Talk:Concussion

There is a lack of information in the research section about current research being conducted. I propose adding the following entry.

In 2014, the National Collegiate Athletic Association and the U.S. Department of Defense launched the largest concussion study in history -- the Concussion Assessment, Research and Education Consortium (CARE)^[1]. The partnership between the NCAA and DOD formed because the organizations recognized that there were similarities in demographics and biomechanics behind the concussions experienced by college athletes and military personnel.

The research study itself is being led by three career concussion researchers: Thomas W. McAllister, the Albert Eugene Sterne Professor and Chairman for the Indiana University School of Medicine Department of Psychiatry; Michael McCrea, Professor of Neurosurgery and Neurology and Director of Brain Injury Research at the Medical College of Wisconsin; and Steven Broglio, Associate Professor at the University of Michigan in the School of Kinesiology and Departments of Neurology and Physical Medicine and Rehabilitation^[2]. The study includes a clinical study core, which aims to define how concussion symptoms present and evolve over time in different people, and an advanced research core, which seeks to understand how the brain itself is affected by concussion and repetitive head impacts.

To date, the study has received more than $46 million in funding from the NCAA and DOD. More than 40,000 college athletes and cadets have been assessed across 30 college campuses and military service academies throughout the U.S., and more than 4,000 concussions have been analyzed from diagnosis and throughout treatment^[3].

The first phase of the study has been completed and aims to study the acute effects of concussion and repetitive head impact exposure. Ten research papers utilizing the first phase of CARE data have been published to date^[4]. The second phase of the study, which aims to assess the intermediate effects of concussion and repetitive head impacts, is in progress. A long-term study, which could last 35 or more years, is also planned and will assess the potential long-term ramifications of concussion and repetitive head impact exposures. It is the only long-term advanced research study of concussion and repetitive head impact exposure ever conducted^[5].

--— Preceding unsigned comment added by Bdhendrickson (talk • contribs) 13:08, 18 July 2018 (UTC)

Thanks for making a suggestion to improve the page. This is heavily sourced from consortium websites and is somewhat promotional. This is unlikely to be implemented. I've left a message at your talk page, User talk:Bdhendrickson. Jytdog (talk) 13:50, 18 July 2018 (UTC)

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Additionally, it is believed that the metabolic vulnerability, as a result of the energy crises, experienced after a concussion relates to the catastrophic effects that occur if re-injury occurs before recovery"^[1] 147.9.36.67 (talk) 13:32, 6 December 2018 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. —KuyaBriBri^Talk 15:15, 6 December 2018 (UTC)

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Under section 6.4 "Second impact syndrome" directly after 3rd sentence (ending with footnote 54), add "Additionally, it is believed that the metabolic vulnerability, as a result of the energy crises, experienced after a concussion relates to the catastrophic effects that occur if re-injury occurs before recovery."

^[2] Larostegui96 (talk) 20:33, 8 December 2018 (UTC)

 Not done: It is believed the idea that this metabolic vulnerability as described in the source over the course of 9 pages (according to the editor's submitted proposal containing the reference template parameter |pages=) is an inordinate amount of individual pages needed to explain how that vulnerability relates to so-called catastrophic effects and re-injury. Either submit the verbatim exchange in the article which verifies the claim by using the |quote= parameter, narrow down the page range, or submit another reference.  Spintendo  03:21, 9 December 2018 (UTC)

This article really needs an update, especially in the treatment section. PMID 28446457 can be used to update the 2008 version of the consensus statement that is used in this article. I am working on a pediatric concussion clinical guideline (so have a COI here) but these edits and updates do not involve or cite any projects that I am involved with, I just noticed that the references (and evidence) is out of date. JenOttawa (talk) 01:02, 11 August 2019 (UTC)

Other sources to consider include the following clinical guidelines:

• Pediatric mTBI Guideline (CDC) 2018
• Ontario Neurotrauma Foundation (ONF)- pediatric and adult clinical guidelines (I have a COI here as I helped develop the ONF pediatric concussion guideline).

