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Erschienen in: Current Neurology and Neuroscience Reports 12/2021

01.12.2021 | Neurotrauma (D Sandsmark, Section Editor)

Management of Concussion and Persistent Post-Concussive Symptoms for Neurologists

verfasst von: John J. Leddy, Mohammad Nadir Haider, James M. Noble, Brian Rieger, Steven Flanagan, Jacob I. McPherson, Kenneth Shubin-Stein, Ghazala T. Saleem, Louis Corsaro, Barry Willer

Erschienen in: Current Neurology and Neuroscience Reports | Ausgabe 12/2021

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Abstract

Purpose of Review

Concussion is a complex injury that may present as a variety of clinical profiles, which can overlap and reinforce one another. This review summarizes the medical management of patients with concussion and persistent post-concussive symptoms (PPCS).

Recent Findings

Management of concussion and PPCS relies on identifying underlying symptom generators. Treatment options include sub-symptom threshold aerobic exercise, cervical physical therapy, vestibular therapy, vision therapy, cognitive rehabilitation, cognitive behavioral therapy, pharmacological management, or a combination of treatments.

Summary

Evidence-based treatments have emerged to treat post-concussion symptom generators for sport-related concussion and for patients with PPCS.
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Literatur
1.
Zurück zum Zitat Ellis MJ, Leddy JJ, Willer B. Physiological, vestibulo-ocular and cervicogenic post-concussion disorders: an evidence-based classification system with directions for treatment. Brain Inj. 2015;29(2):238–48.CrossRef Ellis MJ, Leddy JJ, Willer B. Physiological, vestibulo-ocular and cervicogenic post-concussion disorders: an evidence-based classification system with directions for treatment. Brain Inj. 2015;29(2):238–48.CrossRef
2.
Zurück zum Zitat McCrory P, Meeuwisse W, Johnston K, Dvorak J, Aubry M, Molloy M, et al. Consensus statement on Concussion in Sport–the 3rd International Conference on Concussion in Sport held in Zurich, November 2008. Br J Sports Med. 2009;43(Suppl 1):pp i76–90. McCrory P, Meeuwisse W, Johnston K, Dvorak J, Aubry M, Molloy M, et al. Consensus statement on Concussion in Sport–the 3rd International Conference on Concussion in Sport held in Zurich, November 2008. Br J Sports Med. 2009;43(Suppl 1):pp i76–90.
3.
Zurück zum Zitat Stillman A, Madigan N, Alexander M. Factors associated with prolonged, subjective post-concussive symptoms. Neurology. 2016;86(16):3.325. Stillman A, Madigan N, Alexander M. Factors associated with prolonged, subjective post-concussive symptoms. Neurology. 2016;86(16):3.325.
4.
Zurück zum Zitat Gagnon I, Galli C, Friedman D, Grilli L, Iverson GL. Active rehabilitation for children who are slow to recover following sport-related concussion. Brain Inj. 2009;23(12):956–64.CrossRef Gagnon I, Galli C, Friedman D, Grilli L, Iverson GL. Active rehabilitation for children who are slow to recover following sport-related concussion. Brain Inj. 2009;23(12):956–64.CrossRef
5.
Zurück zum Zitat Kontos AP, Jorgensen-Wagers K, Trbovich AM, Ernst N, Emami K, Gillie B, et al. Association of time since injury to the first clinic visit with recovery following concussion. JAMA Neurol. 2020;77(4):435–40.CrossRef Kontos AP, Jorgensen-Wagers K, Trbovich AM, Ernst N, Emami K, Gillie B, et al. Association of time since injury to the first clinic visit with recovery following concussion. JAMA Neurol. 2020;77(4):435–40.CrossRef
