John J Leddy1, Mohammad Nadir Haider2,3, James M Noble4, Brian Rieger5, Steven Flanagan6, Jacob I McPherson7, Kenneth Shubin-Stein8, Ghazala T Saleem7, Louis Corsaro9, Barry Willer10. 1. UBMD, Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 160 Farber Hall, Buffalo, NY, 14214, USA. leddy@buffalo.edu. 2. UBMD, Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 160 Farber Hall, Buffalo, NY, 14214, USA. 3. Department of Neuroscience, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 160 Farber Hall, Buffalo, NY, 14214, USA. 4. Department of Neurology, Taub Institute for Research On Alzheimer's Disease and the Aging Brain, and G.H. Sergievsky Center, Columbia University, New York, NY, USA. 5. Department of Physical Medicine and Rehabilitation, State University of New York Upstate Medical University, Syracuse, NY, USA. 6. Department of Rehabilitation Medicine, Rusk Institute of Rehabilitation Medicine, New York University School of Medicine, New York, NY, USA. 7. Department of Rehabilitation Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, 160 Farber Hall, Buffalo, NY, 14214, USA. 8. Department of Neurology, Zucker School of Medicine, New York, NY, USA. 9. Northern Westchester and Southern Putnam County School Districts, New York, NY, USA. 10. Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 160 Farber Hall, Buffalo, NY, 14214, USA.
Abstract
PURPOSE OF REVIEW: Concussion produces a variety of signs and symptoms. Most patients recover within 2-4 weeks, but a significant minority experiences persistent post-concussive symptoms (PPCS), some of which may be from associated cervical or persistent neurologic sub-system (e.g., vestibular) dysfunction. This review provides evidence-based information for a pertinent history and physical examination of patients with concussion. RECENT FINDINGS: The differential diagnosis of PPCS is based on the mechanism of injury, a thorough medical history and concussion-pertinent neurological and cervical physical examinations. The concussion physical examination focuses on elements of autonomic function, oculomotor and vestibular function, and the cervical spine. Abnormalities identified on physical examination can inform specific forms of rehabilitation to help speed recovery. Emerging data show that there are specific symptom generators after concussion that can be identified by a thorough history, a pertinent physical examination, and adjunct tests when indicated.
PURPOSE OF REVIEW: Concussion produces a variety of signs and symptoms. Most patients recover within 2-4 weeks, but a significant minority experiences persistent post-concussive symptoms (PPCS), some of which may be from associated cervical or persistent neurologic sub-system (e.g., vestibular) dysfunction. This review provides evidence-based information for a pertinent history and physical examination of patients with concussion. RECENT FINDINGS: The differential diagnosis of PPCS is based on the mechanism of injury, a thorough medical history and concussion-pertinent neurological and cervical physical examinations. The concussion physical examination focuses on elements of autonomic function, oculomotor and vestibular function, and the cervical spine. Abnormalities identified on physical examination can inform specific forms of rehabilitation to help speed recovery. Emerging data show that there are specific symptom generators after concussion that can be identified by a thorough history, a pertinent physical examination, and adjunct tests when indicated.
Authors: Paul McCrory; Willem Meeuwisse; Jiří Dvořák; Mark Aubry; Julian Bailes; Steven Broglio; Robert C Cantu; David Cassidy; Ruben J Echemendia; Rudy J Castellani; Gavin A Davis; Richard Ellenbogen; Carolyn Emery; Lars Engebretsen; Nina Feddermann-Demont; Christopher C Giza; Kevin M Guskiewicz; Stanley Herring; Grant L Iverson; Karen M Johnston; James Kissick; Jeffrey Kutcher; John J Leddy; David Maddocks; Michael Makdissi; Geoff T Manley; Michael McCrea; William P Meehan; Shinji Nagahiro; Jon Patricios; Margot Putukian; Kathryn J Schneider; Allen Sills; Charles H Tator; Michael Turner; Pieter E Vos Journal: Br J Sports Med Date: 2017-04-26 Impact factor: 13.800
Authors: Robert H Bonow; Seth D Friedman; Francisco A Perez; Richard G Ellenbogen; Samuel R Browd; Christine L Mac Donald; Monica S Vavilala; Frederick P Rivara Journal: J Neurotrauma Date: 2017-07-19 Impact factor: 5.269
Authors: Anthony P Kontos; Kendra Jorgensen-Wagers; Alicia M Trbovich; Nathan Ernst; Kouros Emami; Brandon Gillie; Jonathan French; Cyndi Holland; R J Elbin; Michael W Collins Journal: JAMA Neurol Date: 2020-04-01 Impact factor: 18.302
Authors: Lindsay D Nelson; Nancy R Temkin; Sureyya Dikmen; Jason Barber; Joseph T Giacino; Esther Yuh; Harvey S Levin; Michael A McCrea; Murray B Stein; Pratik Mukherjee; David O Okonkwo; Claudia S Robertson; Ramon Diaz-Arrastia; Geoffrey T Manley; Opeolu Adeoye; Neeraj Badjatia; Kim Boase; Yelena Bodien; M Ross Bullock; Randall Chesnut; John D Corrigan; Karen Crawford; Ann-Christine Duhaime; Richard Ellenbogen; V Ramana Feeser; Adam Ferguson; Brandon Foreman; Raquel Gardner; Etienne Gaudette; Luis Gonzalez; Shankar Gopinath; Rao Gullapalli; J Claude Hemphill; Gillian Hotz; Sonia Jain; Frederick Korley; Joel Kramer; Natalie Kreitzer; Chris Lindsell; Joan Machamer; Christopher Madden; Alastair Martin; Thomas McAllister; Randall Merchant; Florence Noel; Eva Palacios; Daniel Perl; Ava Puccio; Miri Rabinowitz; Jonathan Rosand; Angelle Sander; Gabriela Satris; David Schnyer; Seth Seabury; Mark Sherer; Sabrina Taylor; Arthur Toga; Alex Valadka; Mary J Vassar; Paul Vespa; Kevin Wang; John K Yue; Ross Zafonte Journal: JAMA Neurol Date: 2019-09-01 Impact factor: 18.302