JenOttawa (talk) 19:51, 4 November 2019 (UTC)

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Add under the "Research": A novel model of awake closed-head injury has been developed in rats to study the effects of pre-clinical concussion. Early investigations showed deficits in reasoning and spatial memory up to 24 hours post-injury, with region-specific increases in ionized calcium-binding adaptor molecule 1 and glial fibrillary acidic protein (GFAP) at 3 days post-injury. This model demonstrates neuroinflammatory processes that persist beyond behavioural deficits.

Reference: https://www.ncbi.nlm.nih.gov/pubmed/30843474 [doi:10.1089/neu.2018.6169] Latelow (talk) 00:47, 30 October 2019 (UTC)

@Latelow: Would you be okay with the following revised version of your edit? A model of awake closed-head injuries was developed in rats to study the effects of concussion. The model showed decreases in reasoning and spatial memory up to 24 hours post-injury, with region-specific increases in allograft inflammatory factor 1 and the glial fibrillary acidic protein three days after the injury.^[1] Upsidedown Keyboard (talk) 01:19, 13 November 2019 (UTC)

Hello,

We are a group of medical students from Queen's University. We are working to improve this article over the next month and will be posting our planned changes on this talk page. We look forward to working with the community and welcome any feedback regarding our suggestions. — Preceding unsigned comment added by Jr9023 (talk • contribs) 20:21, 11 November 2019 (UTC)

Proposed Change #1: We believe the "Pathophysiology" section requires some updating. Part of the original section is as follows:

"In summary, and extrapolating from animal studies, the pathology of a concussion seems to start with the disruption of the cell membrane of nerve cells. This results in a migration of potassium from within the cell into the extracellular space with the subsequent release of glutamate which potentiates further potassium shift, in turn resulting in depolarization and suppression of nerve activity."

The section, with proposed changes (in bold and strikeout):

[In summary, and extrapolating from] Using animal studies, the pathology of a concussion seems to start with mechanical shearing and stretching forces [the] disrupting [of] the cell membrane of nerve cells through "mechanoporation"ref name=Romeu2019 />. This results in [a migration of] potassium outflow from within the cell into the extracellular space with the subsequent release of excitatory neurotransmitters including glutamate which leads to enhanced potassium extrusion[potentiates further potassium shift], in turn resulting in sustained depolarization, [suppression of] impaired nerve activity and potential nerve damage. Human studies have failed to identify changes in glutamate concentration immediately post-mTBI, though disruptions have been seen 3 days to 2 weeks post-injury^[2].

Jr9023 (talk) 22:35, 18 November 2019 (UTC)

You did a great job communicating this info. I see that your 2019 paper is a primary study. I think that you should hold off on adding this evidence to Wikipedia until it is reviewed in a secondary source. . "Mild Closed-Head Injury in Conscious Rats Causes Transient Neurobehavioral and Glial Disturbances: A Novel Experimental Model of Concussion"JenOttawa (talk) 18:11, 25 November 2019 (UTC)

Proposed Change #2:

“In an effort to restore ion balance, the sodium-potassium ion pumps increase activity, which results in excessive ATP (adenosine triphosphate) consumption and glucose utilization, quickly depleting glucose stores within cells. Lactate accumulates but, paradoxically, cerebral blood flow decreases, which leads to a proposed "energy crisis." Simultaneously, inefficient oxidative metabolism leads to anaerobic metabolism of glucose and increased lactate accumulation.^[1] There is a resultant local acidosis in the brain and increased cell membrane permeability, leading to local swelling.^[1] After this increase in glucose metabolism, there is a subsequent lower metabolic state which may persist for up to 4 weeks after injury. A completely separate pathway involves a large amount of calcium accumulating in cells, which may impair oxidative metabolism and begin further biochemical pathways that result in cell death. Again, both of these main pathways have been established from animal studies and the extent to which they apply to humans is still somewhat unclear.^{[citation needed]}”

References

Meaghan257 (talk) 22:46, 18 November 2019 (UTC)

Thanks for sharing this. Do you mind adding a reference for the last sentence? I added a citation needed template where it is missing. JenOttawa (talk) 23:00, 18 November 2019 (UTC)

Proposed Change #3:

My proposed changes pertain to the “Prevention” section of the Wikipedia article on “Concussion.” Currently, the “Prevention” section focuses almost exclusively on protective equipment (e.g. helmets, airbags and seatbelts, and hard shoes) as useful tools for preventing concussion. I propose highlighting educational interventions as possible prevention strategies as well.

