Concussion Prevalence, Management and Outcomes

Concussion are a serious public health concern and are seen by a variety of physicians and relevant clinicians. Individualized, evidence based medicine will improve clinical outcomes.

Willer B and Leddy JJ. Management of Post-Concussion Syndrome. Current Treatment Options in Neurology 8(5):415-426, 2006.


Leddy JJ, Sandhu H, Baker JG, Sodhi V, and Willer B. Rehabilitation of Concussion and Post Concussion Syndrome. Sports Health 4:147-154, 2012.


Master CL, Gioia GA, Leddy JJ and Grady MF. Importance of ‘Return to Learn’ in Pediatric and Adolescent Concussion. Pediatric Annals 41:366, 2012.


Vidal PG, Goodman AM, Colin A, Leddy JJ and Grady MF. Rehabilitation Strategies for Pediatric and Adolescent Concussion. Pediatric Annals 41:367, 2012.


Echemendia, RJ. Broglio, SP, Davis, GA, Guskiewicz, KM, Hayden, KA, Leddy, JJ, Meehan, WP, Putukian, Sullivan, SJ, Schneider, KJ & McCrory, P. (2017). What tests and measures should be added to the SCAT3 and related tests to improve their reliability, sensitivity and/or specificity in sideline concussion diagnosis? A systematic review. British Journal of Sports Medicine, 51, 895-901. http://dx.doi.org/10.1136/10 1136/bjsports-2016-097466.


Echemendia RJ, Davis GA, Putukian M, Leddy JJ, Makdissi M, Sullivan J,. Broglio SP, Raftery M, Schneider KJ, Kissick J, Meeuwisse W, McCrory P,  McCrea M, Dvorak J, Sills AK, Aubry M, Engebretsen L, Lossemore M, Fuller G, Kutcher J, Ellenbogen R,  Guskiewicz KM, and Herring S. The Concussion Recognition Tool 5th Edition (CRT5). Br J Sports Med. 2017 Apr 26. pii: bjsports-2017-097508. doi: 10.1136/bjsports-2017-097508.


Echemendia RJ, Davis GA, Putukian M, Leddy JJ, Makdissi M, Sullivan J,. Broglio SP, Raftery M, Schneider KJ, Kissick J, Meeuwisse W, McCrory P,  McCrea M, Dvorak J, Sills AK, Aubry M, Engebretsen L, Lossemore M, Fuller G, Kutcher J, Ellenbogen R,  Guskiewicz KM, and Herring S. The Sport Concussion Assessment Tool 5th Edition (SCAT)5. Br J Sports Med. 2017 Apr 26. pii: bjsports-2017-097506. doi: 10.1136/bjsports-2017-097506.


Haider MN, Leddy J, Baker JG, Kiel JM, Tiso M, Ziermann KA, and Willer B. Effect of Specialized Concussion Management Training among Residents and Medical Students. Concussion (2017).


Kozlowski KF, Leddy JJ, Tomita M, Bergen A and Willer B. Use of the ICECI and ICD-10 E-Coding Structures to Evaluate Causes of Head Injury and Concussion from Sport and Recreation Participation in a School Population. Neurorehabilitation 22:191-198, 2007.


Willer B and Leddy JJ. Concussion and Sports. Editorial. Neurorehabilitation 22:159-160, 2007.


Fung M, Willer B, Moreland D, and Leddy JJ. Predictive Factors for Intracranial Lesions in Mild Traumatic Brain Injury: A Literature Review and Recommendation for Evidence-based Emergency Department Discharge Instructions. Brain Injury 9:1-6, 2006. http://www.ncbi.nlm.nih.gov/pubmed/15178669?dopt=Abstract


Baker, J. G., Rieger, B. P., McAvoy, K., Leddy, J. J., Master, C. L., Lana, S. J., Willer, B. S.  Principles for Return to Learn after Concussion.  International Journal of Clinical Practice 68:1286-1288, 2014.


