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Review
. 2021 Nov 24;21(12):70.
doi: 10.1007/s11910-021-01159-2.

Clinical Assessment of Concussion and Persistent Post-Concussive Symptoms for Neurologists

John J Leddy  1 , Mohammad Nadir Haider  2   3 , James M Noble  4 , Brian Rieger  5 , Steven Flanagan  6 , Jacob I McPherson  7 , Kenneth Shubin-Stein  8 , Ghazala T Saleem  7 , Louis Corsaro  9 , Barry Willer  10
Affiliations
Review

Clinical Assessment of Concussion and Persistent Post-Concussive Symptoms for Neurologists

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

Abstract

Purpose of review: Concussion produces a variety of signs and symptoms. Most patients recover within 2-4 weeks, but a significant minority experiences persistent post-concussive symptoms (PPCS), some of which may be from associated cervical or persistent neurologic sub-system (e.g., vestibular) dysfunction. This review provides evidence-based information for a pertinent history and physical examination of patients with concussion.

Recent findings: The differential diagnosis of PPCS is based on the mechanism of injury, a thorough medical history and concussion-pertinent neurological and cervical physical examinations. The concussion physical examination focuses on elements of autonomic function, oculomotor and vestibular function, and the cervical spine. Abnormalities identified on physical examination can inform specific forms of rehabilitation to help speed recovery. Emerging data show that there are specific symptom generators after concussion that can be identified by a thorough history, a pertinent physical examination, and adjunct tests when indicated.

Keywords: Concussion; Neurologist; Persistent symptoms; Physical examination; History.

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