My proposed changes are bolded:

Prevention of mTBI involves general measures such as wearing seat belts, using airbags in cars, and protective equipment such as helmets for high-risk sports. Older people are encouraged to reduce fall risk by keeping floors free of clutter and wearing thin, flat, shoes with hard soles that do not interfere with balance. Protective equipment such as headgear has been found to reduce the number of concussions in athletes and improvements in the design of helmets may decrease the number and severity further. New "Head Impact Telemetry System" technology is being placed in helmets to study injury mechanisms and may generate knowledge that will potentially help reduce the risk of concussions among American Football players.

It has been shown that educational interventions, such as handouts, videos, workshops, and lectures, can improve concussion knowledge of diverse groups, particularly youth athletes and coaches.^{[citation needed]} Some studies have found that strong concussion knowledge is associated with greater recognition of concussion symptoms, higher rates of concussion reporting behaviors, and reduced body checking-related penalties and injuries, thereby lowering risk of mTBI.^[1]

Self-reported concussion rates among U-20 and elite rugby union players in Ireland are 45–48%. Half of these injuries go unreported. Changes to the rules or enforcing existing rules in sports, such as those against ‘head-down tackling’, or ‘spearing’, which is associated with a high injury rate, may also prevent concussions.

References

IAgg6 (talk) 00:23, 19 November 2019 (UTC)

Thank you for sharing these proposed improvements. I added a citation needed tag, you can use the same citation more than once but it is helpful to include it after each sentence when communicating evidence on Wikipedia. Great work so far!JenOttawa (talk) 18:15, 25 November 2019 (UTC)

Hi @IAgg6:, your citations did not come through for your proposed article improvements. Do you mind adding them here? JenOttawa (talk) 00:34, 19 November 2019 (UTC)

Proposed Change #4 (to lead): Any of these symptoms may begin immediately, or appear days after the injury^[1], and it is not unusual for symptoms to last four weeks. The severity of the initial symptoms is the strongest predictor of slower recovery time and it is not unusual for symptoms to last 10-14 days for adults and 4 weeks for children^[2].

Amanda0054 (talk) 00:35, 19 November 2019 (UTC)

Proposed Change #5

From the second paragraph in the introduction:

Known risk[Risk] factors include drinking alcohol and a prior history of concussion.^[1] The mechanism of injury may involve either a direct blow to the head or [forces elsewhere on the body that are]an impact to the body with force impulses transmitted to the head.^[1]

Sinnoh Stone (talk) 00:43, 19 November 2019 (UTC)

Proposed Change #6 :

Current writing: Concussions are estimated to affect more than 6 per 1,000 people a year.[3] It is the most common type of TBI.[3] Males and young adults are most commonly affected.[3] Outcomes are generally good.[11]

Proposed change: Worldwide, concussions are estimated to affect more than 349 per 100,000 people a year^[1]. Concussions are classified as mild traumatic brain injuries and are the most common type of TBIs^[1]. Males are the most commonly affected and those at extreme ends of age (under 15 or over 65) are at lower risk.^[1]

Zhaq123 (talk) 02:29, 19 November 2019 (UTC) zhaq123

Proposed change #7 To replace the following sentence in the "Prevention" section: Protective equipment such as headgear has been found to reduce the number of concussions in athletes and improvements in the design of helmets may decrease the number and severity further. I will be inserting following the information:

Protective equipment such as helmets and other headgear and policy changes such as the banning of body checking in youth hockey leagues have been found to reduce the number and severity of concussions in athletes^[1]. Secondary prevention such as a return to play protocol for an athlete may reduce the risk of repeat concussions^[2].

