title: A Physiological Approach to Prolonged Recovery From Sport-Related Concussion.
abstract: Management of the athlete with postconcussion syndrome (PCS) is challenging because of the nonspecificity of PCS symptoms. Ongoing symptoms reflect prolonged concussion pathophysiology or conditions such as migraine headaches, depression or anxiety, chronic pain, cervical injury, visual dysfunction, vestibular dysfunction, or some combination of these. In this paper, we focus on the physiological signs of concussion to help narrow the differential diagnosis of PCS in athletes. The physiological effects of exercise on concussion are especially important for athletes. Some athletes with PCS have exercise intolerance that may result from altered control of cerebral blood flow. Systematic evaluation of exercise tolerance combined with a physical examination of the neurologic, visual, cervical, and vestibular systems can in many cases identify one or more treatable postconcussion disorders.
authors.affiliation: UBMD Department of Orthopaedics and Sports Medicine.
authors.forename: John
authors.initials: J
authors.lastname: Leddy
authors.affiliation: UBMD Department of Orthopaedics and Sports Medicine.|Department of Nuclear Medicine, and.
authors.forename: John G
authors.initials: JG
authors.lastname: Baker
authors.affiliation: Jacobs School of Medicine and Biomedical Sciences, The State University of New York at Buffalo.
authors.forename: Mohammad Nadir
authors.initials: MN
authors.lastname: Haider
authors.affiliation: UBMD Department of Orthopaedics and Sports Medicine.
authors.forename: Andrea
authors.initials: A
authors.lastname: Hinds
authors.affiliation: Department of Psychiatry.
authors.forename: Barry
authors.initials: B
authors.lastname: Willer
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000209:etiology; D056352:Athletes / Q000706:statistics & numerical data; D001265:Athletic Injuries / Q000175:diagnosis / Q000534:rehabilitation*; D001924:Brain Concussion / Q000175:diagnosis / Q000534:rehabilitation*; D002648:Child; D003863:Depression / Q000209:etiology; D005081:Exercise Therapy / Q000379:methods; D017079:Exercise Tolerance / Q000502:physiology; D005538:Football / Q000293:injuries; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D038223:Post-Concussion Syndrome / Q000175:diagnosis / Q000534:rehabilitation; D017410:Practice Guidelines as Topic; D020127:Recovery of Function / Q000502:physiology; D000068958:Return to Sport / Q000502:physiology; D013177:Sports / Q000502:physiology; D055815:Young Adult
keywords: athlete; exercise intolerance; postconcussion syndrome