Materiały źródłowe

• #1

  https://www.beaumont.org/conditions/concussion/diagnostic-exams

  A concussion is a type of traumatic brain injury. Concussions are usually diagnosed based on symptoms and severity of injury. […] While there are some signs and symptoms that may indicate someone has a concussion, it can only be diagnosed by a medical professional. […] There are a few different exams and tests that can help diagnose a concussion. […] A neurological exam to help diagnose a concussion may include physical tests to make sure your brain is working as it should. […] Cognitive testing may evaluate your memory, recall ability, and concentration. […] A concussion itself wont show up on brain imaging tests, but if you have certain symptoms (like severe headaches, vomiting, or seizures), your doctor may order an MRI or CT of your head to check for visible injury, such as bleeding in the brain.

• #1 Diagnosing Concussion | NYU Langone Health

  https://nyulangone.org/conditions/concussion/diagnosis

  Concussion is caused by an injury to the brain and may or may not be accompanied by a loss of consciousness. […] Any time a concussion is suspected, you should see a doctor immediately. […] At the Concussion Center, our experts diagnose concussion in children, who receive treatment through Hassenfeld Childrens Hospital at NYU Langone, and adults, determining the best course of treatment for each person. […] It is important that anyone with a head injury be evaluated immediately to reduce the risk of serious complications. […] Doctors at the Concussion Center evaluate and, if necessary, manage any symptoms caused by injuries to the head and brain. […] There is no single test used to diagnose a concussion. […] If your NYU Langone doctor suspects a concussion, he or she may perform a physical exam to check your strength, balance, coordination, and reflexes.

• #1 Diagnosing Concussion | NYU Langone Health

  https://nyulangone.org/conditions/concussion/diagnosis

  Your doctor also asks questions about your medical history, including details about the injury its cause and when it occurred, for example and any symptoms you have noticed. […] Evidence of a concussion may not always be visible on MRI or CT scans, so a doctor may perform neuropsychological tests to determine if you are having difficulty with cognition and memory after a concussion. […] To help diagnose a brain injury and pinpoint its location in the brain, NYU Langone doctors might perform a neurodiagnostic test called EyeBoxCNS to track eye movements.

• #1 Traumatic brain injury – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/diagnosis-treatment/drc-20378561

  Traumatic brain injuries may be emergencies. In the case of more-severe traumatic brain injuries (TBIs), consequences can worsen rapidly without treatment. Doctors or first responders need to assess the situation quickly. […] This 15-point test helps a doctor or other emergency medical personnel assess the initial severity of a brain injury by checking a person’s ability to follow directions and move their eyes and limbs. The coherence of speech also provides important clues. […] Imaging tests […] Computerized tomography (CT) scan. This test is usually the first performed in an emergency room for a suspected traumatic brain injury. A computed tomography (CT) scan uses a series of X-rays to create a detailed view of the brain. A CT scan can quickly visualize fractures and uncover evidence of bleeding in the brain (hemorrhage), blood clots (hematomas), bruised brain tissue (contusions), and brain tissue swelling.

• #1

  https://www.orthobullets.com/knee-and-sports/3113/concussions-mild-traumatic-brain-injury

  Concussions are a subset of mild traumatic brain injury (mTBI) characterized by acute transient impairment of neurologic function secondary to an impulsive force transmitted to the head. […] Diagnosis is made by careful neurological evaluation of an athlete following head trauma with a focus on cognitive function. […] any athlete with symptoms or signs of a concussion should be removed from the playing field and undergo immediate cognitive evaluation by a licensed healthcare provider. […] Sports Concussion Assessment Tool 5 (SCAT5) is a standardized neuropsychological test for evaluating concussions in athletes aged 13 years or older. […] indications for transport to ER for advancing imaging include deteriorating mental status, increasingly restless, agitated or combative, severe or worsening headache, and focal neurologic findings. […] need for imaging is determined by the evaluating physician. […] concussion is most often a functional rather than structural pathology. […] diagnosis of Chronic traumatic encephalopathy (CTE) is made through postmortem neuropathologic examination of the brain.

