Bharadwaj, S; Rocker, J
Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management Journal Article
In: Current Opinion in Pediatrics, vol. 28, no. 1, pp. 121–131, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/et [Etiology], *Craniocerebral Trauma/co [Complications], *Craniocerebral Trauma/ra [Radiography], *Radiation Injuries/pc [Prevention & Control], ALGORITHMS, Brain Concussion/ra [Radiography], Brain Concussion/th [Therapy], Brain Injuries/ra [Radiography], Brain Injuries/th [Therapy], Child, Craniocerebral Trauma/th [Therapy], Humans, Radiation Injuries/et [Etiology], Risk Assessment/mt [Methods], Tomography, X-Ray Computed/ae [Adverse Effects]
@article{Bharadwaj2016,
title = {Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management},
author = {Bharadwaj, S and Rocker, J},
year = {2016},
date = {2016-01-01},
journal = {Current Opinion in Pediatrics},
volume = {28},
number = {1},
pages = {121--131},
abstract = {PURPOSE OF REVIEW: We review recommendations from recent publications on the evaluation of minor head trauma. We focus on the risks of radiation from computed tomographies (CTs), the establishment of patient risk stratifications to help guide the necessity of emergent neuroimaging, and current thoughts regarding concussions. RECENT FINDINGS: Pediatric minor head injury is a common complaint in ambulatory settings. There is a significant amount of parental and practitioner anxiety regarding prognosis and whether or not to obtain CT imaging. New evidence has demonstrated the significant harmful effects of ionizing radiation. Recent studies have risk-stratified patients to identify those at risk of clinically important traumatic brain injury, to minimize the exposure to ionizing radiation for those who are at a low risk of any significant disorder. SUMMARY: Pediatric minor head injury is a common complaint, but the vast majority of those injured will suffer no significant consequences. The Pediatric Emergency Care Applied Research Network has created an algorithm to identify minor head trauma patients who require emergent head CTs versus those at low risk who do not require neuroimaging. Additionally, in recent years there has been an increase in the occurrence of concussions. We describe the characteristics of concussions, appropriate management, and the return-to-play guidelines.},
keywords = {*Brain Concussion/et [Etiology], *Craniocerebral Trauma/co [Complications], *Craniocerebral Trauma/ra [Radiography], *Radiation Injuries/pc [Prevention \& Control], ALGORITHMS, Brain Concussion/ra [Radiography], Brain Concussion/th [Therapy], Brain Injuries/ra [Radiography], Brain Injuries/th [Therapy], Child, Craniocerebral Trauma/th [Therapy], Humans, Radiation Injuries/et [Etiology], Risk Assessment/mt [Methods], Tomography, X-Ray Computed/ae [Adverse Effects]},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Leiter, J; Hall, T; McDonald, P J; Sawyer, S; Silver, N; Bunge, M; Essig, M
Neuroimaging findings in pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 16, no. 3, pp. 241–247, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Neuroimaging, Adolescent, Arachnoid Cysts/di [Diagnosis], Athletic Injuries/co [Complications], Athletic Injuries/pa [Pathology], Brain Concussion/pa [Pathology], Brain Injuries/di [Diagnosis], Brain Injuries/et [Etiology], Child, Contusions/di [Diagnosis], Dizziness/et [Etiology], Female, Follow-Up Studies, Headache/et [Etiology], Humans, Intracranial Hemorrhages/di [Diagnosis], Magnetic Resonance Imaging, Male, Neuroimaging/mt [Methods], postural balance, Predictive Value of Tests, Retrospective Studies, Skull Fractures/di [Diagnosis], Tomography, Unconsciousness/et [Etiology], X-Ray Computed
@article{Ellis2015b,
title = {Neuroimaging findings in pediatric sports-related concussion},
author = {Ellis, M J and Leiter, J and Hall, T and McDonald, P J and Sawyer, S and Silver, N and Bunge, M and Essig, M},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {16},
number = {3},
pages = {241--247},
abstract = {OBJECT: The goal in this review was to summarize the results of clinical neuroimaging studies performed in patients with sports-related concussion (SRC) who were referred to a multidisciplinar ypediatric concussion program. METHODS: The authors conducted a retrospective review of medical records and neuroimaging findings for all patients referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Inclusion criteria were as follows: 1) age \< 19 years; and 2) physician-diagnosed SRC. All patients underwent evaluation and follow-up by the same neurosurgeon. The 2 outcomes examined in this review were the frequency of neuroimaging studies performed in this population (including CT and MRI) and the findings of those studies. Clinical indications for neuroimaging and the impact of neuroimaging findings on clinical decision making were summarized where available. This investigation was approved by the local institutional ethics review board. RESULTS: A total of 151 patients (mean age 14 years, 59% female) were included this study. Overall, 36 patients (24%) underwent neuroimaging studies, the results of which were normal in 78% of cases. Sixteen percent of patients underwent CT imaging; results were normal in 79% of cases. Abnormal CT findings included the following: arachnoid cyst (1 patient), skull fracture (2 patients), suspected intracranial hemorrhage (1 patient), and suspected hemorrhage into an arachnoid cyst (1 patient). Eleven percent of patients underwent MRI; results were normal in 75% of cases. Abnormal MRI findings included the following: intraparenchymal hemorrhage and sylvian fissure arachnoid cyst (1 patient); nonhemorrhagic contusion (1 patient); demyelinating disease (1 patient); and posterior fossa arachnoid cyst, cerebellar volume loss, and nonspecific white matter changes (1 patient). CONCLUSIONS: Results of clinical neuroimaging studies are normal in the majority of pediatric patients with SRC. However, in selected cases neuroimaging can provide information that impacts decision making about return to play and retirement from the sport.