China
Africa
Explore chapters and articles related to this topic
Clinical Sequelae and Functional Outcomes
Published in Mark A. Mentzer, Mild Traumatic Brain Injury, 2020
Screening for mTBI in sports often involves the use of the Standardized Assessment of Concussion (SAC) or the Mini Mental Status Exam (MMSE) (Brennan et al., 2014). Military screening uses the Military Acute Concussion Evaluation (MACE) tool. This screening is most suitable for screening within 12 hours after an injury, and includes documentation and brief cognitive and neurological functions elements (Assistant Secretary of Defense, 2015).
Acute assessment, diagnosis, and management of the concussed athlete
Published in Brian Sindelar, Julian E. Bailes, Sports-Related Concussion, 2017
Brian Sindelar, Julian E. Bailes
Military acute concussion evaluation (MACE): For completeness of discussion, the MACE has also been used in the acute evaluation of concussion, but as the name implies, strictly within the military population.68,89 This assessment modality is composed of obtaining a history of the event including important features of loss of consciousness and amnesia, the SAC, and a “yes/no” symptom checklist.
Detecting functional deficits following sub-concussive head impacts: the relationship between head impact kinematics and visual-vestibular balance performance
Published in Brain Injury, 2021
Amanda M. Kelley, Kyle Bernhardt, Norah Hass, Tyler Rooks
During an assessment, a combat medic or a clinician administers the Military Acute Concussion Evaluation (MACE) or other comparable medical evaluation (11,12). MACE consists of several screening questions (incident description, any LOC or alterations in consciousness, whether a head injury was sustained, and concussion history), a cognitive exam (consisting of several memory and concentration exercises), and a neurological exam (consisting of several balance, eye, speech, and motor tests) (10). Administering MACE in an operational/training environment often results in the administrator having to make a determination of whether a Soldier has suffered an mTBI either at the time of the event (rapid evaluation) or at some point following medical evacuation (full evaluation). MACE is heavily reliant on self-reported symptoms and descriptions of the concussive event (13); thus, MACE results could be confounded by a service member’s motivation to continue working in the field. Furthermore, the neuropsychological test battery used to screen for mTBI has been shown to have problems with sensitivity and specificity (14). Without an accurate diagnosis of mTBI, soldiers may go untreated and be allowed to RTD while still affected and vulnerable to damaging secondary effects (e.g., performance deficits, increased risk of secondary injury particularly if balance is affected).
Return-to-Duty Decision Making and Medical Staff Deployed to Afghanistan
Published in Military Behavioral Health, 2018
Jennifer L. McDonald, Amy B. Adler, Joshua E. Wilk
This discrepancy between difficulty and confidence may be due to the more operationally defined nature of concussion/TBI compared to behavioral health problems. Concussion/TBI have specific physiological signs and symptoms, which may make the decision more obvious to the provider. That half of respondents rated concussion/TBI RTD decision making as not at all or a little difficult may reflect the availability of specific screening and decision-making tools available for concussion/TBI and the specific guidance for management of concussion/TBI in the deployed setting initially set out by the Department of Defense in 2010 and updated in 2012 (U.S. Department of Defense, 2012). Tools, such as the Military Acute Concussion Evaluation (MACE; Coldren, Kelly, Parish, Dretsch, & Russell, 2010), are available to medical personnel in combat environments. It may be that the MACE, a useful tool for early screening and detection of concussion/TBI, decreases the difficulty level of decision making; however, personnel may not receive much training beyond these simple screens and directives for concussion/TBI, which may affect their overall level of confidence in their decision making. In contrast, medical personnel may find the presentation of behavioral health symptoms more complex and have less specific tools and algorithms that allow for an easy decision to be made. However, once they make the decision, they are more confident that they are correct because they are relying on their training, experience, and judgment, and not just a simple tool or algorithm.
Rapid improvement in severe long COVID following perispinal etanercept
Published in Current Medical Research and Opinion, 2022
Edward Tobinick, Robert N. Spengler, Tracey A. Ignatowski, Manar Wassel, Samantha Laborde
Cognition, including executive function: Montreal Cognitive Assessment48; Mini-Mental State Examination (MMSE)49; Military Acute Concussion Evaluation (MACE)50; Trail Making Test, Parts A (TMT-A) and B (TMT-B)51; Controlled Oral Word Association Test (COWAT)52;