A measurable signal across the vestibulo-ocular axis, consistent with day-8 post-concussive presentation.
The composite Neurological Readiness Index aggregates the fifteen biomarkers, weighted by validated effect-size against an age- and sex-matched normative cohort. This patient's score sits 2.1 standard deviations below the cohort mean on a downward trajectory from the symptom-onset baseline three days prior, with a measurable recovery vector observed since session 04812 (day 5). Primary signal in the vestibular and ocular subtype channels; secondary signal in cognitive-fatigue.
Z-score -2.1 vs age-matched athletic cohort.
Trend over last 3 sessions: +4.2 points (recovering).
Subtype signal: vestibular, ocular.
Per-biomarker measurement, compared against published normative ranges.
Where the signal lives — biomarkers aggregated to the validated clinical subtypes.
Subtype-Weighted Clinical Picture
The biomarker signal concentrates in the vestibular and ocular subtype channels, with a secondary cognitive-fatigue signal that is modest and likely arousal-mediated. The post-traumatic-migraine and anxiety-mood channels are quiet.
The pattern is consistent with a post-concussive presentation centered on the vestibulo-ocular axis — vergence insufficiency, reduced VOR gain, reduced smooth-pursuit gain, and mild OKN asymmetry — without a measurable migrainous or affective component. Reading and contrast-sensitivity channels are unaffected, suggesting the optic-pathway and cortical visual machinery are intact.
- Vestibular and ocular subtype signal is the clinical fingerprint of this presentation.
- Two of the three "outside-range" biomarkers (VOR, vergence) map to the vestibulo-ocular pathway; smooth pursuit overlaps both.
- The cognitive-fatigue signal is consistent with day-8 post-injury arousal and attention compromise rather than primary cognitive injury.
- Recommended trajectory: targeted vestibular rehabilitation; convergence-insufficiency exercises; serial monitoring at 72-hour intervals.
Smooth Pursuit · Time-series gaze trace vs target.
Composite Index across sessions — pre-injury baseline through day 8.
Narrative synthesis and clinical recommendation.
Summary of Findings
Sixteen-year-old male athlete, day 8 following a sport-related concussion sustained 11 May 2026 during a soccer match. Pre-injury baseline session 04621 (28 April) demonstrated all fifteen biomarkers within range and a composite index of 92. Acute post-injury session 04812 (day 5) demonstrated a composite of 61 with measurable signal across vestibular, ocular, and cognitive-fatigue channels.
Today's session (day 8) shows a composite of 68, a four-point improvement over day 5, with the migraine and anxiety-mood channels essentially quiet. The persistent signal in VOR gain (0.78), near-point of convergence (9.5 cm), and smooth pursuit gain (0.74 left / 0.73 right) is consistent with vestibulo-ocular subtype, the most prevalent post-concussive clinical phenotype in adolescent athletes per the Pittsburgh-five framework.
Reading-saccade fixation duration, contrast sensitivity, fixation stability, and pupillary light reflex with RAPD are all within range — the optic-pathway and primary visual cortex are not implicated.
This is a measurable recovery trajectory. The patient is not yet at baseline, but the direction of travel is favorable.