title: Physiological, vestibulo-ocular and cervicogenic post-concussion disorders: an evidence-based classification system with directions for treatment.
abstract: OBJECTIVE
  To present a novel pathophysiological approach to acute concussion and post-concussion syndrome (PCS).
  
  
  METHODS
  Review of the literature.
  
  
  METHODS
  PubMed searches were performed to identify articles related to the pathophysiology and treatment of concussion and PCS. Relevant articles that contributed to the primary objective of the paper were included.
  
  
  RESULTS
  This paper presents an evidence-based approach to acute concussion and PCS that focuses on the identification of specific post-concussion disorders (PCDs) caused by impairments in global brain metabolism (Physiologic PCD) or neurological sub-system dysfunction (Vestibulo-ocular PCD and Cervicogenic PCD) that can be distinguished by features of the clinical history, physical examination and treadmill exercise testing. This novel approach also allows for the initiation of evidence-based, multi-disciplinary therapeutic interventions that can improve individual symptoms and promote efficient neurological recovery.
  
  
  CONCLUSIONS
  Future studies incorporating neuro-imaging and exercise science techniques are underway at the author's institutions to validate this novel pathophysiological approach to acute concussion and PCS.
authors.affiliation: Division of Neurosurgery, Pan Am Clinic, University of Manitoba , Winnipeg, Manitoba , Canada .
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Ellis
authors.forename: John J
authors.initials: JJ
authors.lastname: Leddy
authors.forename: Barry
authors.initials: B
authors.lastname: Willer
mesh_terms: D002574:Cervical Vertebrae / Q000503:physiopathology*; D019317:Evidence-Based Medicine; D005080:Exercise Test; D006801:Humans; D009483:Neuropsychological Tests; D010808:Physical Examination; D038223:Post-Concussion Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D051298:Post-Traumatic Headache / Q000503:physiopathology*; D012027:Reflex, Vestibulo-Ocular; D012307:Risk Factors; D015837:Vestibular Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*
keywords: Concussion; physiology; post-concussion syndrome; treatment