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Neuroimaging, Adolescent, Arachnoid Cysts/di [Diagnosis], Athletic Injuries/co [Complications], Athletic Injuries/pa [Pathology], Brain Concussion/pa [Pathology], Brain Injuries/di [Diagnosis], Brain Injuries/et [Etiology], Child, Contusions/di [Diagnosis], Dizziness/et [Etiology], Female, Follow-Up Studies, Headache/et [Etiology], Humans, Intracranial Hemorrhages/di [Diagnosis], Magnetic Resonance Imaging, Male, Neuroimaging/mt [Methods], postural balance, Predictive Value of Tests, Retrospective Studies, Skull Fractures/di [Diagnosis], Tomography, Unconsciousness/et [Etiology], X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Rogers, L A
Let the Kids Play Football! Journal Article
In: North Carolina Medical Journal, vol. 76, no. 4, pp. 272, 2015.
BibTeX | Tags: *Brain Concussion/et [Etiology], *Brain Concussion/pc [Prevention & Control], *Football/in [Injuries], Adolescent, Child, Humans, UNITED States
@article{Rogers2015b,
title = {Let the Kids Play Football!},
author = {Rogers, L A},
year = {2015},
date = {2015-01-01},
journal = {North Carolina Medical Journal},
volume = {76},
number = {4},
pages = {272},
keywords = {*Brain Concussion/et [Etiology], *Brain Concussion/pc [Prevention \& Control], *Football/in [Injuries], Adolescent, Child, Humans, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Laws, J
The Bright Spotlight on Pro Football Concussions Journal Article
In: Occupational Health & Safety, vol. 84, no. 10, pp. 4, 2015.
BibTeX | Tags: *Brain Concussion/et [Etiology], *Football/in [Injuries], *Motion Pictures as Topic, Brain Concussion/di [Diagnosis], Brain Concussion/th [Therapy], CANADA, Humans, UNITED States
@article{Laws2015,
title = {The Bright Spotlight on Pro Football Concussions},
author = {Laws, J},
year = {2015},
date = {2015-01-01},
journal = {Occupational Health \& Safety},
volume = {84},
number = {10},
pages = {4},
keywords = {*Brain Concussion/et [Etiology], *Football/in [Injuries], *Motion Pictures as Topic, Brain Concussion/di [Diagnosis], Brain Concussion/th [Therapy], CANADA, Humans, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Comstock, R D; Currie, D W; Pierpoint, L A; Grubenhoff, J A; Fields, S K
An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer Journal Article
In: JAMA Pediatr, vol. 169, no. 9, pp. 830–837, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]
@article{Comstock2015,
title = {An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer},
author = {Comstock, R D and Currie, D W and Pierpoint, L A and Grubenhoff, J A and Fields, S K},
year = {2015},
date = {2015-01-01},
journal = {JAMA Pediatr},
volume = {169},
number = {9},
pages = {830--837},
abstract = {IMPORTANCE: Soccer, originally introduced as a safer sport for children and adolescents, has seen a rapid increase in popularity in the United States over the past 3 decades. Recently, concerns have been raised regarding the safety of soccer ball heading (when an athlete attempts to play the ball in the air with his or her head) given the rise in concussion rates, with some calling for a ban on heading among soccer players younger than 14 years. OBJECTIVES: To evaluate trends over time in boys' and girls' soccer concussions, to identify injury mechanisms commonly leading to concussions, to delineate soccer-specific activities during which most concussions occur, to detail heading-related soccer concussion mechanisms, and to compare concussion symptom patterns by injury mechanism. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of longitudinal surveillance data collected from 2005-2006 through 2013-2014 in a large, nationally representative sample of US high schools. Participants were boys and girls who were high school soccer players. EXPOSURES: Concussions sustained during high school-sanctioned soccer games and practices. MAIN OUTCOMES AND MEASURES: Mechanism and sport-specific activity of concussion. RESULTS: Overall, 627 concussions were sustained during 1,393,753 athlete exposures (AEs) among girls (4.50 concussions per 10,000 AEs), and 442 concussions were sustained during 1,592,238 AEs among boys (2.78 concussions per 10,000 AEs). For boys (68.8%) and girls (51.3%), contact with another player was the most common concussion mechanism. Heading was the most common soccer-specific activity, responsible for 30.6% of boys' concussions and 25.3% of girls' concussions. Contact with another player was the most common mechanism of injury in heading-related concussions among boys (78.1%) and girls (61.9%). There were few differences in concussion symptom patterns by injury mechanism. CONCLUSIONS AND RELEVANCE: Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact. Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.},
keywords = {*Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Wise, J
Banning heading in soccer would have limited effect on concussions, study finds Journal Article
In: BMJ, vol. 351, pp. h3789, 2015.
