From the Guidelines
The treatment for mild traumatic brain injury (MTBI), also known as a concussion, involves active management and treatment of persistent postconcussion symptoms (PPCS) through individual disciplines targeting specific problems and through interdisciplinary rehabilitation.
Key Components of Treatment
- Early information and advice: Providing patients with clear instructions on how to monitor postconcussive symptoms, prevention of further injury, management of cognitive and physical activity/rest, and return to play/recreation and school 1
- Graded physical exercise: Performing physical exercise below symptom exacerbation can reduce postconcussive symptoms in active rehabilitation models 1
- Interdisciplinary coordinated rehabilitative treatment: Combining multiple disciplines to target specific problems and provide comprehensive care 1
- Return to full activity: Patients can return to full activity when they have remained symptom-free at rest and with increasing levels of physical exertion 1
Important Considerations
- Rest and reduction in cognitive/physical activity: May be beneficial immediately after mTBI, but prolonged inactivity can worsen symptoms 1
- Prevention of further injury: Removing the person from sports and other activities posing a risk of reinjury until fully recovered 1
- Monitoring for life-threatening brain injury: Watching for signs such as loss of consciousness, severe or worsening headache, repeated vomiting, altered mental status, seizure, neurological signs and symptoms, and skull fracture 1
From the Research
Treatment Overview
The treatment for mild traumatic brain injury (MTBI), also known as a concussion, typically involves:
- Physical and cognitive rest, with a gradual return to activities 2
- An individualized approach that focuses on the affected domains, such as physical, cognition, mood, and sleep 3
Rehabilitation and Management
Rehabilitation for individuals with MTBI requires:
- Emphasis on both cognitive and physical rest, with a gradual return to activity, including sports 4
- A systematic approach to return to play, such as the Berlin Consensus Statement on Concussion in Sport 4
- Consideration of injuries to the vestibular and balance system, which may require vestibular rehabilitation by a physical therapist 4
Neuromodulation Treatments
Neuromodulation treatments, such as:
- Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), have shown promising results for post-concussive symptoms, including depression, headaches, and cognitive impairment 5
Role of Neuropsychology
Neuropsychologists and rehabilitation psychologists play a crucial role in the interdisciplinary care of patients with MTBI, particularly in the acute, subacute, and chronic phases of recovery 6
Common Symptoms and Recovery
Common symptoms of concussion include headache, dizziness, nausea, and difficulty concentrating, and most patients recover within 48-72 hours, with symptoms and signs usually resolving within 10 days 2