Gillian0423 (talk) 03:24, 19 November 2019 (UTC)

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Current ongoing research has demonstrated that there is a connection between concussions and increased lower extremity (LE) injury risk in sports. These lower extremity injuries can include acute fractures, muscle strains/tears, or ligament strains/ruptures. In a 90 day cohort study, researchers discovered that athletes returning to play post concussion were 2.48 times more likely to sustain a LE injury compared to control groups (Brooks 2016).

Brooks, M. Peterson, K. Biese, K. Sanfilippo, J. Heiderscheit, B. Bell, D. 2016. Concussion Increases Odds of Sustaining a Lower Extremity Musculoskeletal Injury After Return to Play Among Collegiate Athletes. The American Journal of Sports Medicine. 44(3): 742-746. Victoriak33 (talk) 02:09, 23 November 2020 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. Seagull123 Φ 17:03, 23 November 2020 (UTC)

I also noted that the proposed paper is a primary study (cohort study). Wikipedia communicates evidence a little differently than in academia, and the Wikipedia guideline for reliable sources in medicine suggests that secondary sources (see WP:MEDRS) are preferred over primary sources. @Victoriak33: If you can find a systematic review or review article that summarizes this cohort study please share it here, along with your suggested article improvement. I would be happy to help. JenOttawa (talk) 20:53, 23 November 2020 (UTC)

Hello,

We are a group of medical students from Queen's University. We are working to improve this article over the next two-weeks and will be posting our planned changes on this talk page. We look forward to working with the community and welcome any feedback regarding our suggestions. Thanks! RA10-2020 (talk) 20:16, 23 November 2020 (UTC)

1. We propose to insert the following content into the Concussion #Diagnosis section:

Concussion may be under-diagnosed because of the lack of the highly noticeable signs and symptoms while athletes may minimize their injuries to remain in the competition.[69] Direct impact to the head is not required for a concussion diagnosis, as other bodily impacts with a subsequent force transmission to the head are also causes.^[1] A retrospective survey in 2005 suggested that more than 88% of concussions are unrecognized.[70] RA10-2020 (talk) 23:20, 2 December 2020 (UTC)

Thanks for this suggestion. I wonder if we can find a replacement for ref 70^[2] (2005 primary research paper that is very outdated) at the same time? I will look as well. Anything over 2-4 years is very very outdated in concussion as the evidence base has changed significantly. This new systematic review may help for adolescent data but no quick fix IMO for updating this sentence.^[3] I know that this is beyond the scope of your assignment on Wikipedia, just leaving here in case someone has time before I circle back.JenOttawa (talk) 18:00, 2 December 2020 (UTC)

2. We propose to make the following changes pertaining to the Concussion #Treatment section under the #Return-to-school subheading:

The section with changes made (represented by bold and strikethrough) is as follows:

The resumption of low-risk school activities should not begin [as soon as] until the student [feels well enough] has completed an initial period of cognitive rest totalling at least 24-48 hours.^[1] The return to school should be gradual and step-wise.[93] Rushing back to cognitive activities, such as school, has been associated with longer-lasting symptoms and extended recovery time.^[2] Since students may appear 'normal', continuing education of relevant school personnel may be needed to ensure appropriate accommodations are made such as part-days and extended deadlines.^[1] Accommodations should be based on the monitoring of symptoms that are present during the return-to-school transition including headaches, dizziness, vision problems, memory loss, difficulty concentrating, and abnormal behaviour.^[1][2] Rjwilliamson (talk) 17:26, 3 December 2020 (UTC)

Great suggestion @Rjwilliamson: for improving the return to school section. You highlight the need for 24-28 hours rest, however, on the flip side, Dr. Master's paper also says "prescribing strict rest beyond a couple of days has been shown to increase emotional symptoms in adolescents with acute concussion",^[1] highlighting newer research that prolonged rest can be detrimental to recovery and keeping kids out of school too long is not suggested (versus returning with accomodations when they are able to tolerate some school, after that brief but important 24-48 hrs cognitive rest). I think a paraphrased addition about a balance between the need for a short immediate 24-48 hrs maximum of complete rest and the evidence supporting kids to start resuming low-risk physical and cognitive activities as soon as they are able (they do not require med clearance to return to school) should be added to ensure that this accurately conveyed. Great re-use of your citation in this as well! JenOttawa (talk) 19:04, 3 December 2020 (UTC)

