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Concussion: Determining Safe Return to Activity in the College Health Setting

Concussion: Determining Safe Return to Activity in the College Health Setting. Brian Vesci, MA, ATC Senior Athletic Trainer Boston University vesci@bu.edu. Disclosures.

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Concussion: Determining Safe Return to Activity in the College Health Setting

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  1. Concussion: Determining Safe Return to Activity in the College Health Setting Brian Vesci, MA, ATC Senior Athletic Trainer Boston University vesci@bu.edu

  2. Boston University Athletic Training Services Disclosures • Neither I, Brian Vesci, nor any family members, have any relevant financial relationships to be discussed, directly or indirectly, referred to or illustrated with or without recognition within the presentation

  3. Boston University Athletic Training Services Concussion History1

  4. Boston University Athletic Training Services Physical and Cognitive Rest2,3

  5. Boston University Athletic Training Services

  6. Boston University Athletic Training Services Graduated Return to Activity3

  7. Boston University Athletic Training Services Increased Risk of Injury Post Concussion2,3,4,5

  8. Boston University Athletic Training Services Higher Level Language Function6,7

  9. Boston University Athletic Training Services BU Center for the Study of Traumatic Encephalopathy http://www.bu.edu/cste/

  10. Boston University Athletic Training Services Medial Temporal Lobe8 John Grimsley 65 Year old control 73 Year old boxer

  11. Boston University Athletic Training Services Frontal Cortex8 John Grimsley 65 Year old control 73 Year old boxer

  12. Boston University Athletic Training Services 18 Year Old Frontal Cortex8

  13. Boston University Athletic Training Services The Future • Serum s100b protein levels9,10 • >0.32 μg/L • <0.10 μg/L • Docosahexaenoic acid (DHA)11,12 • Silent information regulator 2 (Sir2)

  14. Boston University Athletic Training Services References • Valovich McLeod TC, Bay RC, Heil J, McVeigh SD. Identification of Sport and Recreational Activity Concussion History Through the Pre-Participation Screening and a Symptom Survey in Young Athletes. Clinical Journal of Sport Medicine. 2008;18(3):235-240. • Guskiewicz KM, Bruce SL, Cantu RC, Michael SF, Kelly JP, McCrea M, Putukian M, McLeod TCV. National Athletic Trainers’ Association position statement: management of sports-related concussion. J Athl Train. 2004;39(3):280-297. • McCrory P, Meeuwisse W, Johnston K, Dvorak J, Aubry M, Molloy M, Cantu R. Consensus statement on concussion in sport: the 3rd international conference on concussion in sport held in Zurich, November 2008. Brit J Sports Med. 2009;43:176-184. • Faul M, Xu L, Walk MM, Coronado VG. Traumatic brain injury in the United States; emergency department visits, hospitalizations, and deaths. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2010. • McCrea M, Guskiewicz K, Randolph C, Barr WB, Hammeke TA, Marshall SW, Kelly JP. Effects of a symptom-free waiting period on clinical outcome and risk of reinjury after sport-related concussion. Neurosurgery. 2009;65(5):876-883. • Brooks J, Fos LA, Greve KW, Hammond JS. Assessment of executive function in patients with mild traumatic brain injury. Trauma. 1999;46(1):159-163.

  15. Boston University Athletic Training Services References • Lipton ML, Gulko E, Zimmerman ME, Friedman BW, Kim M, Gellella E, Gold T, Shifteh K, Ardekani BA, Branch CA. Diffusion-tensor imaging implicates prefrontal axonal injury in executive function impairment following very mild traumatic brain injury. Radiology. 2009;252(3):816-824. • Boston University Center for the Study of Traumatic Encephalopathy. http://www.bu.edu/cste/case-studies/. Updated May 3, 2011. Accessed May 30, 2011. • Townend WJ, Guy MJ, Pani MA, Martin B, Yates DW. Head injury outcome prediction in the emergency department: a role for protein S-100B? J Neurol Neurosurg Pshychiatry. 2002;73:542-546. • Biberthaler P, Linsenmeier U, Pfeifer K, Kroetz M, Mussak T, Kanz K, Hoecherl EF, Jonas F, Marzi I, Leucht P, Jochum M, Mutschler W. Serum S-100B concentration provides additional information for the idication of computed tomography in patients after minor head injury: a prospective multicenter study. SHOCK. 2006;25(5):446-453. • Wu A, Ying Z, Gomez-Pinilla F. Omega-3 fatty acids supplementation restores mechanisms that maintain brain homeostasis in traumatic brain injury. J Neurotrauma. 2004;24(10):1587-1595. • Conklin SM, Gianaros PJ, Brown SM, Yao JK, Hariri AR, Manuck SB, Muldoon MF. Long-chain omega-3 fatty acid intake is associated positively with corticolimbic gray matter volume in healthy adults. Neuroscience Letters. 2007;421:209-212.

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