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Orthostatic hypotension in adolescents with concussion

Can orthostatic hypotension be detected in adolescents suspected of sustaining a concussion?

Orthostatic hypotension (OH) can occur following a concussion. This is mostly due to changes in the autonomic nervous system (ANS) regulation of the brain stem as a result of trauma.

Even though there is a high incidence of concussions among adolescents, currently only limited research exists on OH in this population. Therefore, this study aimed to investigate the prevalence of OH following a concussion injury in adolescents.

The concussion group had a higher prevalence of dizziness and lightheadedness than the control group, but did not meet the standard criteria of OH regarding aforementioned changes in blood pressure. However, the concussion group did report being less tolerant to transitional movements than the control group during the 1-Minute Supine to Stand Test.

Symptoms of dizziness with transitional movements are thought to be more correlated with deficits with the Vestibular-Ocular Reflex (VOR), rather than solely from the ANS, indicating additional therapy to address the VOR is more commonly needed to support concussion treatment.  

Symptoms of lightheadedness on the other hand are more correlated with a cardiovascular response. Therefore, the authors of this study state that the 1-Minute Supine to Stand Test may also be helpful in identifying adolescents who have been concussed based on symptoms, even if they don’t fully meet the criteria for OH.

> From: Haider et al., Brain Inj 35 (2021) 226-232 (Epub ahead of print). All rights reserved to Taylor & Francis Group, LLC. Click here for the online summary.

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