Is it really the result of a concussion? Lessons from a case study

Area of Science:

• Neuroscience
• Sports Medicine
• Neurology

Background:

• Sports-related concussion (SRC) is now recognized as a potentially serious brain injury, shifting from previous views of it as minor.
• Public and clinical attention towards SRC has significantly increased over the past two decades.

Purpose of the Study:

• To investigate the root cause of persistent symptoms in an individual with a history of multiple SRCs.
• To differentiate between concussion-related sequelae and other potential causes of ongoing symptoms.

Main Methods:

• A comprehensive case study approach was employed.
• Neurophysiological testing (Neary protocol), detailed concussion assessment (including SCAT-5), neurological and specialized dizziness/balance assessments were performed.
• Structural MRI and neurological referrals were utilized.

Main Results:

• The participant reported persistent symptoms despite multiple SRCs.
• Investigations identified peripheral vestibular dysfunction and otolithic dysfunction as the primary cause of symptoms.
• These vestibular issues appeared unrelated to the individual's concussion history.

Conclusions:

• Ongoing symptoms attributed to concussions may arise from unrelated conditions with similar presentations.
• This case highlights the necessity of multi-disciplinary assessments and repeated testing protocols for accurate diagnosis.
• Emphasizes careful differential diagnosis for persistent post-concussion-like symptoms.