Concussion Concussion Update Update Wayne A. Gordon, Ph.D., ABPP Wayne A. Gordon, Ph.D., ABPP Jack Nash Professor & Vice Chair Jack Nash Professor & Vice Chair Department of Rehabilitation Medicine Department of Rehabilitation Medicine [email protected][email protected]1
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Concussion Update Wayne A. Gordon, Ph.D., ABPP Jack Nash Professor & Vice Chair Department of Rehabilitation Medicine [email protected] 1.
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Concussion UpdateConcussion Update
Wayne A. Gordon, Ph.D., ABPPWayne A. Gordon, Ph.D., ABPPJack Nash Professor & Vice ChairJack Nash Professor & Vice Chair
Department of Rehabilitation MedicineDepartment of Rehabilitation [email protected]@mssm.edu
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GoalsGoals
• Define concussion.Define concussion.
• Review symptoms of concussion.Review symptoms of concussion.
• Review prevalence of concussion in Review prevalence of concussion in
children.children.
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What is concussion?What is concussion?
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• Concussion is a brain injury and is Concussion is a brain injury and is
defined as a complex physiological defined as a complex physiological
process affecting the brain.process affecting the brain.
(Consensus statement on concussion in sport: 4(Consensus statement on concussion in sport: 4thth
International Conference on Sport held in Zurich, International Conference on Sport held in Zurich,
November, 2012. McCory, P. et al. British Journal of November, 2012. McCory, P. et al. British Journal of
Sports Medicine, 2013)Sports Medicine, 2013)
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• TBI is an alteration in brain function TBI is an alteration in brain function
caused by an external force. caused by an external force.
(Menon, et al. Arch. Phys. Med. Rehabil., 2010)(Menon, et al. Arch. Phys. Med. Rehabil., 2010)
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• Symptoms of a concussion may appear Symptoms of a concussion may appear immediately or emerge over time.immediately or emerge over time.
• Learning or behavioral difficulties may not Learning or behavioral difficulties may not emerge until school becomes more emerge until school becomes more demanding.demanding.
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What do we know about the prevalence of What do we know about the prevalence of concussion in children?concussion in children?
• 3 month follow up of 406 children seen in the ED3 month follow up of 406 children seen in the ED
-- At 3 months post-injury 29% had post-At 3 months post-injury 29% had post-
concussion concussion syndrome.syndrome.
-- 7.4 days of school missed (+/-) 13.9 days.7.4 days of school missed (+/-) 13.9 days.
• Most common symptom reported was headache Most common symptom reported was headache
followed by fatigue, frustration, dizziness, followed by fatigue, frustration, dizziness,
concentration and memory difficulties.concentration and memory difficulties.
(Butler et al. JAMA, Neurology, 2013)(Butler et al. JAMA, Neurology, 2013)
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• 20% of Ontario students in grades 7-12 sustained a 20% of Ontario students in grades 7-12 sustained a
TBI (LOC > 5 minutes) at some point in their life.TBI (LOC > 5 minutes) at some point in their life.
• 5.6% sustained a TBI last year.5.6% sustained a TBI last year.
(Ilie, et al JAMA, 2013)(Ilie, et al JAMA, 2013)
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Screening of 134 kids at 12-19 in 3 NYC Screening of 134 kids at 12-19 in 3 NYC schoolsschools
• 9% high probability of TBI.9% high probability of TBI.
• 80% of the 9% had neuropsychological evidence of 80% of the 9% had neuropsychological evidence of