Lack of Sleep and Stress Can Lead to Symptoms Resembling Concussion

AHA Publisher — Thu, 28 Jan 2021 08:00:12 +0000

Ohio State University via EurekAlert – COLUMBUS, Ohio – A new study suggests that a lot of people might be going through life with symptoms that resemble concussion – a finding supporting researchers’ argument that athletes recovering from a brain injury should be assessed and treated on a highly individualized basis. In the national study, between 11% and 27% of healthy college athletes with no history of a recent concussion reported combinations of symptoms that met criteria for post-concussion syndrome (PCS) as defined by an international classification system. Among the nearly 31,000 student-athletes surveyed, three factors stood out as the most likely to predict PCS-like symptoms: lack of sleep, pre-existing mental health problems and stress. The participants were cadets from four U.S. military service academies – who undergo rigorous training and are required to participate in athletics – and students who competed in NCAA sports at 26 U.S. higher education institutions. Beyond the substantial numbers of students who reported clusters of PCS-like symptoms, between one-half and three-quarters of all of the athletes surveyed reported one or more symptoms commonly experienced by people who’ve had a concussion, the most common being fatigue or low energy and drowsiness. “The numbers were high, and were consistent with previous research in this area, but it is quite shocking,” said study lead author Jaclyn Caccese, assistant professor in The Ohio State University School of Health and Rehabilitation Sciences. “These are elite athletes who are physically fit, and they are experiencing that many symptoms commonly reported following concussion. So looking across the general population, they’d probably have even more.” It’s important to understand that there are multiple sources of these symptoms, researchers say, so that student-athletes’ post-concussion care zeroes in on symptoms caused by the injury. In addition, knowing athletes’ medical history and baseline symptom status may help clinicians predict which pre-existing factors could contribute to a slower recovery from a concussion. “When a patient comes into a clinic and they are a month or more out from their most recent concussion, we need to know what symptoms they were experiencing before their concussion to know if their symptoms are attributable to their concussion or something else. Then we can start treating the concussion-related symptoms to hopefully help people recover more quickly,” Caccese said. This study, published last week in the journal Sports Medicine, was conducted by the Concussion Assessment, Research and Education (CARE) Consortium established by the NCAA and U.S. Department of Defense. Caccese completed the research while she was a PhD student and postdoctoral researcher at the University of Delaware, a consortium member institution. The initiative is designed to fill gaps in knowledge about concussion effects and recovery among student-athletes at colleges, universities and military service academies by collecting and analyzing data on men and women who compete in a range of sports and undergo military training. Participants in this study included 12,039 military service academy cadets and 18,548 NCAA student-athletes who completed the Sport Concussion Assessment Tool symptom evaluation as part of the consortium’s baseline testing. The consortium also collected demographic data and personal and family medical histories from participants. Statistical analyses showed which factors in athletes’ medical histories were most closely associated with reports of symptoms that aligned with PCS criteria. Among cadets, 17.8% of men and 27.6% of women reported a cluster of symptoms that met PCS criteria. Among NCAA athletes, 11.4% of men and 20% of women reported combined symptoms that mimicked the PCS criteria. (Caccese said the varied timing of data collection at military service academies compared to NCAA preseason testing likely contributed to the symptoms reported by a higher percentage of cadets.) For both groups, sleep problems – and particularly insufficient sleep the night before the test – and pre-existing psychiatric disorders were the most predictive conditions, and a history of migraines also contributed to symptoms that met PCS criteria. In cadets, academic problems and being a first-year student increased odds of having symptoms that met PCS criteria, and in NCAA athletes, a history of ADHD or depression contributed to meeting PCS criteria. The International Classification of Diseases, Tenth Revision uses the term post-concussion syndrome for persistent symptoms following concussion, although the cause or causes of these symptoms can be difficult to determine. Symptoms range from persistent headaches, dizziness and fatigue to anxiety, insomnia and loss of concentration and memory. A complicating factor with high symptom reporting is that recognizing concussion and determining return to play is based on reported symptoms. And while some symptoms may be more closely connected to concussion than others – such as dizziness, pressure in the head, or sensitivity to light or noise – others, like fatigue, drowsiness and even headaches, can be linked to a variety of causes. “Perhaps we can create a battery of symptoms more specific to concussion,” Caccese said. “That is another project in this series – trying to see if there are groups of symptoms or specific symptoms that may be more able to identify individuals with concussion.” The CARE Consortium also aims to identify factors that will help predict outcomes in student-athletes and cadets who suffer concussions. “This hopefully not only shows clinicians that we need to consider how people would have presented before injury, but also provides some normative data so they can interpret other patients’ data,” Caccese said. “We really don’t know a lot about why people have persistent symptoms, and it seems to be very variable. So we’re trying to understand this better to help predict who will have a prolonged recovery, and who will not.” To read the original article click here.