3.We propose to make the following changes pertaining to the Concussion #Mechanism section under the #Force subheading:

The section with changes made (represented by bold and strikethrough) is as follows:

“The brain is surrounded by cerebrospinal fluid, which protects it from light trauma. More severe impacts, or the forces associated with rapid acceleration, may not be absorbed by this cushion[35].  Concussion may be caused by impact forces, in which the head strikes or is struck by something, or impulsive forces, in which the head moves without itself being subject to blunt trauma (for example, when the chest hits something and the head snaps forward)[32].Concussions, and other head-related injuries, occur when external forces acting on the head are transferred to the brain^[1]. Such forces can occur when the head is struck by an object or surface (a ‘direct impact’), or when the torso rapidly changes position (i.e. from a body check) and force is transmitted to the head (an ‘indirect impact’).^[1]

Rachelw12345 (talk) 01:39, 4 December 2020 (UTC)

4.We propose to create a subheading called #Workplace in the Concussion #Epidemiology section:

Our proposed paragraph is as follows (represented by bold):

Concussions may also be common and occur in the workplace. According to the US Bureau of Labour Statistics, the most common causes of mTBI-related hospitalizations and deaths from the workplace are falls, force of heavy objects, and vehicular collisions^[1]. As a consequence, jobs in the construction, transportation, and natural resource industries (eg. agriculture, fishing, mining) have more elevated mTBI incidence rates ranging from 10-20 cases per 100 000 workers^[1]. In particular, as vehicular collisions are the leading cause of workplace mTBI-related injuries, workers from the transportation sector often carry the most risk^[2]. Despite these findings, there still remain important gaps in data compilation on workplace-related mTBIs, which has raised questions about increased concussion surveillance and preventative measures in private industry^[2].

Thanks, and I welcome any suggestions the community may have regarding this section. Xiuyuan44 (talk) 03:10, 4 December 2020 (UTC)

5.We propose to make the following changes pertaining to the Concussion #Prognosis section under the #Post-concussion Syndrome subheading:

The section with changes made (represented by bold and strikethrough) is as follows:

In post-concussion syndrome, symptoms do not resolve for weeks, months, or years after a concussion, and may occasionally be permanent.[103] About 10% to 20% of people have post-concussion syndrome for more than a month.[104] Symptoms may include headaches, dizziness, fatigue, anxiety, memory and attention problems, sleep problems, and irritability.[105] There is no established treatment, and rRest, a recommended recovery technique, has limited effectiveness.[106] A recommended treatment in both children and adults with symptoms beyond 4 weeks involves an active rehabilitation program with reintroduction of noncontact aerobic activity.^[1] Progressive physical exercise has been shown to reduce long-term post-concussive symptoms. ^[1] Symptoms usually go away on their own within months[84] but may last for years.[107][108] The question of whether the syndrome is due to structural damage or other factors such as psychological ones, or a combination of these, has long been the subject of debate.[71]

Del Fernandes (talk) 03:54, 4 December 2020 (UTC)

6. We propose to make the following changes pertaining to the Concussion #Prognosis section

The overall prognosis for recovery may be influenced by a variety of factors that include age at the time of injury, intellectual abilities, family environment, social support system, occupational status, coping strategies, and financial circumstances.[98] People over age 55 may take longer to heal from mTBI or may heal incompletely.[99] Mild traumatic brain injury recovery time in people over age 65 may have increased complications due to elevated health concerns, or comorbidities^[1]. This often results in longer hospitalization duration, poorer cognitive outcomes, and higher mortality rates.^[2] Similarly, factors such as a previous head injury or a coexisting medical condition have been found to predict longer-lasting post-concussion symptoms.[100] RylieDawn (talk) 04:44, 4 December 2020 (UTC)