Baker, J. G., Leddy, J. J., Darling, S. R., Rieger, B. P., Mashtare, T. L., Sharma, T., Willer, B. S. Factors Associated With Problems for Adolescents Returning to the Classroom After Sport-Related Concussion, Clinical Pediatrics.  Published ahead of print, DOI: 10.1177/0009922815588820.


Smith AM, Stuart MJ, Dodick DW, Roberts WO, Alford PW, Ashare AB, Aubrey M, Benson BW, Burke CJ, Dick R, Eickhoff C, Emery CA, Flashman LA, Gaz D, Giza CC, Greenwald RM, Herring S, Hoshizaki TB, Hudziak JJ, Huston J, 3rd, Krause D, LaVoi N, Leaf M, Leddy JJ, MacPherson A, McKee AC, Mihalik JP, Moessner AM, Montelpare WJ, Putukian M, Schneider KJ, Szalkowski R, Tabrum M, Whitehead J, Wiese-Bjornstal DM. Ice Hockey Summit II: zero tolerance for head hits and fighting. Clin J Sport Med. 2015; 25(2):78-87. doi: 10.1097/JSM.0000000000000195. PubMed PMID: 25866860.


Smith AM, Stuart MJ, Dodick DW, Roberts WO, Alford PW, Ashare AB, Aubrey M, Benson BW, Burke CJ, Dick R, Eickhoff C, Emery CA, Flashman LA, Gaz DV, Giza CC, Greenwald RM, Herring SA, Hoshizaki TB, Hudziak JJ, Huston J, 3rd, Krause D, LaVoi N, Leaf M, Leddy JJ, MacPherson A, McKee AC, Mihalik JP, Moessner AM, Montelpare WJ, Putukian M, Schneider KJ, Szalkowski R, Tabrum M, Whitehead JR, Wiese-Bjornstal DM. Ice hockey summit II: zero tolerance for head hits and fighting. PM R. 2015; 7(3):283-95. doi: 10.1016/j.pmrj.2015.02.002. PubMed PMID: 25797614.


Darling S, Freitas M and Leddy J. Concussions:  Return-to-Sport and Return-to-Learn Considerations. NYSAFP Journal 4:31-34, 2015.


Makki AY, Leddy J, Hinds AL, Baker JG, Palcuh R, Shucard J, and Willer B. School Attendance and Symptoms in Adolescents after Sport-Related Concussion (SRC). Global Pediatric Health 2016, 3: 1-3.


Hinds A, Jungquist CR, Leddy J, Seemant F, Baker J, & Willer B. Sleep disturbance in patients with chronic concussive effects.  Concussion 2016, online ahead of print: 10.2217/cnc-2016-0002.


Ellis MJ, Leddy JJ and Willer B. Evaluation and Treatment of Physiologic, Vestibulo-Ocular, and Cervicogenic Post-Concussion Disorders. Brain Injury Brain Inj, Early Online: 1–11, 2014. Informa UK Ltd. DOI: 10.3109/02699052.2014.965207


Leddy JJ, Baker JG, Merchant A, Picano J, Gaile D, Matuszak J, and Willer B Brain or Strain? Symptoms alone do not distinguish physiologic concussion from cervical/vestibular injury. Clin J Sport Med 25:237–242, 2015.


Marshall CM, Vernon H, Leddy JJ, and Baldwin BA. The role of the cervical spine in post-concussion syndrome. Phys Sportsmed, 2015; Early Online: 1–11. DOI: 10.1080/00913847.2015.1064301


Baker JG, Leddy JJ, Darling SR, Shucard J, Makdissi, M and Willer B.


Gender Differences in Recovery from High School Sport-Related Concussion. Clinical Pediatrics 55(8):771-75, 2016


 

Willer B and Leddy J. Time to Change from a Symptom-based Concussion Assessment to a Structured Physical Examination. Acad Em Med.2016.             doi: 10.1111/acem.12940


Matuszak J, McVige J, McPherson J, Willer B, and Leddy J: A Practical Concussion Physical Examination Toolbox: Evidence-based physical examination for concussion. Sports Health 8(3):260-69, 2016.