6.
Zurück zum Zitat Leddy JJ, Haider MN, Ellis MJ, Mannix R, Darling SR, Freitas MS, et al. Early subthreshold aerobic exercise for sport-related concussion: a randomized clinical trial. JAMA Pediatr. 2019;173(4):319–25.CrossRef Leddy JJ, Haider MN, Ellis MJ, Mannix R, Darling SR, Freitas MS, et al. Early subthreshold aerobic exercise for sport-related concussion: a randomized clinical trial. JAMA Pediatr. 2019;173(4):319–25.CrossRef
7.
Zurück zum Zitat Haider MN, Willer B, Leddy J, Ellis MJ. Multidisciplinary assessment and treatment. In: Silver JM, McAllister TW, Arciniegas DB, editors. Textbook of traumatic brain injury. 3rd ed: American Psychiatric Publishing, Inc. Arlington, VA; 2018. Haider MN, Willer B, Leddy J, Ellis MJ. Multidisciplinary assessment and treatment. In: Silver JM, McAllister TW, Arciniegas DB, editors. Textbook of traumatic brain injury. 3rd ed: American Psychiatric Publishing, Inc. Arlington, VA; 2018.
8.
Zurück zum Zitat Haider MN, Leddy JJ, Du W, A JM, Viera KB, Willer BS. Practical management: brief physical examination for sport-related concussion in the outpatient setting. Clin J Sport Med. 2018. Haider MN, Leddy JJ, Du W, A JM, Viera KB, Willer BS. Practical management: brief physical examination for sport-related concussion in the outpatient setting. Clin J Sport Med. 2018.
9.
Zurück zum Zitat Leddy J, Lesh K, Haider MN, Czuczman N, Baker JG, Miecznikowski J, et al. Derivation of a focused, brief concussion physical examination for adolescents with sport-related concussion. Clin J Sport Med. 2018. Leddy J, Lesh K, Haider MN, Czuczman N, Baker JG, Miecznikowski J, et al. Derivation of a focused, brief concussion physical examination for adolescents with sport-related concussion. Clin J Sport Med. 2018.
10.
Zurück zum Zitat Wang DH, Kostyun RO, Trojian T, Solomito MJ. Overlapping concussion syndrome: defined in a pediatric population. Conn Med. 2017;81(7):389–94. Wang DH, Kostyun RO, Trojian T, Solomito MJ. Overlapping concussion syndrome: defined in a pediatric population. Conn Med. 2017;81(7):389–94.
11.
Zurück zum Zitat Weinstein E, Turner M, Kuzma BB, Feuer H. Second impact syndrome in football: new imaging and insights into a rare and devastating condition. J Neurosurg Pediatr. 2013;11(3):331–4.CrossRef Weinstein E, Turner M, Kuzma BB, Feuer H. Second impact syndrome in football: new imaging and insights into a rare and devastating condition. J Neurosurg Pediatr. 2013;11(3):331–4.CrossRef
12.
Zurück zum Zitat McPherson JI, Saleem GT, Haider MN, Leddy JJ, Torres DM, Willer B. Practical management: telehealth examination for sport-related concussion in the outpatient setting. Clin J Sport Med. 2021. McPherson JI, Saleem GT, Haider MN, Leddy JJ, Torres DM, Willer B. Practical management: telehealth examination for sport-related concussion in the outpatient setting. Clin J Sport Med. 2021.
13.
Zurück zum Zitat Sutton M, Chan V, Escobar M, Mollayeva T, Hu Z, Colantonio A. Neck injury comorbidity in concussion-related emergency department visits: a population-based study of sex differences across the life span. J Womens Health. 2019;28(4):473–82.CrossRef Sutton M, Chan V, Escobar M, Mollayeva T, Hu Z, Colantonio A. Neck injury comorbidity in concussion-related emergency department visits: a population-based study of sex differences across the life span. J Womens Health. 2019;28(4):473–82.CrossRef
14.
