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Concussion (Mild Traumatic Brain Injury)

Michael Maddaleni, MD and J. Herbert Stevenson, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Concussion (or mild traumatic brain injury [mTBI]) is defined as a complex pathophysiologic process affecting the brain, induced by traumatic biomechanical forces. This can be direct...

DIAGNOSIS

HISTORY

  • Cognitive signs and symptoms

    • Confusion, disorientation

    • Posttraumatic and retrograde amnesia

    • LOC occurs in <10%.

    • Feeling “in a fog,” “zoned out”

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

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 (Include PCP, neurologist, psychologist, family members, teachers, patient.):

    • Patient should remain out of school and not use el...

REFERENCES

1
Carney N, Ghajar J, Jagoda A, et al. Concussion guidelines step 1: systematic review of prevalent indicators. Neurosurgery.  2014;75(Suppl 1):S3–S15. [View Abstract on OvidMedline]
2
Me...

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; LOC is not required.

  • Any athlete with a suspected concussion should not return to play pending a complete evaluation by a tr...

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