Hi! I find this a pretty outdated citation for concussion. I do know that there is a lot less research on elderly people with concussion though. I will keep an eye out as well to see if we can find a more recent secondary source to use. Please note: When you add your references while editing the actual article, you can see the options "automatic Manual Re-use". The first time you add the citation (if it is not already used in an article, click "automatic" and add your PMID, DOI, or website, then click "generate" to fill the template. The second time you want to use the same citation in an article, click "reusue" and search for your citation in the list. This adds in the a,b,c versus duplicating the citation in the list. If possible, practice this in your sandbox before editing live on Monday. Thanks very much! JenOttawa (talk) 03:30, 5 December 2020 (UTC)

7. A) We propose to insert the following content into the Concussion #Diagnosis section (further changes from Proposed Change #1):

Concussion may be under-diagnosed because of the lack of the highly noticeable signs and symptoms while athletes may minimize their injuries to remain in the competition.[69] Direct impact to the head is not required for a concussion diagnosis, as other bodily impacts with a subsequent force transmission to the head are also causes.^[3] A retrospective survey in 2005 suggested that more than 88% of concussions are unrecognized.[70] Particularly, many younger athletes struggle with identifying their concussions, which often result in the non-disclosure of concussions and consequently underrepresenting the incidence of concussions in the context of sport.^[4]

7. B) We propose to make the following changes in the Concussion #Diagnosis section under the #Prevention subheading:

Due to the incidence of concussion in sport, younger athletes often do not disclose concussions and their symptoms. Common reasons for non-disclosure include a lack of awareness of the concussion, the belief that the concussion was not serious enough, and not wanting to leave the game or team due to their injury.^[4] Self-reported concussion rates among U-20 and elite rugby union players in Ireland are 45–48%, indicating that many concussions go unreported.[34] Half of these injuries go unreported. Changes to the rules or enforcing existing rules in sports, such as those against "head-down tackling", or "spearing", which is associated with a high injury rate, may also prevent concussions.[34] Rebeccasgl (talk) 00:08, 5 December 2020 (UTC)

In the 2nd paragraph, I noticed this sentence.

"A full differential diagnosis by a physician or nurse practitioner is required to rule out life threatening head injuries, injuries to the cervical spine, and neurological conditions."

As a healthcare provider (physician assistant / PA / PA-C) working in emergency medicine, I find that sentence bizarre and misleading. Use of the phrase "differential diagnosis" in this context doesn't make much sense, or at least is very poorly worded. And specifically listing physician and nurse practitioner (but not physician assistant) is very weird, since all three professions do exactly the same thing when it comes to evaluating concussions.

A better way to word that sentence would be something like this:

"A thorough evaluation by a qualified medical provider (such as a physician, physician assistant, or nurse practitioner) is required to rule out life-threatening head injuries, injuries to the cervical spine, and neurological conditions."

(I noticed there's a similar sentence further down in the article, which should I would also recommend editing for improved accuracy.)

Thanks! Ben Tanner, PA-C

Thanks for suggesting this @Etanner6: I made this improvement. It is super helpful to have experts here helping! JenOttawa (talk) 02:25, 24 July 2021 (UTC)

A sort of basic question. Are all knockouts concussions? Is any time a football player loses consciousness due to impact a concussion? I used to think so, but many times I've read about loss of consciousness in football, but the player was only LATER diagnosed with concussion. The technical definition is head injury that temporarily affects brain function. So what about when boxers become glassy-eyed, or rubbery-legged, or briefly dazed? Are those all concussions? Seems as though they should be, by definition. But you never see it presented that way.

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In the "Prognosis" tab under "Pediatric concussion," change "Most children recovery completely..." to "Most children recover completely..." 2600:1700:1E31:300:751C:8020:E0CD:9499 (talk) 14:41, 21 November 2022 (UTC)

 Done Jiltedsquirrel (talk) 14:47, 21 November 2022 (UTC)

In the Concussion#Diagnosis section, please change

B[[CT scan|rain imaging]] may be suggested. A brain CT or brain MRI should be avoided unless...

to

[[CT scan|Brain imaging]] may be suggested. A brain CT or brain MRI should be avoided unless...

or

Brain imaging such as a [[CT scan]] or [[MRI]] may be suggested, but should be avoided unless...

