Head Injury

Strauss, Israel

doi:10.1001/archneurpsyc.1934.02250050011001

Cited by 80 publications

(5 citation statements)

References 64 publications

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“…The authors identified the syndrome by commonly reported symptoms of severe headache, irritability, memory problems, and dizziness, with symptoms persisting for months or years after the immediate consequences of head injury abated [12]. Not only did the 1934 article fully cover the clinical aspects and diagnosis of post-concussion syndrome it also suggested that multiple mild concussions, not just one severe concussion that results in unconsciousness, could lead to these lingering symptoms.…”

Section: Post-concussion Syndrome and The 'Accumulative Thing'mentioning

confidence: 99%

Epidemiology of neurodegeneration in American-style professional football players

Lehman

2013

Alzheimers Res Ther

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The purpose of this article is to review the history of head injuries in relation to American-style football play, summarize recent research that has linked football head injuries to neurodegeneration, and provide a discussion of the next steps for refining the examination of neurodegeneration in football players. For most of the history of football, the focus of media reports and scientific studies on football-related head injuries was on the acute or short-term effects of serious, traumatic head injuries. Beginning about 10 years ago, a growing concern developed among neurologists and researchers about the long-term effects that playing professional football has on the neurologic health of the players. Autopsy-based studies identified a pathologically distinct neurodegenerative disorder, chronic traumatic encephalopathy, among athletes who were known to have experienced concussive and subconcussive blows to the head during their playing careers. Football players have been well represented in these autopsy findings. A mortality study of a large cohort of retired professional football players found a significantly increased risk of death from neurodegeneration. Further analysis found that non-line players were at higher risk than line players, possibly because of an increased risk of concussion. Although the results of the studies reviewed do not establish a cause effect relationship between football-related head injury and neurodegenerative disorders, a growing body of research supports the hypothesis that professional football players are at an increased risk of neurodegeneration. Significant progress has been made in the last few years on detecting and defining the pathology of neurodegenerative diseases. However, less progress has been made on other factors related to the progression of those diseases in football players. This review identifies three areas for further research: (a) quantification of exposure - a consensus is needed on the use of clinically practical measurements of blows to the head among football players; (b) genetic susceptibility factors - a more rigorous set of unbiased epidemiological and clinical studies is needed before any causal relationships can be drawn between suspected genetic factors, head injury, and neurodegeneration; and (c) earlier detection and prevention of neurodegenerative diseases.

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Section: Post-concussion Syndrome and The 'Accumulative Thing'mentioning

confidence: 99%

Epidemiology of neurodegeneration in American-style professional football players

Lehman

2013

Alzheimers Res Ther

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“…The prevalence of persistent PCS is difficult to determine because of the variability in the definition and the criteria used to diagnose. In some studies, the incidence ranged from 5% to 15% [2][3][4], while, in others, it could be as high as 58% [8]. A recent systematic review of studies reporting persistent symptoms of PCS in adults found prevalence estimates ranging from 7% to 58%, with the overall pooled prevalence being 32% (95% CI: 24-41%) [9].…”

Section: Mechanisms and Predisposing Factors For Persistent Post-conc...mentioning

confidence: 99%

“…Post-concussion syndrome (PCS) is a sequela of traumatic brain injury (TBI), clinically characterized by complex symptoms that includes headache, dizziness, neuropsychiatric symptoms, and cognitive impairment [1]. Although the term "post-concussion syndrome" has been used since 1934 [2], it is more appropriate to use the term "post-TBI syndrome", as it may also occur after moderate and severe TBI or even sub-concussive head impacts [1]. There is controversy regarding PCS when its symptoms are exhibited for longer than usual [3].…”