BibTeX | Tags: *Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Female, Humans, Male
@article{Wise2015,
title = {Banning heading in soccer would have limited effect on concussions, study finds},
author = {Wise, J},
year = {2015},
date = {2015-01-01},
journal = {BMJ},
volume = {351},
pages = {h3789},
keywords = {*Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Female, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Abdullah, K G; Grady, M S; Levine, J M
Concussion and football: a review and editorial Journal Article
In: Current Neurology & Neuroscience Reports, vol. 15, no. 4, pp. 11, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/co [Complications], *Brain Concussion/et [Etiology], *Football, Humans
@article{Abdullah2015,
title = {Concussion and football: a review and editorial},
author = {Abdullah, K G and Grady, M S and Levine, J M},
year = {2015},
date = {2015-01-01},
journal = {Current Neurology \& Neuroscience Reports},
volume = {15},
number = {4},
pages = {11},
abstract = {The issue of concussion in football is of substantial interest to players, coaches, fans, and physicians. In this article, we review specific cultural hindrances to diagnosis and treatment of concussion in football. We review current trends in management and identify areas for improvement. We also discuss the obligations that physicians, particularly neurosurgeons and neurologists, have toward brain-injured football players and the larger societal role they may play in helping to minimize football-associated brain injury.},
keywords = {*Athletic Injuries/co [Complications], *Brain Concussion/et [Etiology], *Football, Humans},
pubstate = {published},
tppubtype = {article}
}
Beckwith, J G; Greenwald, R M; Chu, J J; Crisco, J J; Rowson, S; Duma, S M; Broglio, S P; McAllister, T W; Guskiewicz, K M; Mihalik, J P; Anderson, S; Schnebel, B; Brolinson, P G; Collins, M W
Timing of concussion diagnosis is related to head impact exposure prior to injury Journal Article
In: Medicine & Science in Sports & Exercise, vol. 45, no. 4, pp. 747–754, 2013.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Delayed Diagnosis, *Football/in [Injuries], *HEAD injuries, Adolescent, Closed/ep [Epidemiology], ENVIRONMENTAL exposure, Head Protective Devices, Humans, Male, Telemetry/is [Instrumentation], Time Factors, Young Adult
@article{Beckwith2013a,
title = {Timing of concussion diagnosis is related to head impact exposure prior to injury},
author = {Beckwith, J G and Greenwald, R M and Chu, J J and Crisco, J J and Rowson, S and Duma, S M and Broglio, S P and McAllister, T W and Guskiewicz, K M and Mihalik, J P and Anderson, S and Schnebel, B and Brolinson, P G and Collins, M W},
year = {2013},
date = {2013-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {45},
number = {4},
pages = {747--754},
abstract = {PURPOSE: Concussions are commonly undiagnosed in an athletic environment because the postinjury signs and symptoms may be mild, masked by the subject, or unrecognized. This study compares measures of head impact frequency, location, and kinematic response before cases of immediate and delayed concussion diagnosis. METHODS: Football players from eight collegiate and six high school teams wore instrumented helmets during play (n = 1208), of which 95 were diagnosed with concussion (105 total cases). Acceleration data recorded by the instrumented helmets were reduced to five kinematic metrics: peak linear and rotational acceleration, Gadd severity index, head injury criterion, and change in head velocity (DELTAv). In addition, each impact was assigned to one of four general location regions (front, back, side, and top), and the number of impacts sustained before injury was calculated over two periods (1 and 7 days). RESULTS: All head kinematic measures associated with injury, except peak rotational acceleration (P = 0.284), were significantly higher for cases of immediate diagnosis than delayed diagnosis (P \< 0.05). Players with delayed diagnosis sustained a significantly higher number of head impacts on the day of injury (32.9 +/- 24.9, P \< 0.001) and within 7 d of injury (69.7 +/- 43.3},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Delayed Diagnosis, *Football/in [Injuries], *HEAD injuries, Adolescent, Closed/ep [Epidemiology], ENVIRONMENTAL exposure, Head Protective Devices, Humans, Male, Telemetry/is [Instrumentation], Time Factors, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Bharadwaj, S; Rocker, J
Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management Journal Article
In: Current Opinion in Pediatrics, vol. 28, no. 1, pp. 121–131, 2016.
