Citations 3

Determinants of symptom presentation and resolution following concussions in high school sports

Research in Sports Medicine | October 23, 2024 | Volume: 33 | Issue: 1 | Pages: 72-86

10.1080/15438627.2024.2414972 | PMID 39439229

Determinants Of Symptom Presentation And Resolution Following Concussions In High School Sports

Medicine & Science in Sports & Exercise | September 26, 2023 | Volume: 55 | Issue: 9S | Pages: 984-985

10.1249/01.mss.0000989000.69943.c8

Sport-Related Concussion Preceding Adrenal Insufficiency and Hypopituitarism

Current Sports Medicine Reports | January 12, 2022 | Volume: 21 | Issue: 1 | Pages: 15-17

10.1249/jsr.0000000000000926 | PMID 35018894

Abstract A 49-year-old woman with a history of daily inhaled corticosteroid use for asthma presented to a concussion clinic 7 wk after sport-related head injury with headache, visual blurring, dizziness, nausea, fatigue, polydipsia, and polyuria. Examination revealed difficulty with vestibulo-occulomotor testing due to nausea and visual straining. Cranial CT/MR imaging was unremarkable. Laboratory testing revealed critically low serum cortisol, hypernatremia, and urine studies suggesting diabetes insipidus. The patient was referred to the emergency department. Intravenous fluid resuscitation, corticosteroids, and desmopressin led to significant symptomatic relief. She was maintained on oral hydrocortisone after cosyntropin test revealed adrenal insufficiency. Her clinical picture suggested chronic subclinical adrenal suppression from inhaled corticosteroids, which was exacerbated by hypopituitarism possibly from concussion combined with diabetes insipidus. Adrenal insufficiency should be considered in athletes with history of corticosteroid use and endocrine-related symptoms after concussion, because this can create significant morbidity and can mimic traditional symptoms of concussion.