco, USA 8 th International
More informationSam Schimelpfenig, MD, FAAP Team Physician, University of Sioux Falls Avera Medical Group
Sam Schimelpfenig, MD, FAAP Team Physician, University of Sioux Falls Avera Medical Group Understand the basic management principles of sports-related concussions Review some of the current literature
More informationClosed Head Injury and Concussion
Closed Head Injury and Concussion Stephen M. Simons, MD, FACSM Director, Sports Medicine Saint Joseph Regional Medical Center Co-Director, South Bend - Notre Dame Sports Medicine Fellowship 1 NFL Concussion
More informationVENUS ISD CONCUSSION POLICY
VENUS ISD CONCUSSION POLICY Introduction The Centers for Disease Control (CDC) estimates that there are approximately 300,000 cases of mild traumatic brain injury (MTBI) or concussions annually in the
More informationDr. JoAnne Savoie, L.Psyc. Clinical Neuropsychologist Stan Cassidy Center for Rehabilitation Fredericton, NB. October 16, 2012
Dr. JoAnne Savoie, L.Psyc. Clinical Neuropsychologist Stan Cassidy Center for Rehabilitation Fredericton, NB October 16, 2012 Risk factors for concussion Players at all levels are at risk 5-10% of athletes
More informationWhat is risk management?
From postseason injury analysis through pre-season screening risk management in the team setting Roald Bahr MD PhD Professor & chair, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences,
More informationThe Dangers of CTE. James Ryan Cox. Skylar Spriggs. Sawyer Solfest. Team THS131
The Dangers of CTE James Ryan Cox Skylar Spriggs Sawyer Solfest Team THS131 Dec 10th, 2017 The human body works alike to a well-oiled machine, each vital organ working as a valuable gear or cog. Yet if
More informationConflicts. Objectives. You can t hide. Epidemiology 4/16/2018. I have no relevant financial relationships to disclose.
The Concussion Epidemic What the EM provider needs to know Conflicts I have no relevant financial relationships to disclose. Certified ImPACT consultant NFL/KSI grant reviewer Paid consultant for Weber-Shandwick
More informationSeeking Answers for an Invisible Disease: The GE NFL Head Health Initiative
Issue Spotlight Seeking Answers for an Invisible Disease: The GE NFL Head Health Initiative Unlike other diseases, a concussion or mild traumatic brain injury (mtbi) is an invisible disease. There is currently
More informationChronic Effects of Neurotrauma Consortium (CENC)
Chronic Effects of Neurotrauma Consortium (CENC) 2013-2019 David X. Cifu, MD Senior TBI Specialist, U.S. Department of Veterans Affairs Associate Dean for Innovation and System Integrations, Virginia Commonwealth
More informationPresented By: Corey Dean, MD, FAAP, FACP, CAQ Sports Medicine
Concussions Traumatic Brain Injuries (TBI) in Sports Presented By: Corey Dean, MD, FAAP, FACP, CAQ Sports Medicine Team Physician for Concordia University, Saline and Ypsilanti-Lincoln High Schools IHA
More information