Management of Concussion and Persistent Post-Concussive Symptoms for Neurologists

John J Leddy¹, Mohammad Nadir Haider^{2

3}, James M Noble⁴, Brian Rieger⁵, Steven Flanagan⁶, Jacob I McPherson⁷, Kenneth Shubin-Stein⁸, Ghazala T Saleem⁷, Louis Corsaro⁹, Barry Willer¹⁰

Affiliations

¹ UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA. leddy@buffalo.edu.
² UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA.
³ Department of Neuroscience, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA.
⁴ Department of Neurology, Taub Institute for Research On Alzheimer's Disease and the Aging Brain, and G.H. Sergievsky Center, Columbia University, New York, NY, USA.
⁵ Department of Physical Medicine and Rehabilitation, State University of New York Upstate Medical University, Syracuse, NY, USA.
⁶ Department of Rehabilitation Medicine, Rusk Institute of Rehabilitation Medicine, New York University School of Medicine, New York, NY, USA.
⁷ Department of Rehabilitation Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, USA.
⁸ Department of Neurology, Zucker School of Medicine, New York, NY, USA.
⁹ Northern Westchester and Southern Putnam County School Districts, New York, NY, USA.
¹⁰ Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA.

PMID: 34817719
DOI: 10.1007/s11910-021-01160-9

Review

Management of Concussion and Persistent Post-Concussive Symptoms for Neurologists

John J Leddy et al. Curr Neurol Neurosci Rep. 2021.

. 2021 Nov 24;21(12):72.

doi: 10.1007/s11910-021-01160-9.

Authors

Affiliations

¹ UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA. leddy@buffalo.edu.
² UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA.
³ Department of Neuroscience, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA.
⁴ Department of Neurology, Taub Institute for Research On Alzheimer's Disease and the Aging Brain, and G.H. Sergievsky Center, Columbia University, New York, NY, USA.
⁵ Department of Physical Medicine and Rehabilitation, State University of New York Upstate Medical University, Syracuse, NY, USA.
⁶ Department of Rehabilitation Medicine, Rusk Institute of Rehabilitation Medicine, New York University School of Medicine, New York, NY, USA.
⁷ Department of Rehabilitation Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, USA.
⁸ Department of Neurology, Zucker School of Medicine, New York, NY, USA.
⁹ Northern Westchester and Southern Putnam County School Districts, New York, NY, USA.
¹⁰ Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA.

PMID: 34817719
DOI: 10.1007/s11910-021-01160-9

Abstract

Purpose of review: Concussion is a complex injury that may present as a variety of clinical profiles, which can overlap and reinforce one another. This review summarizes the medical management of patients with concussion and persistent post-concussive symptoms (PPCS).

Recent findings: Management of concussion and PPCS relies on identifying underlying symptom generators. Treatment options include sub-symptom threshold aerobic exercise, cervical physical therapy, vestibular therapy, vision therapy, cognitive rehabilitation, cognitive behavioral therapy, pharmacological management, or a combination of treatments. Evidence-based treatments have emerged to treat post-concussion symptom generators for sport-related concussion and for patients with PPCS.

Keywords: Concussion; Management; Neurologist; Persistent symptoms; Therapy.

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References

1. Ellis MJ, Leddy JJ, Willer B. Physiological, vestibulo-ocular and cervicogenic post-concussion disorders: an evidence-based classification system with directions for treatment. Brain Inj. 2015;29(2):238–48. - DOI
1. McCrory P, Meeuwisse W, Johnston K, Dvorak J, Aubry M, Molloy M, et al. Consensus statement on Concussion in Sport–the 3rd International Conference on Concussion in Sport held in Zurich, November 2008. Br J Sports Med. 2009;43(Suppl 1):pp i76–90.
1. Stillman A, Madigan N, Alexander M. Factors associated with prolonged, subjective post-concussive symptoms. Neurology. 2016;86(16):3.325.
1. Gagnon I, Galli C, Friedman D, Grilli L, Iverson GL. Active rehabilitation for children who are slow to recover following sport-related concussion. Brain Inj. 2009;23(12):956–64. - DOI
1. Kontos AP, Jorgensen-Wagers K, Trbovich AM, Ernst N, Emami K, Gillie B, et al. Association of time since injury to the first clinic visit with recovery following concussion. JAMA Neurol. 2020;77(4):435–40. - DOI

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Management of Concussion and Persistent Post-Concussive Symptoms for Neurologists

Affiliations

Management of Concussion and Persistent Post-Concussive Symptoms for Neurologists

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Research Materials