Zurück zum Zitat McCrory P, Meeuwisse W, Dvorak J, Aubry M, Bailes J, Broglio S, et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017;51(11):838–47.PubMed McCrory P, Meeuwisse W, Dvorak J, Aubry M, Bailes J, Broglio S, et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017;51(11):838–47.PubMed
15.
Zurück zum Zitat Kasamatsu T, Cleary M, Bennett J, Howard K, McLeod TV. Examining academic support after concussion for the adolescent student-athlete: perspectives of the athletic trainer. J Athl Train. 2016;51(2):153–61.CrossRef Kasamatsu T, Cleary M, Bennett J, Howard K, McLeod TV. Examining academic support after concussion for the adolescent student-athlete: perspectives of the athletic trainer. J Athl Train. 2016;51(2):153–61.CrossRef
16.
Zurück zum Zitat Quatman-Yates CC, Hunter-Giordano A, Shimamura KK, Landel R, Alsalaheen BA, Hanke TA, et al. Physical Therapy Evaluation and Treatment After Concussion/Mild Traumatic Brain Injury. J Orthop Sports Phys Ther. 2020;50(4):CPG1–73.CrossRef Quatman-Yates CC, Hunter-Giordano A, Shimamura KK, Landel R, Alsalaheen BA, Hanke TA, et al. Physical Therapy Evaluation and Treatment After Concussion/Mild Traumatic Brain Injury. J Orthop Sports Phys Ther. 2020;50(4):CPG1–73.CrossRef
17.
Zurück zum Zitat Anzalone AJ, Blueitt D, Case T, McGuffin T, Pollard K, Garrison JC, et al. A Positive Vestibular/Ocular Motor Screening (VOMS) Is Associated With Increased Recovery Time After Sports-Related Concussion in Youth and Adolescent Athletes. Am J Sports Med. 2017;45(2):474–9.CrossRef Anzalone AJ, Blueitt D, Case T, McGuffin T, Pollard K, Garrison JC, et al. A Positive Vestibular/Ocular Motor Screening (VOMS) Is Associated With Increased Recovery Time After Sports-Related Concussion in Youth and Adolescent Athletes. Am J Sports Med. 2017;45(2):474–9.CrossRef
18.
Zurück zum Zitat Giza CC, Hovda DA. The new neurometabolic cascade of concussion. Neurosurgery. 2014;75(suppl_4):S24–33.CrossRef Giza CC, Hovda DA. The new neurometabolic cascade of concussion. Neurosurgery. 2014;75(suppl_4):S24–33.CrossRef
19.
Zurück zum Zitat Kozlowski KF, Graham J, Leddy JJ, Devinney-Boymel L, Willer BS. Exercise intolerance in individuals with postconcussion syndrome. J Athl Train. 2013;48(5):627–35.CrossRef Kozlowski KF, Graham J, Leddy JJ, Devinney-Boymel L, Willer BS. Exercise intolerance in individuals with postconcussion syndrome. J Athl Train. 2013;48(5):627–35.CrossRef
20.
Zurück zum Zitat Clausen M, Pendergast DR, Wilier B, Leddy J. Cerebral blood flow during treadmill exercise is a marker of physiological postconcussion syndrome in female athletes. J Head Trauma Rehabil. 2016;31(3):215–24.CrossRef Clausen M, Pendergast DR, Wilier B, Leddy J. Cerebral blood flow during treadmill exercise is a marker of physiological postconcussion syndrome in female athletes. J Head Trauma Rehabil. 2016;31(3):215–24.CrossRef
21.
Zurück zum Zitat Leddy JJ, Baker JG, Kozlowski K, Bisson L, Willer B. Reliability of a graded exercise test for assessing recovery from concussion. Clin J Sport Med. 2011;21(2):89–94.CrossRef Leddy JJ, Baker JG, Kozlowski K, Bisson L, Willer B. Reliability of a graded exercise test for assessing recovery from concussion. Clin J Sport Med. 2011;21(2):89–94.CrossRef
22.
Zurück zum Zitat Haider MN, Johnson SL, Mannix R, Macfarlane AJ, Constantino D, Johnson BD, et al. The buffalo concussion bike test for concussion assessment in adolescents. Sports Health. 2019;11(6):492–7.CrossRef Haider MN, Johnson SL, Mannix R, Macfarlane AJ, Constantino D, Johnson BD, et al. The buffalo concussion bike test for concussion assessment in adolescents. Sports Health. 2019;11(6):492–7.CrossRef
