Postconcussive Syndrome Following Sports-Related Concussion
Postconcussive Syndrome Following Sports-Related Concussion
Neuropsychological (NP) testing is a commonly used tool in the diagnosis and management of SRC and PCS that allows the identification of occult cognitive injury. Computer-based testing (ie, Immediate Post-Concussion Assessment) has improved availability and application by avoiding the time-intensive paper-and-pencil assessments traditionally conducted by neuropsychologists. Research focused on these tools has shown moderate sensitivity in the detection of cognitive deficits and may reveal cognitive deficits that persist beyond an athlete's other concussion-related symptoms. NP testing may be used to monitor recovery, such as with patients who exhibit prominent cognitive PCS symptoms. The American Medical Society for Sports Medicine consensus statement on concussion suggests that most concussions can be managed without NP testing; however, when used, it should be performed and interpreted by trained professionals.
In general, neuroimaging is not a standard component of diagnosis or management of SRC. Use of computed tomographic imaging is isolated to acute evaluations of head injuries to rule out traumatic complications such as fracture, hemorrhage, or mass effect. Validated selection criteria may allow for more appropriate computed tomographic use, avoiding unnecessary radiation and allowing for a more cost-effective initial evaluation of minor head injuries. In the case of PCS, magnetic resonance imaging is the most accepted modality for evaluating persistent or worsening symptoms for underlying pathology. Newer imaging technologies are emerging, the use of which is a focus of research.
Additional Testing
Neuropsychological (NP) testing is a commonly used tool in the diagnosis and management of SRC and PCS that allows the identification of occult cognitive injury. Computer-based testing (ie, Immediate Post-Concussion Assessment) has improved availability and application by avoiding the time-intensive paper-and-pencil assessments traditionally conducted by neuropsychologists. Research focused on these tools has shown moderate sensitivity in the detection of cognitive deficits and may reveal cognitive deficits that persist beyond an athlete's other concussion-related symptoms. NP testing may be used to monitor recovery, such as with patients who exhibit prominent cognitive PCS symptoms. The American Medical Society for Sports Medicine consensus statement on concussion suggests that most concussions can be managed without NP testing; however, when used, it should be performed and interpreted by trained professionals.
In general, neuroimaging is not a standard component of diagnosis or management of SRC. Use of computed tomographic imaging is isolated to acute evaluations of head injuries to rule out traumatic complications such as fracture, hemorrhage, or mass effect. Validated selection criteria may allow for more appropriate computed tomographic use, avoiding unnecessary radiation and allowing for a more cost-effective initial evaluation of minor head injuries. In the case of PCS, magnetic resonance imaging is the most accepted modality for evaluating persistent or worsening symptoms for underlying pathology. Newer imaging technologies are emerging, the use of which is a focus of research.
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