Ellis MJ, Leddy J, and Willer B. Multi-disciplinary management of athletes with post-concussion syndrome: an evolving pathophysiological approach. Front. Neurol., 24 August 2016 | http://dx.doi.org/10.3389/fneur.2016.00136


Haider MN, Leddy J, Baker JG, Pavlesen S, Kluczynski M, and Willer B. Measures of Recovery from Sport-Related Concussion in the Student Athlete: a Systematic Review. British Journal of Sports Medicine 10.1136/bjsports-2016-09655, 2017.


Makdissi M, Schneider  J, Feddermann-Demont N,  Guskiewicz K, Hinds S, Leddy JJ, McCrae M, Turner M, and Johnston K.  Approach to investigation and treatment of persistent symptoms following sport-related concussion: A systematic review. Br J Sports Med. 2017 Jun;51(12):958-968. doi: 10.1136/bjsports-2016-097470. Epub 2017 May 8.


McCrory P, Meeuwisse W, Dvorak J, Bailes J, Broglio S, Cantu RC, Cassidy D, Echemendia RJ, Castellani RJ, Davis GA, Ellenbogen R, Emery C, Engebretsen L, Feddermann-Demont N, Giza CC, Guskiewicz KM, Herring S, Iverson GI, Johnston KM, Kissick J, Kutcher J, Leddy JJ, Maddocks D, Makdissi M, Manley G, McCrea M, Meehan WP, Nagahiro S, Patricios J, Putukian M, Schneider KJ, Sills A, Tator CH, Turner M, and Vos PE. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017 Apr 26. pii: bjsports-2017-097699. doi: 10.1136/bjsports-2017-097699.


McCrory P, Meeuwisse W, Dvorak et al. Infographic: Consensus statement on concussion in sport. Br J Sports Med. 2017 Sep 12. pii: bjsports-2017-098065. doi: 10.1136/bjsports-2017-098065.


Trojian TH, Wang D, and Leddy JJ. Nutritional Supplements for Concussions. Current Sports Medicine Reports 16(4):247-255, 2017.


Leddy J, Lesh K, Haider MN, Czuczman N, Hinds AL, Baker JG, Miecznikowski JC, and Willer B. Derivation of a Focused, Brief Concussion Physical Examination for Adolescents With Sport-Related Concussion. Clin J Sport Med 2018;00:1-8.


Broglio SP, Kontos AP, Levin H, et al. The National Institute of Neurological Disorders and Stroke and Department of Defense Sport-Related Concussion Common Data Elements Version 1.0 Recommendations. Journal of Neurotrauma (in press).


Haider MN, Leddy JJ, Du W, Macfarlane AJ, Viera KB, Willer BS. Practical Management: Brief Physical Exam for Sport Related Concussion in the Outpatient Setting. Clin J Sport Med. 2018. doi: 10.1097/JSM.0000000000000687. [Epub ahead of print] PMID 30418199 


Ellis MJ, Leddy J, Cordingley D, Willer B. A Physiological Approach to Assessment and Rehabilitation of Acute Concussion in Collegiate and Professional Athletes. Front Neurol. 2018;9:1115. doi: 10.3389/fneur.2018.01115. eCollection 2018. PubMed PMID: 30619068; PubMed Central PMCID: PMC6306465.


