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Many concussion patients who complain about problems with memory actually have an attention deficit. General measures: treat insomnia, stop alcohol, prescribe moderate cardiovascular exercise, and refer for cognitive rehabilitation (occupational and speech therapy). Consider treatment with a stimulant such as methylphenidate (Ritalin), amphetamine mixed salts (Adderall), and atomoxetine (Strattera), if appropriate, with careful monitoring for side effects. Contraindications include uncontrolled seizures, dangerous anxiety, active cardiovascular or cerebrovascular disease, active psychosis, drug abuse, irresponsible criminal behavior, dangerously underweight, and uncontrolled headaches. Recommend use is 6 days per week 51 weeks per year to reduce tolerance. Some patients find additional benefit from donepezil, rivastigmine, and regulated caffeine use. Approach options: “aggressive,” involving treatment with stimulants primarily based on history; “moderate,” involving treatment with stimulants only in patients with attention performance impairments documented with neuropsychological evaluation; and “conservative,” not including stimulants unless there is a well-documented history of preinjury attention deficit disorder.
citations This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | 0 | |
popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network. | Average | |
influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | Average | |
impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network. | Average |