@article{Bharadwaj2016,
title = {Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management},
author = {Bharadwaj, S and Rocker, J},
year = {2016},
date = {2016-01-01},
journal = {Current Opinion in Pediatrics},
volume = {28},
number = {1},
pages = {121--131},
abstract = {PURPOSE OF REVIEW: We review recommendations from recent publications on the evaluation of minor head trauma. We focus on the risks of radiation from computed tomographies (CTs), the establishment of patient risk stratifications to help guide the necessity of emergent neuroimaging, and current thoughts regarding concussions. RECENT FINDINGS: Pediatric minor head injury is a common complaint in ambulatory settings. There is a significant amount of parental and practitioner anxiety regarding prognosis and whether or not to obtain CT imaging. New evidence has demonstrated the significant harmful effects of ionizing radiation. Recent studies have risk-stratified patients to identify those at risk of clinically important traumatic brain injury, to minimize the exposure to ionizing radiation for those who are at a low risk of any significant disorder. SUMMARY: Pediatric minor head injury is a common complaint, but the vast majority of those injured will suffer no significant consequences. The Pediatric Emergency Care Applied Research Network has created an algorithm to identify minor head trauma patients who require emergent head CTs versus those at low risk who do not require neuroimaging. Additionally, in recent years there has been an increase in the occurrence of concussions. We describe the characteristics of concussions, appropriate management, and the return-to-play guidelines.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Leiter, J; Hall, T; McDonald, P J; Sawyer, S; Silver, N; Bunge, M; Essig, M
Neuroimaging findings in pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 16, no. 3, pp. 241–247, 2015.
@article{Ellis2015b,
title = {Neuroimaging findings in pediatric sports-related concussion},
author = {Ellis, M J and Leiter, J and Hall, T and McDonald, P J and Sawyer, S and Silver, N and Bunge, M and Essig, M},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {16},
number = {3},
pages = {241--247},
abstract = {OBJECT: The goal in this review was to summarize the results of clinical neuroimaging studies performed in patients with sports-related concussion (SRC) who were referred to a multidisciplinar ypediatric concussion program. METHODS: The authors conducted a retrospective review of medical records and neuroimaging findings for all patients referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Inclusion criteria were as follows: 1) age \< 19 years; and 2) physician-diagnosed SRC. All patients underwent evaluation and follow-up by the same neurosurgeon. The 2 outcomes examined in this review were the frequency of neuroimaging studies performed in this population (including CT and MRI) and the findings of those studies. Clinical indications for neuroimaging and the impact of neuroimaging findings on clinical decision making were summarized where available. This investigation was approved by the local institutional ethics review board. RESULTS: A total of 151 patients (mean age 14 years, 59% female) were included this study. Overall, 36 patients (24%) underwent neuroimaging studies, the results of which were normal in 78% of cases. Sixteen percent of patients underwent CT imaging; results were normal in 79% of cases. Abnormal CT findings included the following: arachnoid cyst (1 patient), skull fracture (2 patients), suspected intracranial hemorrhage (1 patient), and suspected hemorrhage into an arachnoid cyst (1 patient). Eleven percent of patients underwent MRI; results were normal in 75% of cases. Abnormal MRI findings included the following: intraparenchymal hemorrhage and sylvian fissure arachnoid cyst (1 patient); nonhemorrhagic contusion (1 patient); demyelinating disease (1 patient); and posterior fossa arachnoid cyst, cerebellar volume loss, and nonspecific white matter changes (1 patient). CONCLUSIONS: Results of clinical neuroimaging studies are normal in the majority of pediatric patients with SRC. However, in selected cases neuroimaging can provide information that impacts decision making about return to play and retirement from the sport.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Rogers, L A
Let the Kids Play Football! Journal Article
In: North Carolina Medical Journal, vol. 76, no. 4, pp. 272, 2015.
@article{Rogers2015b,
title = {Let the Kids Play Football!},
author = {Rogers, L A},
year = {2015},
date = {2015-01-01},
journal = {North Carolina Medical Journal},
volume = {76},
number = {4},
pages = {272},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Laws, J
The Bright Spotlight on Pro Football Concussions Journal Article
In: Occupational Health & Safety, vol. 84, no. 10, pp. 4, 2015.
@article{Laws2015,
title = {The Bright Spotlight on Pro Football Concussions},
author = {Laws, J},
year = {2015},
date = {2015-01-01},
journal = {Occupational Health \& Safety},
volume = {84},
number = {10},
pages = {4},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Comstock, R D; Currie, D W; Pierpoint, L A; Grubenhoff, J A; Fields, S K
An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer Journal Article
In: JAMA Pediatr, vol. 169, no. 9, pp. 830–837, 2015.
