In the United States, an estimated 300,000 sports-related concussions occur annually (1). Sport-related concussion (SRC) is a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces. [Doolan et al (2). Current recommendations for concussion treatment after sideline diagnosis includes medical follow up with serial clinical evaluation and monitoring of standardized symptom scores to objectively assess resolution of symptoms and return to their preinjury baseline. Treatment of a concussion includes relative physical and cognitive rest, followed by a gradual and progressive return to activity that is specific to the athlete’s sport (2). The literature has not evaluated early interventions, as most individuals recover in 10-14 days (2). From a biomechanical standpoint, a concussion injury is produced by an impact to the head or body of a sufficient magnitude to induce a transient neurologic dysfunction. Using accelerometer data, known as the Head Impact Telemetry (HIT) System, the direction and magnitude of this force is quantified into a linear and rotational head acceleration in football athletes (13). These forces can be associated with soft tissue injury or somatic dysfunction that can be evaluated and treated with Osteopathic Manipulative Treatment (OMT), if indicated. From a neurofunctional standpoint, neuro electroencephalogram (EEG) readings have been discussed as a novel measure of functional brain networking for concussion management (4,5). In the same capacity, functional MRI (fMRI) has also been used as a diagnostic or management tool in SRC by assessing alterations of diffusion values in different areas of the brain (6). Our case demonstrates a sport-related concussion injury managed with OMT in addition to the usual standard of care, as well as correlating of a number of advanced diagnostic metrics including neuro EEG, fMRI, and blood biomarkers.
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