Management of Concussion and Mild Traumatic Brain Injury: A Synthesis of Practice Guidelines

Noah D Silverberg; Mary Alexis Iaccarino; William J Panenka; Grant L Iverson; Karen L McCulloch; Kristen Dams-O'Connor; Nick Reed; Michael McCrea; American Congress of Rehabilitation Medicine Brain Injury Interdisciplinary Special Interest Group Mild TBI Task Force

doi:10.1016/j.apmr.2019.10.179

Management of Concussion and Mild Traumatic Brain Injury: A Synthesis of Practice Guidelines

Arch Phys Med Rehabil. 2020 Feb;101(2):382-393. doi: 10.1016/j.apmr.2019.10.179. Epub 2019 Oct 23.

Authors

Noah D Silverberg¹, Mary Alexis Iaccarino², William J Panenka³, Grant L Iverson⁴, Karen L McCulloch⁵, Kristen Dams-O'Connor⁶, Nick Reed⁷, Michael McCrea⁸; American Congress of Rehabilitation Medicine Brain Injury Interdisciplinary Special Interest Group Mild TBI Task Force

Collaborators

American Congress of Rehabilitation Medicine Brain Injury Interdisciplinary Special Interest Group Mild TBI Task Force:
Alison M Cogan, Min Jeong Park Graf, Maria Kajankova, Gary McKinney, Christina Weyer Jamora

Affiliations

¹ Division of Physical Medicine & Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada; Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada. Electronic address: [email protected].
² Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
³ BC Mental Health and Addictions Research Institute, Vancouver, British Columbia, Canada; British Columbia Provincial Neuropsychiatry Program, Vancouver, British Columbia, Canada; Department of Psychiatry, University of British Columbia, Canada.
⁴ Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts; MassGeneral Hospital for Children Sport Concussion Program, Boston, Massachusetts; Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts.
⁵ Division of Physical Therapy, Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
⁶ Department of Rehabilitation Medicine and Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York.
⁷ Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada; Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada.
⁸ Center for Neurotrauma Research (CNTR) and Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin.

PMID: 31654620
DOI: 10.1016/j.apmr.2019.10.179

Abstract

At least 3 million Americans sustain a mild traumatic brain injury (mTBI) each year, and 1 in 5 have symptoms that persist beyond 1 month. Standards of mTBI care have evolved rapidly, with numerous expert consensus statements and clinical practice guidelines published in the last 5 years. This Special Communication synthesizes recent expert consensus statements and evidenced-based clinical practice guidelines for civilians, athletes, military, and pediatric populations for clinicians practicing outside of specialty mTBI clinics, including primary care providers. The article offers guidance on key clinical decisions in mTBI care and highlights priority interventions that can be initiated in primary care to prevent chronicity.

Keywords: Brain concussion; Brain injuries, traumatic; Practice guidelines as topic; Rehabilitation; Review.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Athletes
Biomarkers
Brain Concussion / diagnosis*
Brain Concussion / diagnostic imaging
Brain Concussion / physiopathology
Brain Concussion / therapy*
Humans
Military Personnel
Patient Education as Topic / organization & administration
Pediatrics
Practice Guidelines as Topic*
Primary Health Care
Prognosis
Referral and Consultation
Return to Sport
United States

Substances

Biomarkers