1/4. Statistical procedures for determining the extent of cognitive change following concussion.Neuropsychological (NP) testing is now often used to help to determine if the cognitive function of a concussed athlete has declined. The NP test score after concussion is compared with the baseline test score. Many clinicians simply subtract one from the other and make a clinical decision about the significance or otherwise of the resulting "difference score". Such techniques are inadequate, as they fail to account for the many factors that may confound interpretation of serially acquired cognitive test scores. This is a review of a number of alternative approaches used in other areas of medicine for differentiating "true" changes from changes caused by these confounding factors. A case example is used to illustrate the effect that the statistical approach may have on clinical decision making. ( info) |
2/4. A punch drunk jockey?The case is reported of a retired professional jockey with progressive memory loss. The concern is that he may be suffering from chronic traumatic encephalopathy or the "punch drunk syndrome". ( info) |
3/4. Traumatic brain injury--the need for support and follow up.BACKGROUND: Mild traumatic brain injury (MTBI) is the commonest type of brain injury. It is sometimes difficult to select patients who require ongoing follow up to avoid the sequelae of MTBI. OBJECTIVE: This article outlines the diagnosis and management of MTBI using case vignettes. DISCUSSION: general practitioners should be aware of the possible long term sequelae that may be the result of external factors, and provide support, follow up and eduction to patients with a history of MTBI.The management of postconcussive syndrome and MTBI are also discussed. ( info) |
4/4. A case of perilymphatic fistula in blunt head injury.dizziness is a common symptom following blunt head injury. This is usually attributed to the "post-concussive" syndrome. Here we present a patient whose symptoms following head injury were a result of him having developed a perilymphatic fistula. ( info) |