23.
Zurück zum Zitat Bezherano I, Haider MN, Willer BS, Leddy JJ. Practical management: prescribing subsymptom threshold aerobic exercise for sport-related concussion in the outpatient setting. Clin J Sport Med. 2021;31:465–68. Bezherano I, Haider MN, Willer BS, Leddy JJ. Practical management: prescribing subsymptom threshold aerobic exercise for sport-related concussion in the outpatient setting. Clin J Sport Med. 2021;31:465–68.
24.
Zurück zum Zitat Leddy JJ, Haider MN, Ellis M, Willer BS. Exercise is medicine for concussion. Curr Sports Med Rep. 2018;17(8):262–70.CrossRef Leddy JJ, Haider MN, Ellis M, Willer BS. Exercise is medicine for concussion. Curr Sports Med Rep. 2018;17(8):262–70.CrossRef
25.
Zurück zum Zitat Majerske CW, Mihalik JP, Ren D, Collins MW, Reddy CC, Lovell MR, et al. Concussion in sports: postconcussive activity levels, symptoms, and neurocognitive performance. J Athl Train. 2008;43(3):265–74.CrossRef Majerske CW, Mihalik JP, Ren D, Collins MW, Reddy CC, Lovell MR, et al. Concussion in sports: postconcussive activity levels, symptoms, and neurocognitive performance. J Athl Train. 2008;43(3):265–74.CrossRef
26.
Zurück zum Zitat Maerlender A, Rieman W, Lichtenstein J, Condiracci C. Programmed physical exertion in recovery from sports-related concussion: a randomized pilot study. Dev Neuropsychol. 2015;40(5):273–8.CrossRef Maerlender A, Rieman W, Lichtenstein J, Condiracci C. Programmed physical exertion in recovery from sports-related concussion: a randomized pilot study. Dev Neuropsychol. 2015;40(5):273–8.CrossRef
27.
Zurück zum Zitat Peres G, Vandewalle H, Havette P. Heart rate, maximal heart rate and pedal rate. J Sports Med Phys Fitness. 1987;27(2):205.PubMed Peres G, Vandewalle H, Havette P. Heart rate, maximal heart rate and pedal rate. J Sports Med Phys Fitness. 1987;27(2):205.PubMed
28.
Zurück zum Zitat Society HCCotIH. The international classification of headache disorders,(beta version). Cephalalgia. 2013;33(9):629–808.CrossRef Society HCCotIH. The international classification of headache disorders,(beta version). Cephalalgia. 2013;33(9):629–808.CrossRef
29.
Zurück zum Zitat Register-Mihalik JK, Vander Vegt CB, Cools M, Carnerio K. Factors Associated with Sport-Related Post-concussion Headache and Opportunities for Treatment. Curr Pain Headache Rep. 2018;22(11):75.CrossRef Register-Mihalik JK, Vander Vegt CB, Cools M, Carnerio K. Factors Associated with Sport-Related Post-concussion Headache and Opportunities for Treatment. Curr Pain Headache Rep. 2018;22(11):75.CrossRef
30.
Zurück zum Zitat Marshall S, Bayley M, McCullagh S, Velikonja D, Berrigan L, Ouchterlony D, et al. Updated clinical practice guidelines for concussion/mild traumatic brain injury and persistent symptoms. Brain Inj. 2015;29(6):688–700.CrossRef Marshall S, Bayley M, McCullagh S, Velikonja D, Berrigan L, Ouchterlony D, et al. Updated clinical practice guidelines for concussion/mild traumatic brain injury and persistent symptoms. Brain Inj. 2015;29(6):688–700.CrossRef
31.
Zurück zum Zitat Petrelli T, Farrokhyar F, McGrath P, Sulowski C, Sobhi G, DeMatteo C, et al. The use of ibuprofen and acetaminophen for acute headache in the postconcussive youth: a pilot study. Paediatr Child Health. 2017;22(1):2–6.CrossRef Petrelli T, Farrokhyar F, McGrath P, Sulowski C, Sobhi G, DeMatteo C, et al. The use of ibuprofen and acetaminophen for acute headache in the postconcussive youth: a pilot study. Paediatr Child Health. 2017;22(1):2–6.CrossRef