Thank you. --173.67.42.107 (talk) 21:30, 21 February 2023 (UTC)

I made this change. @173.67.42.107: thanks for posting.JenOttawa (talk) 13:36, 12 April 2023 (UTC)

I have noticed a minor grammar error a few minutes ago within this part of the page:
"Symptoms may appear immediately or be delayed y 1-2 days."
It should be changed to:
"Symptoms may appear immediately or be delayed by 1-2 days."
(of course, without the bold text though... also, I know I'm logged out) 86.13.169.4 (talk) 16:07, 13 May 2023 (UTC)

Fixed, thanks for flagging.JenOttawa (talk) 17:32, 15 May 2023 (UTC)

I wanted to move the ideas for improving the article and adding in information about Earthquakes to this talk page to prevent going back and forth with edits on the main article. For example, this edit, that I reverted for now until a higher quality source that meets WP:MEDRS can be found. https://en.wikipedia.org/w/index.php?title=Concussion&diff=1156988111&oldid=11569

JenOttawa (talk) 16:37, 25 May 2023 (UTC)

Ah, I just came to post the same and see JenOttawa beat me to it. Yuliadhi, Welcome to Wikipedia and thank you for your interest in this article. I know it can be frustrating when information on a topic seems to be missing from an encyclopedia article. But our articles attempt to summarize what's in mainstream sources on a given topic. We cover each fact/idea in rough proportion to how much coverage it gets in these sources. This connection between earthquakes and concussions, and the phenomenon of "phantom earthquake syndrome" are not well covered in mainstream sources about concussions, and so they don't feature prominently in our article. If you think mainstream sources are failing to appreciate an important element of concussions, then your quarrel is not with us. You need mainstream sources to catch up to this phenomenon, and then it'll be reflected here. I hope that helps clarify things. If you'd like to discuss particular sources or ideas further, we're happy to do so here. Ajpolino (talk) 16:00, 26 May 2023 (UTC)

Hi, i noticed that this earthquake information was added again this week. @Ajpolino: I can revert it, but try to avoid edit wars. Do you have any suggestions for a solution? JenOttawa (talk) 01:18, 19 July 2023 (UTC)

Removed the earthquake (not sure how many times this has been edited in and out) as per above. @WhatamIdoing: do you have any suggestions here? The user is not responding to talk page notes and it seems every few months this is repeated. Thanks! JenOttawa (talk) 14:56, 10 August 2023 (UTC)

Based on how many times she's asked me and other editors if we have been uploaded to a website (no, I still have a human body, and I assume the other editors do, too), I suspect the editor has limited English skills.

We could request a partial block to keep her off this one page. That's likely to be less "expensive" (in terms of computing power) than a Special:AbuseFilter item to prevent anyone from adding those words. WhatamIdoing (talk) 16:37, 10 August 2023 (UTC)

Thanks for the ideas. Sorry for the delayed response. I can keep watching this over the next few months and see if this is still happening this fall, unless you think it is more pressing.JenOttawa (talk) 10:48, 14 August 2023 (UTC)

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Please replace

Resting completely for longer than 24–48 hours follow concussion 

as follows

Resting completely for longer than 24–48 hours following concussion 

Thank you. 86.135.242.225 (talk) 10:04, 9 January 2024 (UTC)

 Done Rehsarb (talk) 12:45, 9 January 2024 (UTC)

In the first paragraph:

Symptoms may include headache, dizziness, difficulty with thinking and concentration, sleep disturbances, mood changes, a brief period of memory loss, brief loss of consciousness; problems with balance; nausea; blurred vision; and mood changes.

Lists mood changes twice. Suggest removing the one that does not link to article. 8.22.108.55 (talk) 01:00, 3 February 2025 (UTC)