Lawrence JB, Haider MN, Leddy JJ, Hinds A, Miecznikowski JC, and Willer B. The King-Devick test in an outpatient concussion clinic: Assessing the diagnostic and prognostic value of a vision test among acutely concussed adolescents. The Journal of Neuroscience Volume 398, 15 March 2019, Pages 91-97


Lumba-Brown A, Ghajar J, Cornwell J, Bloom OJ, Chesnutt J, Clugston JR, Kolluri R, Leddy JJ, Teramoto M, Gioia G. Representation of concussion subtypes in common postconcussion symptom-rating scales. Concussion. 2019 Nov 1;4(3):CNC65. doi: 10.2217/cnc-2019-0005. Review. PubMed PMID: 31827883; PubMed Central PMCID: PMC6902310.


Haider MN, Worts PR, Viera KB, Villarrubia B, Wilber CG, Willer BS, Leddy JJ. Post-exercise Slowing on the King Devick Test Predicts Longer Recovery from Sport-Related Concussion in Adolescents: a Validation Study. Journal of Athletic Training


Harmon KG, Clugston JR, Dec K, Hainline B, Herring S, Kane SF, Kontos AP, Leddy JJ, McCrea M, Poddar SK, Putukian M, Wilson JC, Roberts WO. American Medical Society for Sports Medicine position statement on concussion in sport. Br J Sports Med 2019; 53:213–225. doi:10.1136/bjsports-2018-100338


Zasler N, Haider MN, Grzibowski N, and Leddy JJ. Physician Medical Assessment in a Multidisciplinary Concussion Clinic. JHTR 2019; 34(6):409-18.


Baker JG, Willer BS, and Leddy JJ. Integrating Neuropsychology Services in a Multidisciplinary Concussion Clinic. JHTR 2019; 34(6):419-24.


Smith AM, Alford PA, Aubry M, Benson B, Black A, Brooks A, Burke C, DʼArcy R, Dodick D, Eaves M, Eickhoff C, Erredge K, Farrell K, Finnoff J, Fraser DD, Giza C, Greenwald RM, Hoshizaki B, Huston J, Jorgensen J, Joyner M, Krause D, LaVoi N, Leaf M, Leddy J, Margarucci K, Margulies S, Mihalik J, Munce T, Oeur A, Prideaux C, Roberts WO, Shen F, Soma D, Tabrum M, Stuart MB, Wethe J, Whitehead J, Wiese-Bjornstal D, Stuart MJ. Proceedings From the Ice Hockey Summit III: Action on Concussion. Clin J Sport Med. 2019 Nov 26; doi: 10.1097/JSM.0000000000000745. [Epub ahead of print] PubMed PMID: 31842055.


Mannix R, Zemek R, Yeates KO, Arbogast K, Atabaki S, Badawy M, Beauchamp MH, Beer D, Bin S, Burstein B, Craig W, Corwin D, Doan Q, Ellis M, Freedman SB, Gagnon I, Gravel J, Leddy J, Lumba-Brown A, Master C, Mayer AR, Park G, Penque M, Rhine T, Russell K, Schneider K, Bell M, Wisniewski S. Practice Patterns in Pharmacological and Non-Pharmacological Therapies for Children with Mild Traumatic Brain Injury: A Survey of 15 Canadian and United States Centers. J Neurotrauma. 2019 Oct 15;36(20):2886-2894. doi: 10.1089/neu.2018.6290. Epub 2019 Jun 17. PubMed PMID: 31025612.


Willer B, Dumas J, Hutson A, and Leddy JJ. A population based investigation of head injuries and symptoms of concussion of children and adolescents in schools. Injury Prevention 10:144-148, 2004. http://www.informaworld.com/openurl?genre=article&issn=02699052&volume=20&issue=9&spage=889


Willer B, Kroetsch B, Darling S, Hutson A and Leddy JJ. Injury rates in House League, Select and Representative Youth Ice Hockey. Med. Sci. Sports Exerc. 37:1658-1663, 2005.


Darling SR, Schaubel DE, Baker JG, Leddy JJ, Bisson LJ and Willer B. Intentional versus unintentional contact as a mechanism of injury in youth ice hockey. Br. J. Sports Med 45:492-497, 2011 doi:10.1136/bjsm.2009.063693