• #1 Concussion Diagnostics: How We Evaluate Concussion in Children and Teens | Children’s Hospital of Philadelphia

  https://www.chop.edu/treatments/concussion-diagnostics-how-we-evaluate-concussion-children-and-teens

  Concussions can happen anywhere and everywhere from the school yard to the playing field, from the playground to the home. Historically, clinicians have had to rely on symptom self-reporting from patients and observational reporting from parents and family members. […] A team of clinicians and researchers from CHOPs Minds Matter Concussion Program have developed and are evaluating several cutting-edge tools to better diagnose concussion in youth, provide information regarding prognosis, and assess treatment outcomes. These concussion diagnostic tools include: […] The visio-vestibular examination (VVE) is a series of physical exam maneuvers that tests the concussed youths vision and the function of their vestibular system, which controls elements such as balance and eye movements. […] Learn more about our teams ongoing research into visio-vestibular markers for concussion and how this line of research has the potential to improve concussion diagnosis and recovery.

• #1 Concussion – AANS

  https://www.aans.org/patients/conditions-treatments/concussion/

  A concussion is an injury to the brain that results in temporary loss of normal brain function. Medically, it is defined as a clinical syndrome characterized by immediate and transient alteration in brain function, including alteration of mental status or level of consciousness, that results from mechanical force or trauma. […] Brain imaging studies with MRI and CT scans should not be performed routinely in the diagnosis of concussions. They typically do not show any significant changes and, with CT scans, expose individuals to unnecessary radiation. While such tests are more useful for identifying structural defects, an injury from concussion is metabolic and microscopic in nature that often presents normally on neuroimaging. […] The doctor asks a variety of questions about how the injury occurred, where on the head and what symptoms are shown. The patient should report any unusual experiences to the health care provider.

• #1 Concussion – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/concussion/diagnosis-treatment/drc-20355600

  To diagnose a concussion, your healthcare professional evaluates your symptoms and reviews your medical history. You may need tests that help diagnose a concussion. Tests may include a neurological exam, cognitive testing and imaging tests. […] Brain imaging may be recommended for some people who have had a concussion. Imaging may be done in people with symptoms such as bad headaches, seizures, repeated vomiting or symptoms that are becoming worse. Imaging tests may determine whether the injury has caused bleeding or swelling in the skull. […] A computerized tomography (CT) scan of the head is the standard test in adults to assess the brain right after injury. A CT scan uses a series of X-rays to obtain cross-sectional images of the skull and brain. […] For children with a suspected concussion, CT scans are used only if specific criteria are met, such as the type of injury or signs of a skull fracture. This is to limit radiation exposure in young children.

• #1 Concussion – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/concussion/diagnosis-treatment/drc-20355600

  Magnetic resonance imaging (MRI) may be used to identify changes in your brain or to diagnose complications that may occur after a concussion. An MRI uses powerful magnets and radio waves to produce detailed images of your brain. […] It’s important for anyone who has a head injury to be evaluated by a healthcare professional, even if emergency care isn’t required. […] If your child has received a head injury that concerns you, call your child’s healthcare professional right away. Depending on the symptoms, your healthcare professional may recommend that your child get medical care right away. […] Experts recommend that athletes not return to play until they have been medically evaluated.

• #1 Concussion | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/concussion

  A concussion is a mild traumatic brain injury (mTBI) caused by a blow or jolt to the head or body that causes the brain to shake. […] There is not a single test to diagnose a concussion, but your child’s primary care provider may assess your child’s condition with a combination of tests. […] Because a concussion affects the function of the brain, not the structure, you cannot see a concussion on brain imaging like a CT scan or an MRI. […] Primary care providers will use all of the information they have gathered to diagnose and manage your child’s concussion. […] So despite all of our advances in medical technology, concussion is still a clinical diagnosis. […] As part of the more in-depth concussion evaluation, we would do a physical exam. […] There are no specific tests that prove you have a concussion.

