Management of Concussion and Persistent Post-Concussive Symptoms for Neurologists

John J Leddy; Mohammad Nadir Haider; James M Noble; Brian Rieger; Steven Flanagan; Jacob I McPherson; Kenneth Shubin-Stein; Ghazala T Saleem; Louis Corsaro; Barry Willer

doi:10.1007/s11910-021-01160-9

Management of Concussion and Persistent Post-Concussive Symptoms for Neurologists

Curr Neurol Neurosci Rep. 2021 Nov 24;21(12):72. doi: 10.1007/s11910-021-01160-9.

Authors

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

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.

Publication types

Research Support, N.I.H., Extramural
Review

MeSH terms

Brain Concussion* / therapy
Cognitive Behavioral Therapy*
Exercise
Humans
Neurologists
Post-Concussion Syndrome* / diagnosis
Post-Concussion Syndrome* / therapy