# data[].attributes.headline
                                                        References 

# data[].attributes.subject
                                                        References 

# data[].attributes.body
Concussion detection for youth athletes. (2015, May 1). EMC Insurance. Retrieved September 25, 2020, from https://www.emcins.com/losscontrol/insights-d/newsletters/school/2015/05-1/

Concussion: Academic accommodations for students. (2017, March 2). ReThink Concussions. https://rethinkconcussions.upmc.com/concussion-academic-accommodations-students/

HEADS UP to schools: Teachers, counselors, and school professionals. (2019, December 23). Centers for Disease Control and Prevention. https://www.cdc.gov/headsup/schools/teachers.html

Potential effects. (2019, February 25). Centers for Disease Control and Prevention. https://www.cdc.gov/traumaticbraininjury/outcomes.html

US Department of Health and Human Services. (2019, February 12). Returning to school. Centers for Disease Control and Prevention. https://www.cdc.gov/headsup/basics/return_to_school.html

# data[].attributes.body
This PDF explain in detail the signs and symptoms that parents need to be aware of for their concussion as well as the individuals 504 plan and IEP.

# data[].attributes.body
This website gives parents an overview of symptoms and a detailed description of the injury as well as a test that may be able to diagnose the injury.

# data[].attributes.attachment_link.readable_text
Concussion/Traumatic Brain Injury

Is your world turning upside down? We can help!

Concussion, or mild Traumatic Brain Injury (TBI) results from forceful contact to your head, neck or body that shifts or twists your brain inside your skull, causing damage to the delicate structures of your brain. Traumatic brain injury can result from participation in sports, whiplash injuries, accidental falls or blows to you head, neck or body.

Loss of consciousness is not always experienced as a result of the concussion and the symptoms of a traumatic brain injury are variable. Symptoms of a concussion include confusion, disorientation, loss of balance or unsteadiness, dizziness, headache, visual disturbances, difficulty with concentration or memory, sensitivity to light or sound, changes in behavior, sleep disturbances and others. Symptoms can vary greatly in their intensity and how long they last.

Symptoms of concussion occur often without any detectable changes on standard diagnostic imaging, such as MRI/CT. Symptoms may resolve completely over time, usually within 3 months, but symptoms that interfere with activities of daily living should be evaluated and treated if necessary. If significant impairment of your brain is suspected intervention during the appropriate time of the healing process can help greatly, improving the relief of symptoms and function of your brain.

A variety of neuropsychological and physical performance measures have been developed to aid in the diagnosis and management of concussion because the symptoms of a concussion are often subtle and difficult to detect by standard examination procedures. The Sport Concussion Assessment Tool (SCAT2/3); Immediate Post-concussion Assessment and Cognitive Test (ImPACT); and the King-Devick Test are among tests presently used to assess the effects of traumatic brain injury.

None of these tests are intended to be "stand alone" tests for concussion diagnosis because the effects of a concussion involve brainstem and subcortical areas, not only cortical areas that deal with memory, recall and reaction time. A professional trained in the diagnosis of concussion should evaluate you thoroughly to properly assess the extent of your brain injury.

We utilize a comprehensive, layered approach to the diagnosis and management of concussions. It is ideal to have everyone at risk for concussion establish a baseline of their neurologic function. Our neurologic examination looks at how the different aspects of your brain are functioning. We provide advanced testing technology by using the most sensitive and earliest measures of abnormal neurologic function, computerized balance testing, RightEye Visual Eye Tracking Technology, Quantitative EEG and Computerized Performance Testing for Cognitive Functional Assessment.

RightEye is used in aiding the assessment of the oculomotor system (nervous system control of moving your eyes) and the function of those areas of your brain controlling those movements. Eye activities, such as saccades, pursuits and gaze stabilization, may be abnormal after an injury and can indicate the areas of your brain that are functioning abnormally.

Computerized Balance Assessment testing is performed in our office for assessing how well your brain is perceiving your body position in space.

Your perception of your body position in space is what your brain uses to build brain maps of where your body parts are in relation each other and to your environment. Your brain map is built on the information it receives from all of the nervous system receptors (sight, touch, hearing, inner ear balance organs) and the map is continuously updated.