• #1 Finally, A Blood Test for Traumatic Brain Injury | Abbott Newsroom

  https://www.abbott.com/corpnewsroom/products-and-innovation/finally-a-blood-test-for-traumatic-brain-injury.html

  Finally, A Blood Test for Traumatic Brain Injury […] Traumatic brain injuries (TBI), including concussions, are common, and not only within the sports world. An estimated 4.8 million emergency room visits per year can be attributed to TBIs, and roughly 40% of all concussions are caused by slips and falls. […] However, there has never been an objective method of assessing patients suspected to have sustained these invisible injuries until now. […] The main hurdle to recovery is that these injuries are often undiagnosed or misdiagnosed. Previously, concussions and TBIs have been evaluated through methods such as CT scan, patient questionnaire, or a neurological exam, which, in some cases, are not empirical on their own. For a condition that impacts millions annually and poses short-term risk, long-term risk, and even death objective testing used in tandem with these methods is crucial.

• #1 Head Injury Treatment: Diagnosis, Symptoms, and Recovery

  https://www.cognitivefxusa.com/blog/head-injury-treatment

  Typically, doctors start with a quick examination of the entire body, including cardiac and pulmonary function. […] Healthcare providers who suspect a TBI may order a brain scan. […] These brain scans may include: […] Computerized tomography (CT). A CT scan takes X-rays from multiple angles to create a 3D picture of the brain and can show a skull fracture or any brain bruising (contusion), hematoma, hemorrhage (bleeding), or swelling. […] Magnetic resonance imaging (MRI). MRI uses magnets and radio waves to produce more detailed images than CT scans, particularly of soft tissues. […] Functional neurocognitive imaging (fNCI): This scan only available at Cognitive FX is a type of functional MRI (versus a structural one). […] For patients with less severe injuries, doctors may also perform a series of neurological and cognitive exams to determine how much the brain has been affected.

• #1 Concussion – Diagnosis : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/concussion-diagnosis/

  Rule not applicable if: […] Non-trauma cases […] GCS < 13 [...] Age < 16 [...] Coumadin or bleeding disorder. [...] Obvious open skull fracture [...] Additionally, others recommend CT if: [...] Neurologic deficits [...] Seizure [...] Bleeding diathesis or oral anticoagulant use [...] Return visit for reassessment of a head injury. [...] Criteria For Hospital Admission [...] GCS <15 [...] CT head abnormalities [...] Seizures [...] Underlying bleeding diathesis or oral anticoagulation [...] Neurologic deficit [...] Recurrent vomiting. [...] Acute evaluation of an adult with mild head trauma: [...] CLICK TO ENLARGE [...] Adapted from UpToDate: Acute mild traumatic brain injury (concussion) in adults

• #1 Concussion | Mayfield Brain & Spine, Cincinnati, Ohio

  https://mayfieldclinic.com/pe-concussion.htm

  A concussion is a mild traumatic brain injury caused by a blow or „ding” to the head. […] If left undiagnosed, a concussion may place a person at risk of developing second-impact syndrome, a potentially fatal injury that occurs when an athlete sustains a second head injury before a previous head injury has healed. […] When a concussion is suspected during a sporting event, a coach, athletic trainer, or team physician should immediately perform a „sideline” evaluation. […] When a person is brought to the emergency room with a head injury, doctors will do an exam, ask about his or her symptoms, and ask how the injury occurred. A CT scan of the head may be done if needed. […] Patients with mild brain injury are usually released home after a few hours of observation in the ER. […] No person should return to sports or vigorous activity while signs or symptoms of a concussion are present.

