The 66th Annual Meeting of the American Academy of Neurology
The annual meeting of the American Academy of Neurology was held from April 26 to May 3 in Philadelphia and attracted approximately 12,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in neurology. The conference highlighted recent advances in neurological disorders, with presentations focusing on the diagnosis, management, and treatment of disorders impacting the brain and nervous system.
In one study, Frank Conidi, M.D., D.O., of the Florida Center for Headache and Sports Neurology and Florida State University College of Medicine in Port Saint Lucie, and colleagues found that helmets do not adequately protect athletes against the biomechanical forces suspected to cause concussion; however, they do a very good job of protecting individuals against forces that cause catastrophic brain injury.
"Most helmets tested performed poorly in measures of rotational and angular acceleration, which are the key biomechanical forces required to induce concussion. The Xenith X1 performed best, with approximately a 50 percent estimated risk in concussion," said Conidi. "The other helmets were in the 20 to 30 percent range. In fact, the 1930's leather head helmet out performed some of the more common brands in reduction of concussion risk. All helmets, less the leather head helmet, did well in protecting against catastrophic brain injury, i.e., intra-cerebral bleeds and skull fracture."
As far as the clinical practice impact of these results, Conidi recommends that neurologists and other physicians discuss these findings with athletes and in some cases their parents. They also need to continue to educate about recognizing the signs and symptoms of concussion and immediate removal from play of any athlete suspected of suffering concussion. In addition, Conidi suggests that coaches and athletic trainers teach proper tackling techniques and work with athletes on pre- and in-season cervical strengthening exercises/programs.
The study was supported by BRAINS Inc., a research and development company focused on the biomechanics of traumatic brain injury.
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As part of a case study, Keith Van Haren, M.D., of Stanford University in Palo Alto, Calif., and colleagues reported on five cases (all children) of acute flaccid paralysis due to anterior myelitis, an inflammatory spinal cord injury impacting the anterior part of the cord, including the anterior horn cells. The investigators have identified this polio-like illness among children residing in California.
"In each case, other causes of acute flaccid paralysis have already been excluded. We are finding a unique, specific, and relatively consistent clinical presentation. The cases typically begin with a prodromal illness followed by acute flaccid paralysis with signs of cerebral spinal fluid inflammation and anterior spinal cord injury. Motor recovery is almost uniformly poor, even one year after onset. We are working to identify a common etiology," said Van Haren. "If clinicians see a patient like this, we would like them to contact the California Department of Public Health promptly to make sure blood, spinal fluid, nasal swabs, throat swabs, and stool samples are sent during the acute phase of the illness. This will allow for a prospective analysis to look for infectious etiologies."
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Laura Balcer, M.D., of the New York University School of Medicine in New York City, and colleagues found that the King-Devick test, a test that involves athletes reading single-digit numbers from index cards, was beneficial in diagnosing the presence of a concussion during game play. The test was performed on game sidelines and took one minute to perform.
"The visual pathways are commonly affected in concussion," Balcer said in a statement. "Adding a vision-based test to evaluate athletes on the sidelines may allow us to better detect more athletes with concussion more quickly. This is particularly important since not all athletes reliably report their symptoms of concussion, including any vision problems."
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MONDAY, April 21, 2014 (HealthDay News) -- Asymptomatic carotid artery stenosis (ACS) in the neck may be linked to problems in learning, memory, thinking, and decision making, according to a study to be presented at the annual meeting of the American Academy of Neurology, held from April 26 to May 3 in Philadelphia.
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