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Sci Rep 2021 Jun 11;11(1):12353. Epub 2021 Jun 11.

Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada.

Concussion is a global health concern. Despite its high prevalence, a sound understanding of the mechanisms underlying this type of diffuse brain injury remains elusive. It is, however, well established that concussions cause significant functional deficits; that children and youths are disproportionately affected and have longer recovery time than adults; and that individuals suffering from a concussion are more prone to experience additional concussions, with each successive injury increasing the risk of long term neurological and mental health complications. Read More

Assessment 2021 Jun 11:10731911211022840. Epub 2021 Jun 11.

Brown University, Providence, Rhode Island, USA.

Recent research has yielded multivariate base rates (MBRs) of low scores in healthy populations using a widely adopted concussion screening measure, Immediate Postconcussion and Cognitive Testing (ImPACT). However, the extent to which individuals with concussion obtain reliable changes at divergent frequencies relative to healthy individuals is largely unknown. The present study examined whether MBRs of reliable change accurately discriminated between those with and without concussion. Read More

Front Sports Act Living 2021 25;3:680773. Epub 2021 May 25.

Faculty of Social Sciences, Nord University, Bodø, Norway.

The purpose of this article is to map existing research literature on athletes and coaches' attitudes toward protective headgear in sport in relation to concussion and head injury prevention, and to identify and analyse knowledge gaps in the field. A scoping review was conducted in three databases; PubMed, Scopus, SportDiscus, and reference lists were searched to identify relevant grey literature. This process lead to an in-depth analysis of 18 peer-reviewed journal articles. Read More

Front Neurol 2021 24;12:639179. Epub 2021 May 24.

Department of Neurology, University of Texas McGovern Medical School, Houston, TX, United States.

Cognitive impairment after concussion has been widely reported, but there is no reliable imaging biomarker that predicts the severity of cognitive decline post-concussion. This study tests the hypothesis that patients with a history of concussion and persistent cognitive impairment have fractional anisotropy (FA) and mean diffusivity (MD) values from diffusion tensor imaging (DTI) that are specifically associated with poor performance on the Montreal Cognitive Assessment (MoCA). Fifty-three subjects (19 females) with concussions and persistent cognitive symptoms had MR imaging and the MoCA. Read More

Neurosurgery 2021 Jun 9. Epub 2021 Jun 9.

Division of Neurosciences Oxford University Hospitals Oxford, United Kingdom.

J Spec Oper Med 2021 ;21(2):61-66

Background: Mild traumatic brain injury (mTBI) and its potential long-term consequences is a primary concern for the US military. The purpose of the study is to evaluate if participants improved in anxiety/mood symptoms, sleep quality, and vestibular/ocular symptoms following a 6-month active intervention, and to explore the effect of targeted treatment for those with specific symptoms/impairments (e.g. Read More

J Spec Oper Med 2021 ;21(2):43-48

Special Operations Forces have made brain health a medical priority in recent years, and new guidance identified a new challenge-unconventionally acquired brain injury (UBI). Although this emerging condition is described as a cluster of neurosensory and cognitive symptoms with unknown etiology/ origin, there remain critical questions about how this diagnosis differs from other brain injuries. More importantly, there are limited recommendations about how medical personnel should approach the problem. Read More

Can J Anaesth 2021 Jun 8. Epub 2021 Jun 8.

Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada.

Purpose: Anesthesia is associated with alterations in end-tidal (ET) respiratory gases from the awake state. These alterations result in marked vasoactive changes in regional cerebral blood flow (rCBF). Altered regional cerebrovascular reactivity (rCVR) is linked to neurologic dysfunction. Read More

Georgian Med News 2021 Apr(313):60-65

1State Institution, Dnipropetrovsk Medical Academy, Ministry of Healthcare of Ukraine, Nervous Diseases and Neurosurgery Department, Postgraduate Education Faculty; Ukraine.

Headache after craniocerebral injury is an urgent problem due to its frequent occurrence, tendency towards chronization, and strong patient disadaptation effect. Despite the significant incidence of post-traumatic headache (the PTHA) and related socioeconomic factors, many fundamental aspects of this problem have not been considered adequately. Therefore, the aim of our review is to highlight key points regarding the pathogenetic mechanisms of development, key clinical features, and strategies for optimal management of PTHA. Read More

J Pediatr Orthop B 2021 Jun 7. Epub 2021 Jun 7.

Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh Penn State University College of Medicine, Penn State College of Medicine, Hershey Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh Division of Pediatric Surgery, Penn State Hershey Children's Hospital Department of Orthopaedic Surgery, Penn State Hershey Medical Center Department of Orthopaedic Surgery, Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania, USA.

Golf carts remain a source of morbidity in children. We aimed to establish the incidence and injury characteristics of pediatric patients injured due to golf cart usage over an 11-year period. This is a retrospective study using a single state trauma database of patients ages 0-17 years admitted to a trauma center and who sustained injures while a golf cart was in use. Read More

JBJS Rev 2021 06 8;9(6). Epub 2021 Jun 8.