• #1 Concussion Recognition, Diagnosis, and Acute Management – Sports-Related Concussions in Youth – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK185340/

  A central feature of the campaign is the dissemination of information about the signs and symptoms of concussion […] along with the message that players suspected of having sustained a concussion should be removed from play for the remainder of the day, referred to a health care provider for evaluation, and not permitted to return to play until they have been cleared by a health professional trained in concussion diagnosis and management. […] Given the absence of a diagnostic test or biomarker for concussion, the current cornerstone of concussion diagnosis is confirming the presence of a constellation of signs and symptoms after an individual has experienced a hit to the head or body. […] Reliance on an athlete’s self-report of symptoms as a fundamental part of diagnosing a concussion is complicated by the subjective nature of the assessment and by the possibility of an athlete underreporting the symptoms.

• #1 Concussion Causes, Symptoms, and Treatments

  https://www.upmc.com/services/orthopaedics/conditions/concussion

  When will I start to feel better if I have a concussion? […] Concussions are complex injuries with a wide range of outcomes. Since each case is unique, there’s no standard timeline for recovery. […] Some people get better in days, while others need weeks or months. Some may have long-term effects, usually if they dont get proper care. But the sooner you get the right treatment, the better your chance of recovering fully and faster. […] Why Choose UPMC for Concussion Care? […] When you choose UPMC for concussion care, you will receive: […] Access to world-class concussion expertise – Our world-renowned experts use advanced techniques to treat all types of concussions, tailoring treatment to your concussion type and treatment goals. […] […] A full range of treatment options – Our concussion experts use the latest evidence-based therapies to effectively treat concussions while reducing your risk of side effects. […] […] Multidisciplinary care – Our concussion experts partner with primary care providers, physical therapists, mental health clinicians, and other medical experts to provide complete care that optimizes your recovery and quality of life.

• #1 Diagnosis | Living Concussion Guidelines

  http://concussionsontario.org/concussion/guideline-section/diagnosis

  Diagnosis of concussion is the first critical step in successful management leading to improved outcomes and prevention of further injury. […] The purpose of the initial medical assessment is to establish the diagnosis of concussion by ruling out other conditions with similar symptom profiles such as more severe forms of TBI, cervical spine injuries and medical and neurological conditions. […] Once a diagnosis of concussion is established, Primary Care Providers (PCPs) should provide patients and their support person with written, verbal and/or pictorial education regarding management and prognosis. […] The vestibular ocular motor screening (VOMS) tool may be used within 72 hours after injury to aid in determining concussion diagnosis. […] The need for neuroimaging on acute presentation (within 24-48 hours post-injury) should be determined according to the Canadian CT rule, noting that patients who are anticoagulated or who have bleeding disorders require extra consideration.

• #1

  https://bpac.org.nz/2022/concussion.aspx

  Concussion is a form of mild traumatic brain injury (mTBI) resulting from an external force to the head or body that transiently alters brain function. […] The Brain Injury Screening Tool (BIST) is a standardised and validated assessment tool to evaluate patients with suspected concussion; this is specifically tailored for use in time-limited clinical consultations. […] Initial management of patients with concussion involves physical and mental rest for 24 48 hours; in most cases patients should then progressively re-engage in normal activities after this rest period, assuming the degree of engagement does not significantly worsen symptoms excessive rest can prolong recovery. […] A concussion injury to the brain occurs either as a result of a direct impact to the head, or via impulsive force being indirectly transmitted to the head.

• #2 Concussion: What It Is, Symptoms, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/15038-concussion

  Only a healthcare provider can diagnose a concussion. Its important to visit a provider if you hit your head, experience an injury or think you have any concussion symptoms. […] Your provider will diagnose a concussion with a physical exam, a neurological exam or a specific concussion test. Theyll ask about any symptoms youre experiencing and when they first started. […] Imaging tests cant diagnose a concussion, but your provider may recommend a CT scan (computed tomography scan) or MRI (magnetic resonance imaging) to look for serious complications like bleeding in or around your brain.

