A - 25 Initial Clinic Visit Outcomes Among Patients With and Without Visual Aura Following Concussion

Abstract Purpose To compare clinical outcomes between patients with and without visual aura following concussion. Method This retrospective study involved patients aged 11–83 years who presented to a concussion specialty clinic with a diagnosed concussion within twenty days of injury on average. Participants completed the Concussion Clinical Profile Screen (CP-Screen), Vestibular/ Ocular Motor Screening (VOMS), and Immediate Post-concussion Cognitive Testing (ImPACT). Participants were categorized into Aura or No Aura based on endorsement of the CP Screen item 20, “Visual aura (e.g., flashes, stars, spots, flickering light) with or without headache.” Concussion clinical profiles were determined by clinicians. T-tests, chi-square tests, and ANCOVAs were used to evaluate group differences. Results 442 participants (M = 27.74 ± 15.92 years; 52.2% female) participated, including 190 (42.4%) with Aura and 258 (57.6%) with No Aura. The No Aura group was more likely to report motion sickness (26.8% vs 17.1%, p = 0.035). The Aura group was more likely to have an ocular clinical profile than the No Aura group (30.4% vs 14.3%, p = 0.003). The Aura group had worse CP-Screen total (38.15 ± 14.8 vs. 22.87 ± 13.12, p < 0.001), VOMS total (63.56 ± 44.39 vs. 37.55 ± 36.15, p < 0.001), ImPACT verbal memory (73.01 ± 16.95 vs. 80.5 ± 13.95, p < 0.001), visual memory (59.27 ± 15.6 vs. 66.93 ± 14.62, p < 0.001), visual motor speed (31.44 ± 8.33 vs. 34.6 ± 8.25, p < 0.001) and reaction time (0.78 ± 0.22 vs. 0.71 ± 0.16, p = 0.003), even after controlling for motion sickness history (p < 0.05). Conclusions Participants reporting visual aura had worse clinical outcomes than those without. Clinicians should screen for aura following concussion as this can inform prognosis and more effective treatments.