Based on neuroscientific research Computerized Performance Testing for Cognitive Functional Assessment contains standardized neurocognitive tests that provide information on key cognitive measures, such as verbal and visual memory, reaction time, motor control and coordination, attention/shifting attention and executive function. A Concussion Symptom Scale helps to detail and track symptoms during recovery.

Without the use of objective measurement techniques, it may be very difficult to distinguish between these brain areas and monitor your response to treatment. You may read more about our advanced diagnostic testing by clicking here.

Clinical laboratory testing may be necessary to identify underlying metabolic conditions (such as inflammation, cortisol levels, anemia, dysglycemia, etc) that may be contributing to your concussion symptoms.

Your functional neurologic examination and diagnostic testing aids in identifying those areas of your brain being affected, and in applying the right mix of individualized, specific neurologic therapies to create improvement.

# data[].attributes.attachment_link.keywords[]
post traumatic stress doctor in greenville

# data[].attributes.attachment_link.title
Brain Injury | East Carolina Brain Center - 252-412-3463

# data[].attributes.attachment_link.description
Is your world turning upside down? We can help! Concussion, or mild Traumatic Brain Injury (TBI) results from forceful contact to your head, neck or body that shifts or twists your brain inside your skull, causing damage to the delicate structures of your brain.

# data[].attributes.body
This website tells parents about being a strong support for their teen by being aware of whats going on in their child's life, hopefully allowing the child to open up about the difficult tasks.

# data[].attributes.attachment_link.provider_name
Centers for Disease Control and Prevention

# data[].attributes.attachment_link.description
Parents, know your concussion ABCs. Download the HEADS UP to Schools Factsheet for Parents.

# data[].attributes.body
This website brings awareness for concussions with special attention to the guide principles, they make sure anyone who is involved in sports is aware of their health and safety.

# data[].attributes.attachment_link.provider_name
North Carolina High School Athletic Association

# data[].attributes.attachment_link.readable_text
Information The Gfeller-Waller Concussion Awareness Act was drafted and implemented to protect the safety of student-athletes in North Carolina and was signed into law on June 16, 2011 by Governor Beverly Purdue.

There are three major areas of focus in the law and these include: education, emergency action and postconcussion protocol implementation, and clearance/return to play or practice following concussion.

Read more
N.C. State Board of Education Policy entitled "Concussion Safety Requirements for Interscholastic Athletic Competition" (Policy Date July 9, 2015)
NCHSAA member schools have been required by law to be in compliance with the Gfeller-Waller Act since 2011. The State Department of Public Instruction has been doing audits of school compliance with the act.

The State Board of Education has now taken action which authorizes the NCHSAA to apply and enforce this rule. In anticipation of this action, the NCHSAA Board of Directors, in December of 2014, developed policy for fines and penalties for non-compliance which was included in the minutes of that meeting.

Since this involves health and safety of participants, there would be a $1000 fine for non-compliance and a $500 fine per venue for failure to post venue specific emergency action plans.

CSS Accordion Slider

Also see Health & Safety

# data[].attributes.attachment_link.title
Concussion Awareness | North Carolina High School Athletic Association

# data[].attributes.attachment_link.description
InformationThe Gfeller-Waller Concussion Awareness Act was drafted and implemented to protect the safety of student-athletes in North Carolina and was signed into law on June 16, 2011 by Governor Beverly Purdue.There are three major areas of focus in the law and these include: education, emergency action and postconcussion protocol implementation, and clearance/return to play or practice following concussion.

# data[].attributes.body
This website tells us about how teachers, coaches and administrative staff are able to cope with those that have concussions as well as diagnosing those with concussions by taking a concussion baseline test ( ImPACT)

# data[].attributes.attachment_link.readable_text
ImPACT Testing

The Immediate Post-Concussion Assessment and Cognitive Testing ( ImPACT) computerized evaluation system is one of several state-of-the-art tools The Center Foundation uses for concussion management. This powerful tool helps determine if a concussion has occurred, as well as giving an idea of its severity. Most importantly, ImPACT testing aids in deciding if, and when, it is safe for an athlete to return to contact sports.

How it works:

At the beginning of each sport season, athletes are given a computerized test (ImPACT), establishing a baseline of their normal mental function. These baseline tests are especially important if the student has ADHD, dyslexia, or learning disabilities.

Additional evaluations include a neurological examination, the SCAT3,balance testing, and a visual and verbal assessment.