Section: Introductionmentioning

confidence: 99%

Functional Overlay Model of Persistent Post-Concussion Syndrome

et al. 2023

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Persistent post-concussion syndrome (PPCS) is a complex and debilitating condition that can develop after head concussions or mild traumatic brain injury (mTBI). PPCS is characterized by a wide range of symptoms, including headaches, dizziness, fatigue, cognitive deficits, and emotional changes, that can persist for months or even years after the initial injury. Despite extensive research, the underlying mechanisms of PPCS are still poorly understood; furthermore, there are limited resources to predict PPCS development in mTBI patients and no established treatment. Similar to PPCS, the etiology and pathogenesis of functional neurological disorders (FNDs) are not clear neither fully described. Nonspecific multifactorial interactions that were also seen in PPCS have been identified as possible predispositions for FND onset and progression. Thus, we aimed to describe a functional overlay model of PPCS that emphasizes the interplay between functional and structural factors in the development and perpetuation of PPCS symptoms. Our model suggests that the initial brain injury triggers a cascade of physiological and psychological processes that disrupt the normal functioning of the brain leading to persistent symptoms. This disruption can be compounded by pre-existing factors, such as genetics, prior injury, and psychological distress, which can increase the vulnerability to PPCS. Moreover, specific interventions, such as cognitive behavioral therapy, neurofeedback, and physical exercise can target the PPCS treatment approach. Thus, the functional overlay model of PPCS provides a new framework for understanding the complex nature of this condition and for developing more effective treatments. By identifying and targeting specific functional factors that contribute to PPCS symptoms, clinicians and researchers can improve the diagnosis, management, and ultimately, outcomes of patients with this condition.

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“…In the late 1800s, Erichsen believed that hysteria was over‐diagnosed and misdiagnosed and argued that mild head injuries could result in severe disability because of true injuries of the central nervous system –“concussion of the spine” or “subacute cerebral meningitis and arachnitis.” 24 The American neurosurgeon Dr. Harvey Cushing opined in 1908 that “although no objective signs accompany these [PTH] complaints, they are so uniform from case to case that the symptoms cannot be regarded as other than genuine” (courtesy of Dr. John Edmeads, personal communication, 2006). Strauss indicated that “failure to understand the problem is no proof of psychogenicity.” 25,26 Dr. William Speed, past‐president of the American Headache Society, advocated strongly for the validity of PTH based on organic or physical underpinnings, stating that “it is essential that physicians recognize that minor head trauma can lead to devastating effects on an individual to the point of totally disrupting one's life for long periods of time and that these symptoms are real and not the manifestations of a primary emotional disorder.” 27…”

Section: The History Of Pth: From Psychoneurosis To Compensation Neurmentioning

confidence: 99%

“…Strauss indicated that "failure to understand the problem is no proof of psychogenicity." 25,26 Dr. William Speed, past-president of the American Headache Society, advocated strongly for the validity of PTH based on organic or physical underpinnings, stating that "it is essential that physicians recognize that minor head trauma can lead to devastating effects on an individual to the point of totally disrupting one's life for long periods of time and that these symptoms are real and not the manifestations of a primary emotional disorder." 27…”

Section: The History Of Pth: From Psychoneurosis To Compensation Neurmentioning

confidence: 99%

From Psychoneurosis to ICHD‐2: An Overview of the State of the Art in Post‐Traumatic Headache

Gladstone

2009

Headache

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Post-traumatic headache (PTH) is an important public health issue - head injuries are common, headache is the most common sequelae of head injuries, and PTH can be particularly disabling. Fortunately, for most individuals with PTH, the headache gradually dissipates over a period of several days, weeks, or months either spontaneously or aided by non-pharmacologic and/or pharmacologic management. Regrettably, for a minority of head-injured individuals, the PTH is intractable and disabling despite aggressive and comprehensive treatment. Unfortunately, there are many prejudices against individuals with PTH. Frequently, the presence or absence of litigation and/or the mechanism of head injury (sports-related trauma, slip-and-fall injury, motor vehicle accident, or military service-related injury) biases physicians' views on the legitimacy of the patient's PTH. Accordingly, this review attempts to summarize the state of the art of our understanding of PTH. This clinical review highlights: (a) views on PTH throughout the last few centuries, (b) the ICHD-2 classification of PTH, (c) the epidemiology of head injuries and PTH, (d) the clinical characteristics of PTH, (e) PTH related postconcussive symptoms, (f) pathophysiology of PTH, (g) evaluation of PTH, and (h) management of PTH.

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Head Injury

Cited by 80 publications

References 64 publications

Epidemiology of neurodegeneration in American-style professional football players

Epidemiology of neurodegeneration in American-style professional football players

Functional Overlay Model of Persistent Post-Concussion Syndrome

From Psychoneurosis to ICHD‐2: An Overview of the State of the Art in Post‐Traumatic Headache

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