Departments of Orthopaedic Surgery (C.A.S., N.N.T., G.B.N., S.A.C., and J.E.V.) and Family Medicine (S.A.C.), University Hospitals Cleveland Medical Center, Cleveland, Ohio.

»: Concussion is a complex pathophysiologic process that affects the brain; it is induced by biomechanical forces, with alteration in mental status with or without loss of consciousness.

»: Concussion assessment tools may be broadly categorized into (1) screening tests such as the SAC (Standardized Assessment of Concussion), the BESS (Balance Error Scoring System), and the King-Devick (KD) test; (2) confirmatory tests including the SCAT (Sport Concussion Assessment Tool), the ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing), and the VOMS (Vestibular Oculomotor Screening); and (3) objective examinations such as brain network activation (BNA) analysis, imaging studies, and physiologic markers.

»: The KD, child SCAT3 (cSCAT3), child ImPACT (cImPACT), and VOMS tests may be used to evaluate for concussion in the pediatric athlete. Read More

Curr Sports Med Rep 2021 Jun;20(6):291-297

Division of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, UT.

Abstract: A web-based injury surveillance system was implemented through a collaboration between University of Utah researchers and the National Interscholastic Cycling Association (NICA) to better understand injury characteristics in mountain biking. Data were collected from NICA leagues during the 2018 and 2019 seasons. Injuries were tracked in 41,327 student-athlete-years, identifying 1750 unique injuries during 1155 injury events. Read More

Child Neuropsychol 2021 Jun 7:1-13. Epub 2021 Jun 7.

UPMC Sports Concussion Program, University of Pittsburgh, Pittsburgh, PA, USA.

The utilization of principal component analysis (PCA) approaches to concussion is beneficial to inform the interpretation of clinical outcome data in adolescent patients. While researchers have identified factors using post-concussive symptom scales and cognitive testing, there has yet to be a PCA that incorporates vestibular or oculomotor outcomes, or that focuses exclusively on adolescents. Moreover, the role of time since injury has not been examined in relation to concussion factors in this at-risk population. Read More

Sports Med Open 2021 Jun 7;7(1):39. Epub 2021 Jun 7.

Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Callaghan, NSW, Australia.

Background: The tackle is the most common in-play event in rugby union and rugby league (the rugby codes). It is also associated with the greatest propensity for injury and thus accounts for the most injuries in the sport. It is therefore of critical importance to accurately quantify how tackle technique alters injury risk using gold-standard methodology of three-dimensional motion (3D) capture. Read More

Front Neurol 2021 21;12:653442. Epub 2021 May 21.

Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, ON, Canada.

Concussion is associated with acute cognitive impairments, with declines in processing speed and reaction time being common. In the clinical setting, these issues are identified symptom assessments and neurocognitive test (NCT) batteries. Practice guidelines recommend integrating both symptoms and NCTs into clinical decision-making, but correlations between these measures are often poor. Read More

J Safety Res 2021 Jun 29;77:255-262. Epub 2021 Mar 29.

University of Florida, P.O. Box 118208, Gainesville, FL 32611, USA. Electronic address:

Introduction: The rate of concussions in youth soccer is among the highest of all youth sports. Parents play an important role in caring for their children and making decisions regarding whether they should participate in a sport, such as soccer, where concussions are well known. This study examined parental perceptions regarding: (a) coaches' role in concussion management, (b) heading restriction policies, and (c) overall concussion risk and participation issues. Read More

Arch Phys Med Rehabil 2021 Jun;102(6):1239

Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital and Spaulding Research Institute, MassGeneral Hospital for Children Sports Concussion Program, Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, MA.

Neurosurgery 2021 Jun 5. Epub 2021 Jun 5.

Krembil Brain Institute and Division of Neurosurgery and Canadian Concussion Centre Toronto Western Hospital University of Toronto Toronto, ON, Canada.

Transl Psychiatry 2021 Jun 4;11(1):345. Epub 2021 Jun 4.

Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada.

Post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) are highly prevalent and closely related disorders. Affected individuals often exhibit substantially overlapping symptomatology - a major challenge for differential diagnosis in both military and civilian contexts. According to our symptom assessment, the PTSD group exhibited comparable levels of concussion symptoms and severity to the mTBI group. Read More

J Emerg Med 2021 Jun 1. Epub 2021 Jun 1.

Independent Researcher, Austin, Texas. Electronic address:

Background: Rodeo is an extreme sport involving powerful forces created by large animals.

Objective: The objective of this study was to characterize rodeo-related injuries among adolescents treated at United States emergency departments (EDs).

Methods: Cases were rodeo-related injuries among patients ages 13-19 years reported to the National Electronic Injury Surveillance System during 2000-2019. Read More

Neuroscience 2021 Jun 2. Epub 2021 Jun 2.

