A Review of the Postconcussion Syndrome

Szymanski, Herman V.; Linn, Richard T.

doi:10.2190/xara-b1ef-j2hc-vae0

Cited by 43 publications

(22 citation statements)

References 50 publications

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“…It has been associated with conditions that are frequently reported after TBI, such as depression, pain, and disturbed sleep. [6][7][8][9][10][11] PTBIF has also been associated with neuroendocrine abnormalities. 12 In addition, there is empirical support for the "coping hypothesis" proposed by van Zomeren, Brouwer, and Deelman that suggests that the injured brain is more subject to fatigue because it is required to "work harder" in order to compensate for impairments to cognitive functions such as attention and processing speed.…”

Section: Etiology Of Post-tbi Fatiguementioning

confidence: 99%

Fatigue After Traumatic Brain Injury and Its Impact on Participation and Quality of Life

Cantor

Ashman

Gordon

et al. 2008

Journal of Head Trauma Rehabilitation

238

122

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PTBIF has significant impact on well-being and quality of life and cannot be accounted for by comorbid conditions alone, suggesting that it is related to brain injury itself. It appears to be unrelated to demographic and injury variables other than gender. PTBIF does not limit the quantity and frequency of participation. Future research should focus on the relationship between fatigue and the quality of participation.

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Section: Etiology Of Post-tbi Fatiguementioning

confidence: 99%

Fatigue After Traumatic Brain Injury and Its Impact on Participation and Quality of Life

Cantor

Ashman

Gordon

et al. 2008

Journal of Head Trauma Rehabilitation

238

122

View full text Add to dashboard Cite

show abstract

“…44 Others have maintained that PCS may be more strongly associated with pre-or postinjury psychological factors. 45 Rutherford 46 hypothesized that the delayed onset of PCS (days to weeks) often coincides with patients' return to daily activities. Although plausible, such an explanation does not account for the immediate onset of symptoms, such as headaches, dizziness, and nausea, in patients who have been exposed to blasts and have mTBI.…”

Section: Epidemiology Of Bitbimentioning

confidence: 99%

Traumatic Brain Injury and Vestibular Pathology as a Comorbidity After Blast Exposure

Scherer

Schubert²

2009

Physical Therapy

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Blasts or explosions are the most common mechanisms of injury in modern warfare. Traumatic brain injury (TBI) is a frequent consequence of exposure to such attacks. Although the management of orthopedic, integumentary, neurocognitive, and neurobehavioral sequelae in survivors of blasts has been described in the literature, less attention has been paid to the physical therapist examination and care of people with dizziness and blast-induced TBI (BITBI). Dizziness is a common clinical finding in people with BITBI; however, many US military service members who have been exposed to blasts and who are returning from Iraq and Afghanistan also complain of vertigo, gaze instability, motion intolerance, and other symptoms consistent with peripheral vestibular pathology. To date, few studies have addressed such "vestibular" complaints in service members injured by blasts. Given the demonstrated efficacy of treating the signs and symptoms associated with vestibular pathology, vestibular rehabilitation may have important implications for the successful care of service members who have been injured by blasts and who are complaining of vertigo or other symptoms consistent with vestibular pathology. In addition, there is a great need to build consensus on the clinical best practices for the assessment and management of BITBI and blast-related dizziness. The purpose of this review is to summarize the findings of clinicians and scientists conducting research on the effects of blasts with the aims of defining the scope of the problem, describing and characterizing the effects of blasts, reviewing relevant patients' characteristics and sensorimotor deficits associated with BITBI, and suggesting clinical best practices for the rehabilitation of BITBI and blast-related dizziness.

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“…It has been hypothesised that PCS are caused by microstructural damage to the brain due to shearing injury, which is not detectable with conventional imaging, and may be responsible for a functional deficit [Bigler, 2001[Bigler, , 2003King, 1997;Lishman, 1988;Szymanski and Linn, 1992]. A compensatory mechanism of the brain could explain the discrepancy between the subjective severity of cognitive complaints and-near-normal findings on neuropsychological testing [Audoin et al, 2003].…”

Section: Introductionmentioning

confidence: 99%

Postconcussion syndrome after minor head injury: Brain activation of working memory and attention

Smits¹,

Dippel²,

Houston³

et al. 2008

Human Brain Mapping

110

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After minor head injury (MHI) postconcussive symptoms (PCS) such as memory and attention deficits frequently occur. It has been hypothesised that PCS are caused by microstructural damage to the brain due to shearing injury, which is not detectable with conventional imaging, and may be responsible for a functional deficit. The purpose of this study was to correlate functional magnetic resonance imaging brain activation of working memory and selective attention with PCS. 21 MHI patients and 12 healthy controls were scanned at 3T. Stimulation paradigms were the n-back and Counting Stroop tasks to engage working memory and selective attention, respectively. Functional data analysis consisted of random effects group analyses, correlating brain activation patterns with the severity of PCS as evaluated with the Rivermead postconcussion symptoms questionnaire. At minimal working memory load, activation was seen in patients with greater severity of PCS in the working memory network. With an increase of working memory load, increase of activation was more pronounced in patients with greater severity of PCS. At high and increased working memory load, activation associated with the severity of PCS was seen in the posterior parietal area, parahippocampal gyrus, and posterior cingulate gyrus. Activation related to selective attention processing was increased with greater severity of PCS. The increased activity in relation to working memory and attention, and the recruitment of brain areas outside the working memory network at high working memory load, may be considered a reflection of the brain's compensatory response to microstructural injury in patients with PCS.

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A Review of the Postconcussion Syndrome

Cited by 43 publications

References 50 publications

Fatigue After Traumatic Brain Injury and Its Impact on Participation and Quality of Life

Fatigue After Traumatic Brain Injury and Its Impact on Participation and Quality of Life

Traumatic Brain Injury and Vestibular Pathology as a Comorbidity After Blast Exposure

Postconcussion syndrome after minor head injury: Brain activation of working memory and attention

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