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{{Concussion}}
{{Concussion}}


==Diagnosis==
==[[Concussion overview|Overview]]==
 
==[[Concussion historical perspective|Historical Perspective]]==
 
==[[Concussion classification|Classification]]==
 
==[[Concussion pathophysiology|Pathophysiology]]==
 
==[[Concussion causes|Causes]]==
 
==[[Concussion differential diagnosis|Differentiating Concussion from other Diseases]]==


==[[Concussion epidemiology and demographics|Epidemiology and Demographics]]==


==[[Concussion risk factors|Risk Factors]]==


Concussion may be under-diagnosed.  The lack of the highly noticeable signs and symptoms that are frequently present in other forms of head injury could lead [[clinician]]s to miss the injury, and athletes may cover up their injuries in order to be allowed to remain in the competition.<ref name="BarthVarney99"/>  A retrospective survey in 2005 found that more than 88% of concussions go unrecognized.<ref name="Delaney">
==[[Concussion natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
{{
cite journal |author=Delaney JS, Abuzeyad F, Correa JA, Foxford R |title=Recognition and characteristics of concussions in the emergency department population |journal=Journal of Emergency Medicine |volume=29 |issue=2 |pages=189–197 |year=2005 |pmid=16029831 |doi=10.1016/j.jemermed.2005.01.020
}}
</ref>


==Dementia pugilistica==
==Diagnosis==
[[Concussion diagnostic criteria|Diagnostic Criteria]] | [[Concussion history and symptoms|History and Symptoms]] | [[Concussion physical examination|Physical Examination]] | [[Concussion CT|CT]] | [[Concussion MRI|MRI]] | [[Concussion other imaging findings|Other Imaging Findings]] | [[Concussion other diagnostic studies|Other Diagnostic Studies]]


{{main|Dementia pugilistica}}
==Treatment==
Chronic [[encephalopathy]] is an example of the cumulative damage that can occur as the result of multiple concussions or less severe blows to the head.  The condition called [[dementia pugilistica]], or "punch drunk" syndrome, which is associated with boxers, can result in cognitive and physical deficits such as [[parkinsonism]], speech and memory problems, slowed mental processing, tremor, and inappropriate behavior.<ref name="Mendez">
[[Concussion medical therapy|Medical Therapy]] | [[Concussion primary prevention|Primary Prevention]] | [[Concussion secondary prevention|Secondary Prevention]] | [[Concussion cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Concussion future or investigational therapies|Future or Investigational Therapies]]
{{
cite journal |author=Mendez MF |title=The neuropsychiatric aspects of boxing |journal=International Journal of Psychiatry in Medicine |volume=25 |issue=3 |pages=249–262 |year=1995 |pmid=8567192 |doi=
}}
</ref>  It shares features with Alzheimer's disease.<ref name="Jordan00">
{{
cite journal |author=Jordan BD |title=Chronic traumatic brain injury associated with boxing |journal=Seminars in Neurology |volume=20 |issue=2 |pages=179–85 |year=2000 |pmid=10946737 |doi=10.1055/s-2000-9826
}}
</ref>


===Second-impact syndrome===
==Case Studies==
{{main|Second-impact syndrome}}
[[Concussion case study one|Case #1]]
Second-impact syndrome, in which the brain swells dangerously after a minor blow, may occur in very rare cases. The condition may develop in people who receive a second blow days or weeks after an initial concussion, before its symptoms have gone away.<ref name="Bowen03"/>  No one is certain of the cause of this often fatal complication, but it is commonly thought that the swelling occurs because the brain's [[arteriole]]s lose the ability to regulate their diameter, causing a loss of control over cerebral blood flow.<ref name=moser/> As the brain [[swelling|swells]], intracranial pressure rapidly rises.<ref name="CookSchweer"/> The brain can [[brain herniation|herniate]], and the brain stem can fail within five minutes.<ref name="Bowen03"/> Except in boxing, all cases have occurred in athletes under age&nbsp;20.<ref name="Team"/>  Due to the very small number of documented cases, the diagnosis is controversial, and doubt exists about its validity.<ref name=McCroryP01>
{{
cite journal|author=McCrory P |date=2001 |title=Does second impact syndrome exist? |journal=Clinical Journal of Sport Medicine |volume=11 |issue=3 |pages=144–149 |pmid=11495318
}}
</ref>


==Related Chapters==
==Related Chapters==
*[[Post-concussion syndrome]]
*[[Post-concussion syndrome]]
*[[Second-impact syndrome]]
*[[Dementia pugilistica]]




== References ==
{{Reflist|2}}


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{{Injuries, other than fractures, dislocations, sprains and strains}}
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Latest revision as of 21:03, 29 July 2020

For patient information, click here

Concussion
Deceleration can exert rotational forces in the brain, especially the midbrain and diencephalon.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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