In the event of a concussion, research-based protocols guide care and treatment until releasing the student to play.

It is important to note that, injured athletes cannot return to play until cleared by a physician. Thereby reducing the potential for further injury, such as Second Impact Syndrome.

What is Second Impact Syndrome?

Second Impact Syndrome occurs when a person suffers a second concussion before the symptoms of the first one have subsided. Specifically, in this condition the brain swells rapidly and catastrophically. Sometimes, even fatally.

School protocols require at least seven days off from contact sports following the initial concussion. This allows the brain to heal, reducing the risk for a second concussion. For this reason, Jenna's Law, an extension of Max's Law, legislated against immediate return to play after a concussion. The result is a marked decrease in the number of students developing Second Impact Syndrome.

# data[].attributes.attachment_link.title
Concussion Management - Concussion Safety in Youth Sports

# data[].attributes.attachment_link.description
The Immediate Post-Concussion Assessment and Cognitive Testing ( ImPACT) computerized evaluation system is one of several state-of-the-art tools The Center Foundation uses for concussion management. This powerful tool helps determine if a concussion has occurred, as well as giving an idea of its severity.

# data[].attributes.body
This fact sheet informs teachers of the signs, symptoms, and important behaviors to be aware of just in case the student is at school while the concussion is getting worst.

# data[].attributes.body
With the effects of concussions changing so often, it is important to focus on the aspect that are affecting the child as a whole which is thinking, sensation, language, and emotions. Making sure that everyone around the student is aware that they have a concussion is very important for keeping those social relationships going. While the student is facing memory loss, attention difficulties and constant headaches, maintaining a supportive background aids in a thorough recovery process.

# data[].attributes.attachment_link.title
Social and Emotional Support for Students with Concussions

# data[].attributes.body
Accommodating the individual plays a huge role in the success of the concussion getting better. For students, allowing more time to turn in assignments, reducing the amount of homework and school work as well as separate testing through different sessions definitely helps. Another way to accommodate the student is to be aware of their concussion by knowing how to detect it, and understanding how serious it is. It is very critical to be able to balance enough rest as well as still progressing in school and normal daily activities.

# data[].attributes.headline
          Identification and Service Delivery

# data[].attributes.subject
          Identification and Service Delivery

# data[].attributes.body
When a student or athlete is suspected of having a concussion, they undergo a series concentrations test all put together in what is called a Concussion Baseline Testing. Also another way to examine those that are diagnosed for the severity of their concussion is by getting a CT or an MRI to check for bleeding or inflammation. Once a concussion has been diagnosed, the type of support is based on the individual. Depending on the individual, schools offer 504 plans if they qualify, Response to Intervention Protocol (RTI), and what many use which is the Individualized Educational Plan (IEP). These allow the students to get the help they need as well as recovering from the brain injury.

# data[].attributes.attachment_link.title
Identifying a Concussion and Its Long- and Short-Term Effects

# data[].attributes.body
Concussions come from an impact, or blow to the head leading to temporary or prolonged difficulties with concentration, headaches, dizziness, nausea, vomiting, and sensitivity to sound and light.

# data[].attributes.attachment_link.provider_name
Center for Injury Research and Prevention

# data[].attributes.attachment_link.readable_text
In addition to our main lines of Concussion research at CIRP, we are actively engaged in research activity to capture and describe characteristics of concussion in youth. Our researchers are studying the diversity and variability of the pediatric concussion patient population at Children's Hospital of Philadelphia and more broadly. By doing so, clinicians will be better equipped to recognize and treat specific concussion symptoms, as well as to predict recovery outcomes.

Leveraging Electronic Health Records (EHR) for Concussion Surveillance

The Minds Matter team and the Centers for Disease Control and Prevention (CDC) leverage CHOP's EHR system to expand concussion surveillance research and improve how clinicians manage concussion in children and adolescents. Read more about this concussion surveillance research.