@article{Comstock2015,
title = {An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer},
author = {Comstock, R D and Currie, D W and Pierpoint, L A and Grubenhoff, J A and Fields, S K},
year = {2015},
date = {2015-01-01},
journal = {JAMA Pediatr},
volume = {169},
number = {9},
pages = {830--837},
abstract = {IMPORTANCE: Soccer, originally introduced as a safer sport for children and adolescents, has seen a rapid increase in popularity in the United States over the past 3 decades. Recently, concerns have been raised regarding the safety of soccer ball heading (when an athlete attempts to play the ball in the air with his or her head) given the rise in concussion rates, with some calling for a ban on heading among soccer players younger than 14 years. OBJECTIVES: To evaluate trends over time in boys' and girls' soccer concussions, to identify injury mechanisms commonly leading to concussions, to delineate soccer-specific activities during which most concussions occur, to detail heading-related soccer concussion mechanisms, and to compare concussion symptom patterns by injury mechanism. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of longitudinal surveillance data collected from 2005-2006 through 2013-2014 in a large, nationally representative sample of US high schools. Participants were boys and girls who were high school soccer players. EXPOSURES: Concussions sustained during high school-sanctioned soccer games and practices. MAIN OUTCOMES AND MEASURES: Mechanism and sport-specific activity of concussion. RESULTS: Overall, 627 concussions were sustained during 1,393,753 athlete exposures (AEs) among girls (4.50 concussions per 10,000 AEs), and 442 concussions were sustained during 1,592,238 AEs among boys (2.78 concussions per 10,000 AEs). For boys (68.8%) and girls (51.3%), contact with another player was the most common concussion mechanism. Heading was the most common soccer-specific activity, responsible for 30.6% of boys' concussions and 25.3% of girls' concussions. Contact with another player was the most common mechanism of injury in heading-related concussions among boys (78.1%) and girls (61.9%). There were few differences in concussion symptom patterns by injury mechanism. CONCLUSIONS AND RELEVANCE: Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact. Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Wise, J
Banning heading in soccer would have limited effect on concussions, study finds Journal Article
In: BMJ, vol. 351, pp. h3789, 2015.
@article{Wise2015,
title = {Banning heading in soccer would have limited effect on concussions, study finds},
author = {Wise, J},
year = {2015},
date = {2015-01-01},
journal = {BMJ},
volume = {351},
pages = {h3789},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Abdullah, K G; Grady, M S; Levine, J M
Concussion and football: a review and editorial Journal Article
In: Current Neurology & Neuroscience Reports, vol. 15, no. 4, pp. 11, 2015.
@article{Abdullah2015,
title = {Concussion and football: a review and editorial},
author = {Abdullah, K G and Grady, M S and Levine, J M},
year = {2015},
date = {2015-01-01},
journal = {Current Neurology \& Neuroscience Reports},
volume = {15},
number = {4},
pages = {11},
abstract = {The issue of concussion in football is of substantial interest to players, coaches, fans, and physicians. In this article, we review specific cultural hindrances to diagnosis and treatment of concussion in football. We review current trends in management and identify areas for improvement. We also discuss the obligations that physicians, particularly neurosurgeons and neurologists, have toward brain-injured football players and the larger societal role they may play in helping to minimize football-associated brain injury.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Beckwith, J G; Greenwald, R M; Chu, J J; Crisco, J J; Rowson, S; Duma, S M; Broglio, S P; McAllister, T W; Guskiewicz, K M; Mihalik, J P; Anderson, S; Schnebel, B; Brolinson, P G; Collins, M W
Timing of concussion diagnosis is related to head impact exposure prior to injury Journal Article
In: Medicine & Science in Sports & Exercise, vol. 45, no. 4, pp. 747–754, 2013.
@article{Beckwith2013a,
title = {Timing of concussion diagnosis is related to head impact exposure prior to injury},
author = {Beckwith, J G and Greenwald, R M and Chu, J J and Crisco, J J and Rowson, S and Duma, S M and Broglio, S P and McAllister, T W and Guskiewicz, K M and Mihalik, J P and Anderson, S and Schnebel, B and Brolinson, P G and Collins, M W},
year = {2013},
date = {2013-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {45},
number = {4},
pages = {747--754},
abstract = {PURPOSE: Concussions are commonly undiagnosed in an athletic environment because the postinjury signs and symptoms may be mild, masked by the subject, or unrecognized. This study compares measures of head impact frequency, location, and kinematic response before cases of immediate and delayed concussion diagnosis. METHODS: Football players from eight collegiate and six high school teams wore instrumented helmets during play (n = 1208), of which 95 were diagnosed with concussion (105 total cases). Acceleration data recorded by the instrumented helmets were reduced to five kinematic metrics: peak linear and rotational acceleration, Gadd severity index, head injury criterion, and change in head velocity (DELTAv). In addition, each impact was assigned to one of four general location regions (front, back, side, and top), and the number of impacts sustained before injury was calculated over two periods (1 and 7 days). RESULTS: All head kinematic measures associated with injury, except peak rotational acceleration (P = 0.284), were significantly higher for cases of immediate diagnosis than delayed diagnosis (P \< 0.05). Players with delayed diagnosis sustained a significantly higher number of head impacts on the day of injury (32.9 +/- 24.9, P \< 0.001) and within 7 d of injury (69.7 +/- 43.3},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Bharadwaj, S; Rocker, J
Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management Journal Article
In: Current Opinion in Pediatrics, vol. 28, no. 1, pp. 121–131, 2016.
