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Concussion (Mild Traumatic Brain Injury)

Lee A. Mancini, CSN, CSCS*D, MD, CAQSM, Emily J. Eshleman, MS, DO and Michael J. Maddaleni, CAQSM, MD Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Mild traumatic brain injury (mTBI) is defined as a complex pathophysiologic process affecting the brain, induced by traumatic biomechanical forces. This can be direct (blow to the he...

DIAGNOSIS

HISTORY

  • Cognitive signs and symptoms

    • Confusion, disorientation

    • Antegrade and retrograde amnesia

    • LOC occurs in <10%

    • Feeling “in a fog,” “zoned out”

    • Inability to focus (i.e., difficulty at work o...

TREATMENT

GENERAL MEASURES

  • There are no specific treatments for concussion. Current guidelines recommend physical and cognitive rest as the mainstays of initial management.

  • Sunglasses, ear plugs if need...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Return to school recommendations (multidisciplinary team might include primary care provider PCP, neurologist, psychologist, family members, teachers, patient):

    • Pa...

REFERENCES

1
Silverberg ND, Iaccarino MA, Panenka WJ, et al. Management of concussion and mild traumatic brain injury: a synthesis of practice guidelines. Arch Phys Med Rehabil. 2020;101(2):382–393. do...

ADDITIONAL READING

SEE ALSO

Postconcussion Syndrome (Mild Traumatic Brain Injury); Seizure Disorders; Traumatic Brain Injury (TBI)—Long Term Care 

CODES

ICD10

  • S06.0X0A Concussion without loss of consciousness, initial encounter

  • S06.9X0A Unsp intracranial injury w/o loss of consciousness, init

  • S06.0X9A Concussion w loss of consciousness of unsp dura...

CLINICAL PEARLS

  • Concussions occur from direct or indirect force to the head—a loss of consciousness is not required for the diagnosis.

  • Any athlete with a suspected concussion should not return to play ...

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