Tag Archives: Diagnosis
An estimated 1.6 to 3.8 million traumatic brain injuries occur every year, according to the Centers for Disease Control and Prevention. More than 75 percent of the injuries are sports-related mild traumatic brain injuries or concussions.
While this issue is being recognized at the professional and elite levels, many youth and collegiate athletic programs across the U.S. lack the adequate medical personnel, specifically concussion specialists, to handle these injuries on the sidelines in real time.
Doctors at Mayo Clinic, in collaboration with the Northern Arizona University football team, conducted a study, Feasibility and Accuracy of Teleconcussion for Acute Evaluation of Suspected Concussion, which was recently published in the journal Neurology. The study, funded by Mayo Clinic, focuses on concussion specialists using telemedicine technology to determine if a player needs to be removed from play in real time.
“Telemedicine has been shown to be a safe and effective means to evaluate and treat numerous acute neurologic conditions, including stroke,” says Amaal Starling, M.D., neurologist and concussion expert at Mayo Clinic. “Now, doctors are starting to explore using telemedicine to manage concussions.”
Dr. Starling and Bert Vargas, M.D., director of the concussion program at UT Southwestern Medical Center, evaluated 11 consecutive male collegiate football players who suffered from a suspected concussion over two football seasons. All athletes received face-to-face baseline examination scores, including a symptom severity checklist, Standardized Assessment of Concussion, King-Devick test, and modified Balance Error Scoring System.
In total, 123 athletes were enrolled in the study, 50 of whom participated through two seasons.
During two football seasons, athletes with suspected concussions were evaluated in person by Northern Arizona University medical personnel and certified athletic trainers. Simultaneously, Dr. Vargas or Dr. Starling would perform a concussion examination via a telemedicine robot.
“During the remote examination, we had the ability to ask additional questions and repeat any portion of the physical evaluation,” says Dr. Vargas. “The decision as to whether or not the athlete should be removed from play was made by both the athletic trainer and neurologist.”
Both physicians had high agreement with the evaluation scoring and 100 percent agreement of the most important decision — removal from play. This suggests neurologists may be able to use telemedicine to manage concussions, make removal from play decisions, and close the gaps in medical care by providing all collegiate and youth athletes similar concussion care as professional athletes receive.
Concussion Legacy Foundation: More Than 100 Former College Football Players Have Now Been Diagnosed with CTE
|The Concussion Legacy Foundation announced yesterday that former players from over 100 college football programs have now been diagnosed with chronic traumatic encephalopathy (CTE) at the VA-BU-CLF Brain Bank. 15 colleges have had 3 or more confirmed cases, and those schools have combined for 64 national championships. Every conference within the Power 5 (ACC, Big 10, Big 12, Pac 12 and SEC) has at least one school represented in those 15 colleges with the most CTE diagnoses.
“This information is being released to raise awareness that CTE is not just an issue for professional football players,” said our co-founder and CEO Chris Nowinski. “The data should not be interpreted to say that players from these schools are at greater risk than other college players. Instead, the data shows the widespread reach of this disease, and the commitment by the alumni and their families of these schools to support CTE research by participating in brain donation.”
Sustaining a concussion during adolescence may be more common than previous estimates, according to researchers presenting their study recently at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Annual Meeting in Colorado Springs, CO.
“Our team looked at the administrative health records of more than 8.8 million members of a large private payer insurance group and noted that 32 percent of the individuals diagnosed with concussion were between the ages of 10-19 years old with the largest increase in incidence between 2007 and 2014 in that age group. This is the first study to evaluate trends in concussion diagnoses across the general US population in a variety of age groups,” said lead author, Alan L. Zhang, MD from the University of California San Francisco Medical Center.
The highest incidence of concussion was seen in the 15-19 age group (16.5 cases per 1,000 patients) followed by the 10-14 (10.5 per 1,000), 20-24 (5.2 per 1,000) and 5-9 (3.5 per 1,000) age groups. Overall, there was a 60% increase in concussion incidence from 2007-2014. The largest increases were in the 10-14 (143%) and 15-19 (87%) age groups. Fifty-six percent of concussions were diagnosed in the emergency room and 29% in a physician’s office with the remainder being seen in urgent care or inpatient settings.
Zhang and his team also noted that irrespective of sport, the incidence of concussion in male patients was one and a half times higher than that in female patients.
“The rates at which concussions are rising may in part be due to the rise in youth sports participation and also better diagnostic skills/training for coaches and sports medicine professionals. This trend is alarming however, and the youth population should definitely be prioritized for ongoing work in concussion diagnosis, education, treatment and prevention,” said Zhang.