Abstract | BibTeX | Tags: *Brain Concussion/et [Etiology], *Craniocerebral Trauma/co [Complications], *Craniocerebral Trauma/ra [Radiography], *Radiation Injuries/pc [Prevention & Control], ALGORITHMS, Brain Concussion/ra [Radiography], Brain Concussion/th [Therapy], Brain Injuries/ra [Radiography], Brain Injuries/th [Therapy], Child, Craniocerebral Trauma/th [Therapy], Humans, Radiation Injuries/et [Etiology], Risk Assessment/mt [Methods], Tomography, X-Ray Computed/ae [Adverse Effects]
@article{Bharadwaj2016,
title = {Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management},
author = {Bharadwaj, S and Rocker, J},
year = {2016},
date = {2016-01-01},
journal = {Current Opinion in Pediatrics},
volume = {28},
number = {1},
pages = {121--131},
abstract = {PURPOSE OF REVIEW: We review recommendations from recent publications on the evaluation of minor head trauma. We focus on the risks of radiation from computed tomographies (CTs), the establishment of patient risk stratifications to help guide the necessity of emergent neuroimaging, and current thoughts regarding concussions. RECENT FINDINGS: Pediatric minor head injury is a common complaint in ambulatory settings. There is a significant amount of parental and practitioner anxiety regarding prognosis and whether or not to obtain CT imaging. New evidence has demonstrated the significant harmful effects of ionizing radiation. Recent studies have risk-stratified patients to identify those at risk of clinically important traumatic brain injury, to minimize the exposure to ionizing radiation for those who are at a low risk of any significant disorder. SUMMARY: Pediatric minor head injury is a common complaint, but the vast majority of those injured will suffer no significant consequences. The Pediatric Emergency Care Applied Research Network has created an algorithm to identify minor head trauma patients who require emergent head CTs versus those at low risk who do not require neuroimaging. Additionally, in recent years there has been an increase in the occurrence of concussions. We describe the characteristics of concussions, appropriate management, and the return-to-play guidelines.},
keywords = {*Brain Concussion/et [Etiology], *Craniocerebral Trauma/co [Complications], *Craniocerebral Trauma/ra [Radiography], *Radiation Injuries/pc [Prevention \& Control], ALGORITHMS, Brain Concussion/ra [Radiography], Brain Concussion/th [Therapy], Brain Injuries/ra [Radiography], Brain Injuries/th [Therapy], Child, Craniocerebral Trauma/th [Therapy], Humans, Radiation Injuries/et [Etiology], Risk Assessment/mt [Methods], Tomography, X-Ray Computed/ae [Adverse Effects]},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Leiter, J; Hall, T; McDonald, P J; Sawyer, S; Silver, N; Bunge, M; Essig, M
Neuroimaging findings in pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 16, no. 3, pp. 241–247, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Neuroimaging, Adolescent, Arachnoid Cysts/di [Diagnosis], Athletic Injuries/co [Complications], Athletic Injuries/pa [Pathology], Brain Concussion/pa [Pathology], Brain Injuries/di [Diagnosis], Brain Injuries/et [Etiology], Child, Contusions/di [Diagnosis], Dizziness/et [Etiology], Female, Follow-Up Studies, Headache/et [Etiology], Humans, Intracranial Hemorrhages/di [Diagnosis], Magnetic Resonance Imaging, Male, Neuroimaging/mt [Methods], postural balance, Predictive Value of Tests, Retrospective Studies, Skull Fractures/di [Diagnosis], Tomography, Unconsciousness/et [Etiology], X-Ray Computed
@article{Ellis2015b,
title = {Neuroimaging findings in pediatric sports-related concussion},
author = {Ellis, M J and Leiter, J and Hall, T and McDonald, P J and Sawyer, S and Silver, N and Bunge, M and Essig, M},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {16},
number = {3},
pages = {241--247},
abstract = {OBJECT: The goal in this review was to summarize the results of clinical neuroimaging studies performed in patients with sports-related concussion (SRC) who were referred to a multidisciplinar ypediatric concussion program. METHODS: The authors conducted a retrospective review of medical records and neuroimaging findings for all patients referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Inclusion criteria were as follows: 1) age \< 19 years; and 2) physician-diagnosed SRC. All patients underwent evaluation and follow-up by the same neurosurgeon. The 2 outcomes examined in this review were the frequency of neuroimaging studies performed in this population (including CT and MRI) and the findings of those studies. Clinical indications for neuroimaging and the impact of neuroimaging findings on clinical decision making were summarized where available. This investigation was approved by the local institutional ethics review board. RESULTS: A total of 151 patients (mean age 14 years, 59% female) were included this study. Overall, 36 patients (24%) underwent neuroimaging studies, the results of which were normal in 78% of cases. Sixteen percent of patients underwent CT imaging; results were normal in 79% of cases. Abnormal CT findings included the following: arachnoid cyst (1 patient), skull fracture (2 patients), suspected intracranial hemorrhage (1 patient), and suspected hemorrhage into an arachnoid cyst (1 patient). Eleven percent of patients underwent MRI; results were normal in 75% of cases. Abnormal MRI findings included the following: intraparenchymal hemorrhage and sylvian fissure arachnoid cyst (1 patient); nonhemorrhagic contusion (1 patient); demyelinating disease (1 patient); and posterior fossa arachnoid cyst, cerebellar volume loss, and nonspecific white matter changes (1 patient). CONCLUSIONS: Results of clinical neuroimaging studies are normal in the majority of pediatric patients with SRC. However, in selected cases neuroimaging can provide information that impacts decision making about return to play and retirement from the sport.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Neuroimaging, Adolescent, Arachnoid Cysts/di [Diagnosis], Athletic Injuries/co [Complications], Athletic Injuries/pa [Pathology], Brain Concussion/pa [Pathology], Brain Injuries/di [Diagnosis], Brain Injuries/et [Etiology], Child, Contusions/di [Diagnosis], Dizziness/et [Etiology], Female, Follow-Up Studies, Headache/et [Etiology], Humans, Intracranial Hemorrhages/di [Diagnosis], Magnetic Resonance Imaging, Male, Neuroimaging/mt [Methods], postural balance, Predictive Value of Tests, Retrospective Studies, Skull Fractures/di [Diagnosis], Tomography, Unconsciousness/et [Etiology], X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Rogers, L A
Let the Kids Play Football! Journal Article
In: North Carolina Medical Journal, vol. 76, no. 4, pp. 272, 2015.
