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Clinical Applications - Sport-related Concussion

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The recent systematic review by Gardner et al, investigates the use of transcranial Doppler ultrasound in the assessment and monitoring of cerebral blood flow following concussion in sports.9 Although, only three studies on a small number of athletes were included in the analysis, the results draw attention to the potential role of autonomic changes in the development and maintenance of post-traumatic symptoms. Physiological stress, such as exercise, has long been recognised to exacerbate symptoms following a concussion. The pathophysiological mechanism underlying this phenomenon remains unclear. It is possible that altered vascular reactivity may be a contributing factor. It is also possible that vascular changes may account for the persistence of symptoms in some cases, as is the case with conditions such as migraines. There is also a theory that disordered vascular autoregulation is the mechanism for acute cerebral oedema observed in rare cases following concussion in children and adolescents.

Hence, vascular reactivity may be important in terms of acute assessment and determination of recovery from injury, or for the identification of a subgroup of concussions that may be at higher risk in the short term.

Transcranial Doppler ultrasound may prove to be another technology that facilitates assessment and further understanding of post concussion symptoms.

Gardner A.J. (2014, Dec 2) Cerebrovascular reactivity assessed by transcranial Doppler ultrasound in sport-related concussion: A systematic review. Retrieved from 

 

https://www.researchgate.net/publication/269179040_Cerebrovascular_reactivity_assessed_by_transcranial_Doppler_ultrasound_in_sport-related_concussion_A_systematic_review#pf7

Makdissi M. and Patricios J. (2015, Aug 18). Comprehending concussion: evolving and expanding our clinical insight.
Retrieved from 
http://www.sportsconcussion.co.za/Research/Assessment/Comprehending-Concussion.pdf