Occipital Neuralgia as a Sequela of Sports Concussion

Zaremski, Jason L.; Herman, Daniel C.; Clugston, James R.; Hurley, Robert W.; Ahn, Andrew H.

doi:10.1249/jsr.0000000000000121

Cited by 22 publications

(17 citation statements)

References 24 publications

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“…Bogduk underlined that most if not all studies on CeH involved patients who had a whiplash injury . Concussion can cause occipital neuralgia . Trauma can cause lesions to the cervical structures leading to persistent pain.…”

Section: Discussionmentioning

confidence: 99%

Neurostimulation for Refractory Cervicogenic Headache: A Three-Year Retrospective Study

Eghtesadi

Leroux

Fournier‐Gosselin

et al. 2018

Neuromodulation: Technology at the Neural Interface

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Section: Discussionmentioning

confidence: 99%

Neurostimulation for Refractory Cervicogenic Headache: A Three-Year Retrospective Study

Eghtesadi

Leroux

Fournier‐Gosselin

et al. 2018

Neuromodulation: Technology at the Neural Interface

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“…A review in 2006 [3] found that PTH is often characterized by symptoms similar to other primary headache disorders, such as migraine and tension-type, as well as cervicogenic headaches. Also, occipital neuralgia has been implicated in PTH [4]. The preceding two cases illustrate another potential cause of headache in a concussed athlete: intracranial hypotension.…”

Section: Discussionmentioning

confidence: 99%

Intracranial Hypotension in the Setting of Post-Concussion Headache: A Case Series

Pettyjohn

Donlan²,

Breck

et al. 2020

Cureus

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Intracranial hypotension can be a common sequela of a cerebrospinal fluid (CSF) leak. However, evidence of such a condition related to an injury in American football is currently lacking in the literature. While a positional or orthostatic headache is the most classic symptom of headaches due to intracranial hypotension, a variety of nonspecific symptoms such as neck pain, nausea, vomiting, photophobia, phonophobia, and visual changes can also be present. We present two cases where collegiate American football players developed protracted headaches after a concussive injury and were subsequently diagnosed with intracranial hypotension thought secondary to spinal CSF leaks. Both players underwent multiple procedures of fluoroscopic-guided autologous blood patching, with improvement in their headaches. Recovery varied between the athletes. Case 1 achieved full resolution of his headaches and returned to full activity. Case 2 continued to have intermittent headaches after blood patching, but the positional nature had resolved and he was cleared for full participation in football and was closely followed during the remainder of his collegiate career. Both these cases emphasize the importance of including CSF leak as a cause of post-traumatic headache in an American football player.

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“…101 One of the underlying mechanisms behind this may be cranial nerve trauma, including the vagus nerve which regulates the ANS, 102,103 either as a direct result of impact, or as a secondary effect based on changes in arthrokinematics and joint degeneration. 104,105 Cervical trauma has been linked to oculomotor deficiencies 32,106,107 and whether as a result of whiplash or otherwise, issues with convergence, accommodation and saccades occur regularly after mTBI and often lingers in patients with PCS. 19,108 Screening for this, and possibly referring to neuro-ophthalmologic treatment, is recommended.…”

Section: Best Research Evidencementioning

confidence: 99%

An active approach in the treatment of post-concussion syndrome - Evidence-based practice in a collective case study

Christensen

Kyvsgaard

Vindelev

et al. 2020

Preprint

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Rational, Aims and Objectives: Prolonged symptoms after a mTBI, known as Post-Concussion Syndrome (PCS), remains a challenging area of rehabilitation. Evidence shows that an active approach can improve prognosis, however PCS is a multifaceted condition with many comorbidities and large variety in patient response. This study investigated the use of submaximal aerobic exercise and body awareness therapy, and the influence on symptoms in PCS cases, viewed through the lens of evidence-based practice (EBP). Method: Four cases were separated into two case studies. Cases in Study A received an aerobic exercise protocol consisting of 8 individual sessions distributed twice a week over 4 weeks, with additional cervical endurance training. Cases in Study B received a body awareness therapy protocol consisting of 6 guided practices distributed twice a week over 3 weeks. Using method triangulation, both quantitative and qualitative data were gathered through the use of the Rivermead Post-Concussion Questionnaire (RPQ) and semi-structured interviews, as well as the Craniocervical Flexion Test (CCFT) in Study A, and the Short Form-36v2 (SF-36) questionnaire in study B. Lastly, research evidence on PCS was included to contextualize cases. Results: Both cases in Study A showed marked improvements in their RPQ scores, but only one showed improvement in the CCFT. In Study B, one case improved in RPQ score and in the mental component of SF-36v2, while the other case did not experience any significant change. All cases expressed positive associations with the interventions during the interviews. Conclusion: These results illustrate how an active and individualized approach can represent important qualities that can be applied to further and larger studies. Based on the results and discussion of this paper, relevant findings and suggestions are summarized in a modified EBP model, which may be of help to practitioners in dealing with PCS patients in the clinical practice.

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Occipital Neuralgia as a Sequela of Sports Concussion

Cited by 22 publications

References 24 publications

Neurostimulation for Refractory Cervicogenic Headache: A Three-Year Retrospective Study

Neurostimulation for Refractory Cervicogenic Headache: A Three-Year Retrospective Study

Intracranial Hypotension in the Setting of Post-Concussion Headache: A Case Series

An active approach in the treatment of post-concussion syndrome - Evidence-based practice in a collective case study

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