32.
Zurück zum Zitat Nicolas S, Nicolas D. Triptans. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2020. Nicolas S, Nicolas D. Triptans. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2020.
33.
Zurück zum Zitat Navratilova E, Rau J, Oyarzo J, Tien J, Mackenzie K, Stratton J, et al. CGRP-dependent and independent mechanisms of acute and persistent post-traumatic headache following mild traumatic brain injury in mice. Cephalalgia. 2019;39(14):1762–75.CrossRef Navratilova E, Rau J, Oyarzo J, Tien J, Mackenzie K, Stratton J, et al. CGRP-dependent and independent mechanisms of acute and persistent post-traumatic headache following mild traumatic brain injury in mice. Cephalalgia. 2019;39(14):1762–75.CrossRef
34.
Zurück zum Zitat Baker JG, Willer BS, Dwyer MG, Leddy JJ. A preliminary investigation of cognitive intolerance and neuroimaging among adolescents returning to school after concussion. Brain Inj. 2020;34(6):818–27.CrossRef Baker JG, Willer BS, Dwyer MG, Leddy JJ. A preliminary investigation of cognitive intolerance and neuroimaging among adolescents returning to school after concussion. Brain Inj. 2020;34(6):818–27.CrossRef
35.
Zurück zum Zitat Macnow T, Curran T, Tolliday C, Martin K, McCarthy M, Ayturk D, et al. Effect of Screen Time on Recovery From Concussion: a Randomized Clinical Trial. JAMA Pediatrics. 2021. Macnow T, Curran T, Tolliday C, Martin K, McCarthy M, Ayturk D, et al. Effect of Screen Time on Recovery From Concussion: a Randomized Clinical Trial. JAMA Pediatrics. 2021.
36.
Zurück zum Zitat Wasserman EB, Bazarian JJ, Mapstone M, Block R, van Wijngaarden E. Academic dysfunction after a concussion among US high school and college students. Am J Public Health. 2016;106(7):1247–53.CrossRef Wasserman EB, Bazarian JJ, Mapstone M, Block R, van Wijngaarden E. Academic dysfunction after a concussion among US high school and college students. Am J Public Health. 2016;106(7):1247–53.CrossRef
37.
Zurück zum Zitat Reddy CC, Collins M, Lovell M, Kontos AP. Efficacy of amantadine treatment on symptoms and neurocognitive performance among adolescents following sports-related concussion. J Head Trauma Rehabil. 2013;28(4):260–5.CrossRef Reddy CC, Collins M, Lovell M, Kontos AP. Efficacy of amantadine treatment on symptoms and neurocognitive performance among adolescents following sports-related concussion. J Head Trauma Rehabil. 2013;28(4):260–5.CrossRef
38.
Zurück zum Zitat Plenger PM, Dixon CE, Castillo RM, Frankowski RF, Yablon SA, Levin HS. Subacute methylphenidate treatment for moderate to moderately severe traumatic brain injury: a preliminary double-blind placebo-controlled study. Arch Phys Med Rehabil. 1996;77(6):536–40.CrossRef Plenger PM, Dixon CE, Castillo RM, Frankowski RF, Yablon SA, Levin HS. Subacute methylphenidate treatment for moderate to moderately severe traumatic brain injury: a preliminary double-blind placebo-controlled study. Arch Phys Med Rehabil. 1996;77(6):536–40.CrossRef
39.
Zurück zum Zitat Jaffee MS, Winter WC, Jones CC, Ling G. Sleep disturbances in athletic concussion. Brain Inj. 2015;29(2):221–7.CrossRef Jaffee MS, Winter WC, Jones CC, Ling G. Sleep disturbances in athletic concussion. Brain Inj. 2015;29(2):221–7.CrossRef
40.