BibTeX | Tags: *Brain Concussion/et [Etiology], *Brain Concussion/pc [Prevention & Control], *Football/in [Injuries], Adolescent, Child, Humans, UNITED States
@article{Rogers2015b,
title = {Let the Kids Play Football!},
author = {Rogers, L A},
year = {2015},
date = {2015-01-01},
journal = {North Carolina Medical Journal},
volume = {76},
number = {4},
pages = {272},
keywords = {*Brain Concussion/et [Etiology], *Brain Concussion/pc [Prevention \& Control], *Football/in [Injuries], Adolescent, Child, Humans, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Laws, J
The Bright Spotlight on Pro Football Concussions Journal Article
In: Occupational Health & Safety, vol. 84, no. 10, pp. 4, 2015.
BibTeX | Tags: *Brain Concussion/et [Etiology], *Football/in [Injuries], *Motion Pictures as Topic, Brain Concussion/di [Diagnosis], Brain Concussion/th [Therapy], CANADA, Humans, UNITED States
@article{Laws2015,
title = {The Bright Spotlight on Pro Football Concussions},
author = {Laws, J},
year = {2015},
date = {2015-01-01},
journal = {Occupational Health \& Safety},
volume = {84},
number = {10},
pages = {4},
keywords = {*Brain Concussion/et [Etiology], *Football/in [Injuries], *Motion Pictures as Topic, Brain Concussion/di [Diagnosis], Brain Concussion/th [Therapy], CANADA, Humans, UNITED States},
pubstate = {published},
tppubtype = {article}
}
Comstock, R D; Currie, D W; Pierpoint, L A; Grubenhoff, J A; Fields, S K
An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer Journal Article
In: JAMA Pediatr, vol. 169, no. 9, pp. 830–837, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]
@article{Comstock2015,
title = {An Evidence-Based Discussion of Heading the Ball and Concussions in High School Soccer},
author = {Comstock, R D and Currie, D W and Pierpoint, L A and Grubenhoff, J A and Fields, S K},
year = {2015},
date = {2015-01-01},
journal = {JAMA Pediatr},
volume = {169},
number = {9},
pages = {830--837},
abstract = {IMPORTANCE: Soccer, originally introduced as a safer sport for children and adolescents, has seen a rapid increase in popularity in the United States over the past 3 decades. Recently, concerns have been raised regarding the safety of soccer ball heading (when an athlete attempts to play the ball in the air with his or her head) given the rise in concussion rates, with some calling for a ban on heading among soccer players younger than 14 years. OBJECTIVES: To evaluate trends over time in boys' and girls' soccer concussions, to identify injury mechanisms commonly leading to concussions, to delineate soccer-specific activities during which most concussions occur, to detail heading-related soccer concussion mechanisms, and to compare concussion symptom patterns by injury mechanism. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of longitudinal surveillance data collected from 2005-2006 through 2013-2014 in a large, nationally representative sample of US high schools. Participants were boys and girls who were high school soccer players. EXPOSURES: Concussions sustained during high school-sanctioned soccer games and practices. MAIN OUTCOMES AND MEASURES: Mechanism and sport-specific activity of concussion. RESULTS: Overall, 627 concussions were sustained during 1,393,753 athlete exposures (AEs) among girls (4.50 concussions per 10,000 AEs), and 442 concussions were sustained during 1,592,238 AEs among boys (2.78 concussions per 10,000 AEs). For boys (68.8%) and girls (51.3%), contact with another player was the most common concussion mechanism. Heading was the most common soccer-specific activity, responsible for 30.6% of boys' concussions and 25.3% of girls' concussions. Contact with another player was the most common mechanism of injury in heading-related concussions among boys (78.1%) and girls (61.9%). There were few differences in concussion symptom patterns by injury mechanism. CONCLUSIONS AND RELEVANCE: Although heading is the most common activity associated with concussions, the most frequent mechanism was athlete-athlete contact. Such information is needed to drive evidence-based, targeted prevention efforts to effectively reduce soccer-related concussions. Although banning heading from youth soccer would likely prevent some concussions, reducing athlete-athlete contact across all phases of play would likely be a more effective way to prevent concussions as well as other injuries.},
keywords = {*Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Adolescent, Athletic Injuries/ep [Epidemiology], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ep [Epidemiology], Brain Concussion/rh [Rehabilitation], Child, Evidence-Based Medicine/mt [Methods], Female, Humans, Male, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, United States/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Wise, J
Banning heading in soccer would have limited effect on concussions, study finds Journal Article
In: BMJ, vol. 351, pp. h3789, 2015.
