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. 2021 Jan 18;35(2):226-232.
doi: 10.1080/02699052.2021.1871951. Epub 2021 Jan 17.

Symptoms upon postural change and orthostatic hypotension in adolescents with concussion

M Nadir Haider  1   2 , Kush S Patel  1 , Barry S Willer  3 , Victoria Videira  4 , Charles G Wilber  1 , Andrew R Mayer  5   6 , Christina L Master  7   8 , Brandon L Mariotti  2 , Christopher Wertz  5 , Eileen P Storey  8 , Kristy B Arbogast  8 , Grace Park  9 , Scott J Oglesbee  9 , Itai Bezherano  1 , Kenneth Aguirre  1 , Jesse G Fodero  10 , Blair D Johnson  11 , Rebekah Mannix  12 , Jeffrey C Miecznikowski  13 , John J Leddy  1
Affiliations

Symptoms upon postural change and orthostatic hypotension in adolescents with concussion

M Nadir Haider et al. Brain Inj. .

Abstract

Objective: Concussion is associated with dysautonomia, altered blood pressure (BP) control, and may cause Orthostatic Hypotension (OH). We measured prevalence of OH using the 1-minute supine-to-standing OH Test in adolescents with concussion and controls.Participants: Adolescents within 10 days of injury (Concussion Group, n = 297, 15.0 ± 1.7 years, 59% male) were compared with controls (Control Group, n = 214, 15.0 ± 1.5 years, 58% male).Methods: BP, heart rate (HR), and complaints of lightheadedness/dizziness were measured after 2-minute supine and 1-minute standing. Control Group was assessed once. Concussion Group was assessed twice; (1) initial visit (mean 6.0 ± 3 days-since-injury) and (2) after clinical recovery (mean 46.3 ± 42 days-since-injury).Results: Initial visit; Concussion Group reported feeling lightheaded/dizzy on postural change more often than the Control Group (37% vs 4%, p < .001) but did not differ in meeting standard OH criteria (3% vs 5%, p = .32). Experiencing symptoms did not correlate with meeting OH criteria, but correlated with abnormal vestibulo-ocular reflex. After clinical recovery; Concussion Group did not differ in experiencing lightheaded/dizziness on postural change than controls (4%, p = .65).Conclusion: Adolescents commonly experience orthostatic intolerance after concussion without meeting the standard criteria for OH.

Keywords: adolescent; autonomic nervous system; concussion; orthostatic hypotension; orthostatic intolerance.

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Conflict of interest statement

Potential Conflicts of Interest:

The authors have no conflicts of interest relevant to this article to disclose.

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