ABSTRACT
Sport-related concussion typically resolves within a few weeks of the injury; however, persistent symptoms have been reported to occur in 10% to 15% of concussions. These ongoing symptoms can cause significant disability and be frustrating for the patient and family. In addition, factors other than brain injury can cause complications for these patients, such as adjustment disorder or exacerbation of preexisting conditions such as depression or migraine. Individuals with prolonged symptoms of concussion may be classified as having post-concussion syndrome. A careful and thoughtful evaluation is important, as the clinician must determine whether these prolonged symptoms reflect brain injury pathophysiology versus another process. Although there have been numerous studies on the acute management of concussion, much less is available on the treatment of persistent disease. This review will provide an evaluation approach for the patient with prolonged concussion symptoms and review recent literature on treatment strategies.
Subject(s)
Brain Concussion/complications , Brain Concussion/therapy , Cognition Disorders/drug therapy , Cognition Disorders/etiology , Dyssomnias/etiology , Dyssomnias/therapy , Headache/etiology , Humans , Mood Disorders/etiology , Mood Disorders/therapy , Post-Concussion Syndrome/etiology , Post-Concussion Syndrome/therapy , Return to Sport , Return to WorkABSTRACT
OBJECTIVES: To evaluate the efficacy of cognitive and physical rest for the treatment of concussion. STUDY DESIGN: High school and collegiate athletes (N = 49) underwent post-concussion evaluations between April 2010 and September 2011 and were prescribed at least 1 week of cognitive and physical rest. Participants were assigned to groups on the basis of the time elapsed between sustaining a concussion and the onset of rest (1-7 days, 8-30 days, 31+ days). Main outcome measures included Concussion Symptom Scale ratings and scores on the 4 composite indices of the Immediate Post-Concussion Assessment and Cognitive Testing measure, both before and following rest. Mixed-factorial design ANOVA were used to compare changes on the dependent measures within and between groups. RESULTS: Participants showed significantly improved performance on Immediate Post-Concussion Assessment and Cognitive Testing and decreased symptom reporting following prescribed cognitive and physical rest (P < .001), regardless of the time between concussion and onset of rest (P = .44). CONCLUSION: These preliminary data suggest that a period of cognitive and physical rest may be a useful means of treating concussion-related symptoms, whether applied soon after a concussion or weeks to months later.