Select Describing Pediatric and Adolescent Concussion Publications

Radiologic Common Data Elements Rates in Pediatric mTBI -- Radiologic common data elements (rCDE) have been developed to standardize reporting of radiologic findings in research settings for mTBI. However, the clinical significance of these findings remains unclear, with some findings more likely to be related to mTBI while others are only possibly related to mTBI and others are incidental findings. In this multi-site study, 287 patients with subacute pediatric mTBI, 106 matched healthy controls, and 71 orthopedically injured patients underwent imaging approximately 1 week post-injury and were followed for 3-4 months. Each category of rCDE was examined-- probable, possible or incidental findings. Probable rCDE were found at a rate of 4-5% in the population with mTBI and were not observed in either control group, whereas possible rCDE and incidental findings were found at similar rates across all three populations, indicating that refinement of rCDE in the context of pediatric mTBI may be helpful in differentiating populations with more significant injury with mTBI. CHOP researchers collaborated on this multi-site study with the lead authors.

High School Football and Later Life Cognition -- In this study of men who graduated from Wisconsin high schools in 1957, playing high school football was not adversely associated with cognitive impairment or depression later in life. Researchers from University of Pennsylvania's Wharton School and CHOP used data from the Wisconsin Longitudinal Study (WLS) of high school graduates in the state in 1957, which included information on high school football participation and cognitive psychological well-being assessments of participants later in life in their 50s, 60s and 70s. However, the WLS data doesn't include history of concussion and total exposure to football before high school. In the study of 3,904 men, high school football players were compared with their nonplaying counterparts and depression and cognitive impairment were assessed in their 60s and 70s using composite cognition and depression scores.The authors report cognitive and depression outcomes later in life were similar for high school football players and those who did not play. JAMA Neurology. July 2017.

Emergency Department Visits and Neuroimaging for Concussion Patients from 2006-2011 -- To better understand the epidemiology of concussion and rates of head computed tomography (CT) use in head injured patients in Emergency Departments, researchers conducted a cross-sectional analysis of the Nationwide Emergency Departments Sample (NEDS) and found rates of concussion visits increased over this time period for all age groups. The rate of CT use also increased, even though the severity of injury decreased. Academic Emergency Medicine. June 2015. Read this blog article for more details.

Characteristics of Prolonged Recovery - This study identified pre-existing characteristics (depression, anxiety) and presenting symptoms (abnormal oculomotor, dizziness) associated with prolonged recovery from concussion in a sample of patients referred to a pediatric sports medicine clinic. Read this blog article for more details.

Select Describing Pediatric and Adolescent Concussion Review Publications

In the Clinic: Concussion -- This review discusses the important role of the primary care doctor across the spectrum of concussion from injury to recovery, including prevention, diagnosis (with detailed descriptions of diagnostic tests), treatment (including graduated return to play and rehabilitation) and prognosis. Additionally, it provides a list of resources for both the provider and patient. Ann Inter Med. July 2018.

The spectrum of mild traumatic brain injury: A review -- This review discusses the varied and often conflicting diagnostic criteria for concussion, proposes an ideal diagnostic nosology for mild traumatic brain injury encouraging clinicians to adopt a probabilistic framework, describes the management of both acute and chronic concussion, and reviews the etiologies that contribute to prolonged symptoms following concussion. Neurology. August 2017.

The Clinical Implications of Youth Sports Concussion Laws: A Review -- This article explores the varied specifications described in state concussion laws for children and adolescents and their affect on clinical practice, including who is qualified to provide clearance, after how long clearance can be provided, and what a medical evaluation entails. Return to play and return to learn protocols are also examined. Am J Lifestyle Med. March 2019.

Sports-Related Head Injuries in Adolescents: A Comprehensive Update -- This review article summarizes the current state of the rapidly changing field of sports-related head injuries of all severities with a particular emphasis on mild TBI (mTBI) and concussion in adolescents ages 10-19 years. The definition, incidence, epidemiology, pathophysiology, diagnosis, management, long-term consequences and prevention of these injuries are discussed. Adolesc Med State Art Rev. December 2015.

# data[].attributes.attachment_link.title
Describing Pediatric and Adolescent Concussion

# data[].attributes.attachment_link.description
In addition to our main lines of Concussion research at CIRP, we are actively engaged in research activity to capture and describe characteristics of concussion in youth. Our researchers are studying the diversity and variability of the pediatric concussion patient population at Children's Hospital of Philadelphia and more broadly.

# data[].attributes.headline
              Traumatic Brain Injury (ACE/ Mild TBI)

# data[].attributes.subject
              Traumatic Brain Injury (ACE/ Mild TBI)

# data[].attributes.body
The traumatic brain injury that I chose was a concussion.