12 / 26
Page 56
Notes:
allied
academies
March 14-16, 2019 | London, UK
12
th
International Conference on
8
th
International Conference on
Vascular Dementia and Dementia
Neurological Disorders and Stroke
Joint Event
&
Journal of Brain and Neurology | Volume 3
The many faces of Concussion
David Wang
Connecticut Children’s Medical Center, USA
P
reviously stated in the international consensus statements,
a concussion is defined as a complexed pathophysiologic
process. Inherent in the term “complexed pathophysiologic
process” is the fact that the presentation of concussion can
be widely varied. Concussion presentations include variable
symptoms, symptom clusters, and severities. Consequently, the
diagnosis of concussion has not always been straightforward,
especially when premorbid conditions exist. Those who
evaluate concussions are saddled with the fact that they must
often rely upon the patient’s reported symptoms. These well-
recognized symptoms are often followed until there has been
a resolution of the concussion. To help diagnose concussions,
easy to administer neurocognitive tests were created. These
neurocognitive tests, which were once relied upon, are now
being used less frequently due to the inherent weaknesses
and inconsistencies of the tests. Concussion diagnosis is now
facilitated by other more measurable deficiencies such as
ocular motor dysfunction, balance impairments, or impaired
physiologic response to exercise. More recently, biomarkers
have been studied to help facilitate the diagnosis of concussion,
but are not yet proven to be effective in the management of
concussion within the general population. To date, imaging
studies have been ineffective in the diagnosis of concussion,
as a concussion is a functional injury rather than a structural
one. More advanced imaging studies such as DTI MRI’s and
functional MRI’s are being studied at research centers, but are
not ready to be used outside of the research environment.
Outside of imaging, a functional assessment of concussion
using EEG or a variant of EEG is also being studied. Although
there is an abundance of new and exciting research currently
being performed regarding the diagnosis of concussion, the
mainstay of the current concussion diagnosis and management
still relies upon a thorough history and physical examination
.
e:
dhwang@comcast.net