BibTeX | Tags: *Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Female, Humans, Male
@article{Wise2015,
title = {Banning heading in soccer would have limited effect on concussions, study finds},
author = {Wise, J},
year = {2015},
date = {2015-01-01},
journal = {BMJ},
volume = {351},
pages = {h3789},
keywords = {*Athletic Injuries/et [Etiology], *Brain Concussion/et [Etiology], *Soccer/in [Injuries], Female, Humans, Male},
pubstate = {published},
tppubtype = {article}
}
Abdullah, K G; Grady, M S; Levine, J M
Concussion and football: a review and editorial Journal Article
In: Current Neurology & Neuroscience Reports, vol. 15, no. 4, pp. 11, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/co [Complications], *Brain Concussion/et [Etiology], *Football, Humans
@article{Abdullah2015,
title = {Concussion and football: a review and editorial},
author = {Abdullah, K G and Grady, M S and Levine, J M},
year = {2015},
date = {2015-01-01},
journal = {Current Neurology \& Neuroscience Reports},
volume = {15},
number = {4},
pages = {11},
abstract = {The issue of concussion in football is of substantial interest to players, coaches, fans, and physicians. In this article, we review specific cultural hindrances to diagnosis and treatment of concussion in football. We review current trends in management and identify areas for improvement. We also discuss the obligations that physicians, particularly neurosurgeons and neurologists, have toward brain-injured football players and the larger societal role they may play in helping to minimize football-associated brain injury.},
keywords = {*Athletic Injuries/co [Complications], *Brain Concussion/et [Etiology], *Football, Humans},
pubstate = {published},
tppubtype = {article}
}
Beckwith, J G; Greenwald, R M; Chu, J J; Crisco, J J; Rowson, S; Duma, S M; Broglio, S P; McAllister, T W; Guskiewicz, K M; Mihalik, J P; Anderson, S; Schnebel, B; Brolinson, P G; Collins, M W
Timing of concussion diagnosis is related to head impact exposure prior to injury Journal Article
In: Medicine & Science in Sports & Exercise, vol. 45, no. 4, pp. 747–754, 2013.
Abstract | BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Delayed Diagnosis, *Football/in [Injuries], *HEAD injuries, Adolescent, Closed/ep [Epidemiology], ENVIRONMENTAL exposure, Head Protective Devices, Humans, Male, Telemetry/is [Instrumentation], Time Factors, Young Adult
@article{Beckwith2013a,
title = {Timing of concussion diagnosis is related to head impact exposure prior to injury},
author = {Beckwith, J G and Greenwald, R M and Chu, J J and Crisco, J J and Rowson, S and Duma, S M and Broglio, S P and McAllister, T W and Guskiewicz, K M and Mihalik, J P and Anderson, S and Schnebel, B and Brolinson, P G and Collins, M W},
year = {2013},
date = {2013-01-01},
journal = {Medicine \& Science in Sports \& Exercise},
volume = {45},
number = {4},
pages = {747--754},
abstract = {PURPOSE: Concussions are commonly undiagnosed in an athletic environment because the postinjury signs and symptoms may be mild, masked by the subject, or unrecognized. This study compares measures of head impact frequency, location, and kinematic response before cases of immediate and delayed concussion diagnosis. METHODS: Football players from eight collegiate and six high school teams wore instrumented helmets during play (n = 1208), of which 95 were diagnosed with concussion (105 total cases). Acceleration data recorded by the instrumented helmets were reduced to five kinematic metrics: peak linear and rotational acceleration, Gadd severity index, head injury criterion, and change in head velocity (DELTAv). In addition, each impact was assigned to one of four general location regions (front, back, side, and top), and the number of impacts sustained before injury was calculated over two periods (1 and 7 days). RESULTS: All head kinematic measures associated with injury, except peak rotational acceleration (P = 0.284), were significantly higher for cases of immediate diagnosis than delayed diagnosis (P \< 0.05). Players with delayed diagnosis sustained a significantly higher number of head impacts on the day of injury (32.9 +/- 24.9, P \< 0.001) and within 7 d of injury (69.7 +/- 43.3},
keywords = {*Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Delayed Diagnosis, *Football/in [Injuries], *HEAD injuries, Adolescent, Closed/ep [Epidemiology], ENVIRONMENTAL exposure, Head Protective Devices, Humans, Male, Telemetry/is [Instrumentation], Time Factors, Young Adult},
pubstate = {published},
tppubtype = {article}
}