Management of concussion and post-concussion syndrome

  title={Management of concussion and post-concussion syndrome},
  author={Barry S Willer and John J Leddy},
  journal={Current Treatment Options in Neurology},
  • B. Willer, J. Leddy
  • Published 1 September 2006
  • Medicine
  • Current Treatment Options in Neurology
Opinion statementConcussion and mild traumatic brain injury (mTBI) are common clinical problems. [] Key Method We evaluate the limited evidence-based pharmacologic treatment of acute concussion symptoms and PCS symptoms and also discuss return to activity recommendations, with an emphasis on athletes. Lastly, we suggest a promising new direction for helping patients recover from PCS.
Mild Traumatic Brain Injury and Post-concussion Syndrome: Treatment and Related Sequela for Persistent Symptomatic Disease
A careful and thoughtful evaluation is important, as the clinician must determine whether these prolonged symptoms reflect brain injury pathophysiology versus another process.
Sports-Related Concussion
The article covers the most recent literature on the diagnosis and management of SRC, including evidence-based recommendations and expert-based consensus opinion, and will also discuss issues regarding medical retirement, legislation, and future concepts in concussion diagnosis andmanagement.
Rehabilitation of Concussion and Post-concussion Syndrome
An algorithm is presented to aid clinicians in the evaluation and treatment of concussion and PCS and in the return-to-activity decision and depends on the clinician’s ability to differentiate among the various conditions associated with PCS.
Neuropsychology and clinical neuroscience of persistent post-concussive syndrome
  • E. Bigler
  • Medicine, Psychology
    Journal of the International Neuropsychological Society
  • 2007
The focus of this review is on the current status of PPCS as a clinical entity from the perspective of recent advances in the biomechanical modeling of concussion in human and animal studies, particularly directed at a better understanding of the neuropathology associated with concussion.
Current Understanding of Concussion: Treatment Perspectives
Clinicians and researchers are provided with a summary of interventions across disciplines in the field of sports-related concussion to determine how these interventions may benefit the individual recovering from concussion.
Review of the Management of Pediatric Post-Concussion Syndrome—a Multi-Disciplinary, Individualized Approach
Successful management of PCS requires a multi-disciplinary and individualized approach and there remains a significant need for further research, specifically looking into the outcomes and effective interventions in pediatric PCS.
Postconcussion Syndrome: A Physiatrist's Approach
  • Cara Camiolo Reddy
  • Medicine, Psychology
    PM & R : the journal of injury, function, and rehabilitation
  • 2011
Active Rehabilitation of Concussion and Post-concussion Syndrome.
Concussion: A Global Perspective.


The Development of Guidelines for the Management of Concussion in Sports
The formal process of developing guidelines for the diagnosis and management of concussion in sports, including the grading scale, sideline evaluation, and management strategy adopted as a practice parameter by the American Academy of Neurology are described.
Treatment of Post-Concussion Syndrome Following Mild Head Injury
A review of controlled treatment outcome studies conducted over the past 2 decades in Scandinavia, Great Britain, Canada, and the United States suggests that early single session treatment can prevent the syndrome as effectively as traditional outpatient therapy.
Electrophysiological indices of persistent post-concussion symptoms
Evidence of changes in brain function in individuals with persistent post-concussion symptoms is consistent with the position that the post- Concussion syndrome has a substantial biological, as opposed to a psychological, basis.
Grade 1 or “Ding” Concussions in High School Athletes
The data suggest that current grade 1 return-to-play recommendations that allow for immediate return to play may be too liberal and a reconsideration of current concussion grading systems appears to be warranted.
Predicting postconcussion syndrome after minor traumatic brain injury.
  • J. Bazarian, S. Atabaki
  • Medicine
    Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
  • 2001
To identify mTBI patients at low and high risk of PCS by comparing the predictive values of variables generated by logistic regression (LR) and recursive partitioning (RP), which expanded the number of patients able to be classified as high/low risk.
The Neurometabolic Cascade of Concussion.
Improved guidelines for clinical management of concussion may be formulated as the functional significance and duration of these postinjury neurometabolic derangements are better delineated.
Cumulative effects of concussion in amateur athletes
This study provides preliminary evidence to suggest that athletes with multiple concussions might have cumulative effects of injury, with differences between groups in symptom reporting and memory performance.
Definition, diagnosis, and forensic implications of postconcussional syndrome.
The authors review the pathology of brain trauma, symptoms of postconcussional syndrome, and criteria for diagnosis, and pharmacotherapies helpful, but care should be used in prescribing drugs that could produce deleterious CNS effects.
Electrophysiological evidence for the cumulative effects of concussion.
The results suggest that players with three or more concussions differed significantly on the several cognitive PCS symptoms as well as for the latency of the P3 response compared to those with no concussion history.
Assessment of postural stability following sport-related concussion.
  • K. Guskiewicz
  • Medicine, Psychology
    Current sports medicine reports
  • 2003
It appears that postural stability testing provides a useful tool for objectively assessing the motor domain of neurologic functioning, and should be considered a reliable and valid adjunct to the assessment of athletes suffering from concussion.