Etiology and Clinical Presentation of Concussion: An Age- and Sex-matched Case Series

Abstract

Abstract Purpose Differential patterns of clinical presentation in concussion have been explored previously based on etiology (e.g., sport vs. non-sport) and may be affected by biomechanical, pathophysiological, and psychological factors. The purpose of the study was to compare neurocognitive performance and symptom presentation across different etiologies in concussed patients. Methods 36 concussion patients, 12 slip-and-fall (SNF) were age- and sex-matched with motor vehicle accident (MVA) and sport-related concussions (SRC) (20.3±1.5 years; 4 males; 8 females per group). They were evaluated ≤ 2 weeks (7.2±3.7 days) after their injury. Patients completed medical history, an Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), and Post-Concussion Symptom Scale (PCSS) at initial visit. Descriptive statistics, a series of Kruskal-Wallis H Tests, χ² tests and one-way ANOVAs were performed using SPSS 24. Results The three groups exhibited no differences in verbal memory (p=0.11), visual memory (p=0.10), visual motor speed (p=0.19), or reaction time (p=0.19) composites. There were no differences in symptom severity (p=0.69) or symptom count (p=0.99) or the cognitive-migraine-fatigue (p=0.69), somatic (p=0.26), affective (p=0.92), or sleep (p=0.73) symptom clusters. Comorbidities (i.e., learning disorder, previous concussion, migraine, seizure, psychological condition, or motion sickness) were not significantly different across groups. Conclusion No significant differences were found on ImPACT or PCSS across etiologies. When controlling for comorbidities and demographic variables, these groups appear similar at the initial evaluation. Future research will focus on practice patterns and clinical outcomes.