Cervical Injury Assessments for Concussion Evaluation: A Review

Overview

Journal J Athl Train

Specialty Orthopedics

Date 2016 Nov 12

PMID 27835042

Citations 26

Authors

Kelly Cheever

Keisuke Kawata

Ryan Tierney

Anne Galgon

Affiliations

Soon will be listed here.

Abstract

Background: A concussion is a complex pathophysiologic process that is induced by biomechanical forces and affects the brain. Cervical injuries and concussion can share similar mechanisms and nearly identical symptoms or causes. Therefore, symptoms or causes alone may be insufficient to differentiate between patients with a concussion and patients with cervical injuries.

Objective: To demonstrate the homogeneous causes and symptoms observed in patients with a concussion and patients with cervical injury and to provide information on clinical tests that can differentiate cervical injury from pathologic conditions of vestibular or central origin.

Summary: Given that concussion and cervical injury share similar causes and symptoms, this information alone may be insufficient to diagnose a concussion. Clinical assessments, such as the cervical joint-reposition error test, smooth-pursuit neck-torsion test, head-neck differentiation test, cervical flexion-rotation test, and physical examination of the cervical spine, can be performed after a head and neck pathomechanical event to identify the presence of cervical injury. Differentiating between a concussion and cervical injury is clinically vital for timely and appropriate evidence-based treatment.

Conclusions: Specific clinical tests should be used after a head and neck pathomechanical event to differentiate between symptoms due to a concussion and cervical injury. Continued research on the clinical utility of the 5 identified cervicogenic tests is also recommended.

Citing Articles

Cervical spine sensorimotor deficits persist in people post-concussion despite minimal symptoms.

Kinney A, Richmond S, Mizner R Ann Med. 2024; 56(1):2422048.

PMID: 39511971 PMC: 11552255. DOI: 10.1080/07853890.2024.2422048.

Clinician-Prioritized Measures to Use in a Remote Concussion Assessment: Delphi Study.

Barnes K, Sveistrup H, Bayley M, Egan M, Bilodeau M, Rathbone M JMIR Form Res. 2024; 8:e47246.

PMID: 39222352 PMC: 11406108. DOI: 10.2196/47246.

Management of concussion symptoms utilizing Mechanical Diagnosis and Therapy: a case series.

Pleva D, Hanson J, Greer B J Man Manip Ther. 2024; 32(6):640-645.

PMID: 38949207 PMC: 11578411. DOI: 10.1080/10669817.2024.2368923.

The role of the physiotherapist in concussion.

Robertson M, McLoughlin J S Afr J Physiother. 2024; 80(1):2013.

PMID: 38725965 PMC: 11079349. DOI: 10.4102/sajp.v80i1.2013.

National Athletic Trainers' Association Bridge Statement: Management of Sport-Related Concussion.

Broglio S, Register-Mihalik J, Guskiewicz K, Leddy J, Merriman A, Valovich McLeod T J Athl Train. 2024; 59(3):225-242.

PMID: 38530653 PMC: 10976337. DOI: 10.4085/1062-6050-0046.22.

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