Curtin University, Faculty of Health Sciences, Curtin Health Innovation Research Institute, Bentley, WA Australia; Perron Institute for Neurological and Translational Science, Nedlands, WA Australia. Electronic address:

Traumatic brain injury (TBI) is a common but heterogeneous injury underpinned by numerous complex and interrelated pathophysiological mechanisms. An essential trace element, iron is abundant within the brain and involved in many fundamental neurobiological processes, including oxygen transportation, oxidative phosphorylation, myelin production and maintenance, as well as neurotransmitter synthesis and metabolism. Excessive levels of iron are neurotoxic and thus iron homeostasis is tightly regulated in the brain, however, many details about the mechanisms by which this is achieved are yet to be elucidated. Read More

Curr Pain Headache Rep 2021 Jun 4;25(8):51. Epub 2021 Jun 4.

Norton Children's Neuroscience Institute, Norton Healthcare, Louisville, KY, USA.

Purpose Of Review: Post-traumatic headache is a common disorder in the pediatric age group, seen both by child neurologists and by non-neurologists. The current review of post-traumatic headache in children and adolescents aims to review the pathophysiology, risk factors, clinical features, neuroimaging, and both acute and preventive treatment options.

Recent Findings: Recent literature provides insight into specific risk factors in the pediatric age group for developing post-traumatic headache as well as unique pathophysiologic changes seen in neuroimaging and neurometabolic pathways. Read More

Cureus 2021 Apr 28;13(4):e14732. Epub 2021 Apr 28.

Internal Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA.

Background Traumatic brain injuries (TBIs), specifically concussions, affect many athletes and have dangerous immediate and long-term sequelae. Lack of awareness surrounding concussion impedes prevention, identification, and treatment. This study aims to assess parental knowledge and attitudes regarding concussions in youth baseball before and after administering an educational intervention called PitchSafe. Read More

Concussion 2021 May 14;6(2):CNC91. Epub 2021 May 14.

Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, USA.

Aim: To examine whether neck strength and symmetry are associated with psychological function in athletes with exposure to repetitive head impacts.

Methods: Collegiate soccer (n = 29) and limited/noncontact (n = 63) athletes without a history of concussion completed the Brief Symptom Inventory 18 and assessments of isometric neck strength. Neck strength symmetry was calculated as the difference in strength between opposing muscle groups. Read More

Concussion 2021 Apr 15;6(2):CNC90. Epub 2021 Apr 15.

Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Neurosurgery, Lund, Sweden.

We aimed to investigate whether selective head-neck cooling could shorten recovery after sports-related concussions (SRCs). In a nonrandomized study of 15 Swedish professional ice hockey teams, 29 concussed players received immediate head and neck cooling for ≥30 min (initiated at 12.3 ± 9. Read More

Concussion 2021 Apr 9;6(2):CNC89. Epub 2021 Apr 9.

SUNY/College of Optometry, University Eye Center, Vision Rehabilitation Service, New York, NY 10036, USA.

J Phys Ther Sci 2021 May 15;33(5):439-443. Epub 2021 May 15.

Department of Physical Therapy, Crean College of Health & Behavioral Sciences, Rinker Health Science Campus in Irvine, Chapman University: 9401 Jeronimo Rd, Irvine, CA 92618, USA.

[Purpose] Determine if female adolescent soccer players with a history of concussion, impaired K-D scores, and pre-season subjective complaints of neck pain, dizziness, and headache were predisposed to additional risk of musculoskeletal or concussive injury during 10-weeks of competitive play. [Participants and Methods] Twenty-three female high school soccer athletes provided concussion history and reported pre-season subjective complaints. K-D testing was performed pre and postseason. Read More

BMJ Open 2021 Jun 3;11(6):e044320. Epub 2021 Jun 3.

Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University, Melbourne, Victoria, Australia.

Objectives: To assess the association between soft-shell headgear (HG) use and sports-related concussion (SRC). Secondary objectives were to assess the association between HG and superficial head injury and investigate potential increase in injury risk among HG users.

Design: A systematic search in Ovid MEDLINE, Cochrane Library, Scopus, PsycINFO and SPORTDiscus was conducted in April 2020. Read More

BMJ Open Sport Exerc Med 2021 19;7(2):e001055. Epub 2021 May 19.

Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA.

Sport-related concussion has garnered increasing scientific attention and research over the last decade. Collegiate student-athletes represent an important cohort in this field. As such, the Pac-12 CARE-Affiliated Program (CAP) was formed in 2017 as a regional hub of the Concussion Assessment, Research and Education (CARE) consortium. Read More

J Sci Med Sport 2021 May 5. Epub 2021 May 5.

Colorado School of Public Health, University of Colorado Anschutz, United States of America.

Objectives: Research suggests that a recent concussion increases subsequent lower extremity injury risk; however, data in high school athletes is limited. This study evaluates the association between concussion and subsequent injury risk among male, collision sport, high school athletes over a single season.

Design: Retrospective cohort study. Read More