Zurück zum Zitat Barlow KM, Kirk V, Brooks B, Esser MJ, Yeates KO, Zemek R, et al. Efficacy of melatonin for sleep disturbance in children with persistent post-concussion symptoms: secondary analysis of a randomized controlled trial. J Neurotrauma. 2021;38(8):950–9.CrossRef Barlow KM, Kirk V, Brooks B, Esser MJ, Yeates KO, Zemek R, et al. Efficacy of melatonin for sleep disturbance in children with persistent post-concussion symptoms: secondary analysis of a randomized controlled trial. J Neurotrauma. 2021;38(8):950–9.CrossRef
41.
Zurück zum Zitat Kamins J, Bigler E, Covassin T, Henry L, Kemp S, Leddy JJ, et al. What is the physiological time to recovery after concussion? Systematic review. Br J Sports Med. 2017:bjsports-2016–097464. Kamins J, Bigler E, Covassin T, Henry L, Kemp S, Leddy JJ, et al. What is the physiological time to recovery after concussion? Systematic review. Br J Sports Med. 2017:bjsports-2016–097464.
42.
Zurück zum Zitat Whooley MA, Simon GE. Managing depression in medical outpatients. N Engl J Med. 2000;343(26):1942–50.CrossRef Whooley MA, Simon GE. Managing depression in medical outpatients. N Engl J Med. 2000;343(26):1942–50.CrossRef
43.
Zurück zum Zitat Trojian TH, Wang DH, Leddy JJ. Nutritional supplements for the treatment and prevention of sports-related concussion-evidence still lacking. Curr Sports Med Rep. 2017;16(4):247–55.CrossRef Trojian TH, Wang DH, Leddy JJ. Nutritional supplements for the treatment and prevention of sports-related concussion-evidence still lacking. Curr Sports Med Rep. 2017;16(4):247–55.CrossRef
44.
Zurück zum Zitat Barrett EC, McBurney MI, Ciappio ED. ω-3 fatty acid supplementation as a potential therapeutic aid for the recovery from mild traumatic brain injury/concussion. Adv Nutr. 2014;5(3):268–77.CrossRef Barrett EC, McBurney MI, Ciappio ED. ω-3 fatty acid supplementation as a potential therapeutic aid for the recovery from mild traumatic brain injury/concussion. Adv Nutr. 2014;5(3):268–77.CrossRef
45.
Zurück zum Zitat McCrea M, Broglio SP, McAllister TW, Gill J, Giza CC, Huber DL, et al. Association of blood biomarkers with acute sport-related concussion in collegiate athletes: findings from the NCAA and department of defense CARE consortium. JAMA Netw Open. 2020;3(1):e1919771.CrossRef McCrea M, Broglio SP, McAllister TW, Gill J, Giza CC, Huber DL, et al. Association of blood biomarkers with acute sport-related concussion in collegiate athletes: findings from the NCAA and department of defense CARE consortium. JAMA Netw Open. 2020;3(1):e1919771.CrossRef
46.
Zurück zum Zitat Haider MN, Leddy JJ, Pavlesen S, Kluczynski M, Baker JG, Miecznikowski JC, et al. A systematic review of criteria used to define recovery from sport-related concussion in youth athletes. Br J Sports Med. 2017:bjsports-2016–096551. Haider MN, Leddy JJ, Pavlesen S, Kluczynski M, Baker JG, Miecznikowski JC, et al. A systematic review of criteria used to define recovery from sport-related concussion in youth athletes. Br J Sports Med. 2017:bjsports-2016–096551.
Metadaten
Titel
Management of Concussion and Persistent Post-Concussive Symptoms for Neurologists
verfasst von
John J. Leddy
Mohammad Nadir Haider
James M. Noble
Brian Rieger
Steven Flanagan
Jacob I. McPherson
Kenneth Shubin-Stein
Ghazala T. Saleem
Louis Corsaro
Barry Willer
Publikationsdatum
01.12.2021
Verlag
Springer US
Erschienen in
Current Neurology and Neuroscience Reports / Ausgabe 12/2021
Print ISSN: 1528-4042
Elektronische ISSN: 1534-6293
DOI
https://doi.org/10.1007/s11910-021-01160-9

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