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Man Walks Out of Hospital After Iron Rod Rams Through Skull

AHA Publisher — Sun, 24 May 2020 07:00:40 +0000

Naama Barak via Israel21c – When I arrived at the trauma room, I saw a man with an iron rod in his head – literally crossing his head from side to side,’ says doctor from Hadassah Medical Center. An Israeli man who was severely injured when an iron rod penetrated through his skull was recently discharged in good shape from the hospital, after multiple surgeries to remove the metal from his head and to repair the damage. “Four weeks ago, on a Friday lunchtime, I went with my brothers to check up how the apartment I’m building for my family is coming along,” recalls Kamel Abdel Rahman, 46, from the Israeli-Arab town of Abu Ghosh outside of Jerusalem. “As I walked around the construction site I slipped and fell from the second floor of the apartment to the first floor, with my head on iron rods.” Abdel Rahman says he couldn’t move so he shouted for help. “I was conscious and didn’t feel any pain; I don’t know how to explain it,” he says. “My brother came and then the rest of the family and all the people who were there. I saw the expressions on their faces and the shock, and I heard them shouting and understood that the situation was grave.” Seeing that his brother was frozen on the spot, “I just started giving him orders. I told him that this wasn’t the time to be in shock and that he needs to call Magen David Adom and fire rescue services because they’d have to cut the iron rod so that I could be evacuated. I was really operating there with full understanding.” Once the emergency medical technicians appeared, they sedated Abdel Rahman and took him to Hadassah Ein Kerem Medical Center, where doctors began working on removing the iron rod from his head and stabilizing his condition, which had rapidly deteriorated. “When I arrived at the trauma room I saw a man with an iron rod in his head – literally crossing his head from side to side. After his breathing was stabilized, we conducted various imaging tests to understand the position of the rod, what we had to watch out for, what it had hit and how to remove it,” neurosurgeon Dr. Samuel Moscovici said. “The imaging tests showed that very fortunately the iron entered in between the two important arteries that provide the brain with blood and that it didn’t seem as if they were damaged. Our fear was that there was a tear that we couldn’t see because the rod was blocking it, and that the moment we remove the rod the artery would begin bleeding, which could cause immediate death,” he adds. “After the doctors’ lengthy discussion we decided to carry out the surgery according to the strictest protocols, and in fact prepare for the worst-case scenario that could happen during the operation, in which the artery would tear and the patient would deteriorate.” ‘The patient every surgeon dreams of’ The operation took many hours, during which the medical team removed the rod and carried out a catherization. A few days later, when the swelling reduced, they operated again – this time a complicated endoscopic surgery to repair further damages including leaking cerebrospinal fluid. “After the surgery we were optimistic, but we didn’t know what the level of injury would be and how the patient would wake up. To our happiness, after only two weeks of being treated at neurosurgical intensive care, Kamel woke up and showed vital signs and that everything was working properly and without any leakage,” Moscovici says. “You could certainly say that he was the patient that every surgeon dreams of.” Walking out of the hospital, Abdel Rahman summarized the experience. “I have no words to thank the doctors at Hadassah. They saved my life, my speech and my walking. Those who saw me didn’t believe that I’d live, and those who thought I’d live didn’t believe I’d be standing up on my feet,” he says. “I’ll be thanking them my whole life.” To read the original article click here. For more articles from Israel21c click here.

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Lack of Sleep and Stress Can Lead to Symptoms Resembling Concussion

Man Walks Out of Hospital After Iron Rod Rams Through Skull