• #2 Concussion | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/injuries/head-and-neck-injuries/concussion/

  Concussion is a type of brain injury. […] Theres no test that can rule out concussion. If someone has a head injury, its not possible to say for certain if someone does or does not have a concussion. […] Concussion will only be diagnosed once other injuries have been ruled out. […] You should not diagnose concussion without consulting a healthcare professional. […] Concussion can cause complications which can be severe. This is why you should treat anyone with a suspected concussion as if they definitely have one.

• #2 Concussion Causes, Symptoms, and Treatments

  https://www.upmc.com/services/orthopaedics/conditions/concussion

  How Do You Diagnose Concussion? […] The provider will review your health history, ask about your symptoms, and do a physical exam. […] To confirm if you have a concussion and which type you have, your concussion specialist will: […] Ask about your symptoms. […] […] Perform several tests. […] […] Review your health history. […] Your concussion specialist will do an exam and may ask you questions to test your memory and ability to pay attention. […] Your provider might also: […] Check your strength, balance, eye motion, coordination, reflexes, and sensation. […] […] See how quickly you can solve problems. […] […] Show you objects and then hide them and ask you to recall what they are. […] Tests to diagnose concussion […] Imaging does not diagnose a concussion.

• #2

  https://www.beaumont.org/conditions/concussion/diagnostic-exams

  A concussion is a type of traumatic brain injury. Concussions are usually diagnosed based on symptoms and severity of injury. […] While there are some signs and symptoms that may indicate someone has a concussion, it can only be diagnosed by a medical professional. […] There are a few different exams and tests that can help diagnose a concussion. […] A neurological exam to help diagnose a concussion may include physical tests to make sure your brain is working as it should. […] Cognitive testing may evaluate your memory, recall ability, and concentration. […] A concussion itself wont show up on brain imaging tests, but if you have certain symptoms (like severe headaches, vomiting, or seizures), your doctor may order an MRI or CT of your head to check for visible injury, such as bleeding in the brain.

• #2 Concussion Causes, Symptoms, and Treatments

  https://www.upmc.com/services/orthopaedics/conditions/concussion

  To rule out bruising or bleeding in your brain, your doctor may order imaging tests, such as: […] CT scan – A test that creates images of your brain and is used to diagnose stroke, brain aneurysm, or another type of brain injury. […] […] MRI – Uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of your brain. […] At UPMC, we also use ImPACT, or Immediate Post-Concussion Assessment and Cognitive Testing. […] This test compares pre-concussion results with a post-concussion assessment and looks at: […] Brain processing speed. […] […] Reaction time. […] […] Verbal and visual memory. […] Concussion prognosis […] Most people make a full recovery after concussion. However, the time it takes to return to normal differs depending on the severity of your injury and how quickly your brain heals.

• #2 Concussion Diagnostics: How We Evaluate Concussion in Children and Teens | Children’s Hospital of Philadelphia

  https://www.chop.edu/treatments/concussion-diagnostics-how-we-evaluate-concussion-children-and-teens

  Another instrument that we’re really excited about is the pupillometer. […] What the pupillometry does, is it shines a light at your eye, and then it uses an infrared camera to capture how your pupil responds to that light. […] And so we’re actually able to get very precise measurements in terms of how quickly your pupil responds to light. And that seems to be changed after concussion. […] We’re hopefully moving the diagnosis of concussion from, „Hey, how you feeling? Do you think you have a concussion?” […] The automated eye tracking assessment is a rapid, objective and non-invasive aid in the diagnosis of concussion and does not require a patients pre-injury baseline as a comparison to identify concussion. […] CHOP researchers were among the first to evaluate this technology as an objective method for identifying concussions in young patients.

• #2 Concussion Recognition, Diagnosis, and Acute Management – Sports-Related Concussions in Youth – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK185340/

  Using multiple evaluation tools, such as symptom scales and checklists, balance testing, and neurocognitive assessments, may increase the sensitivity and specificity of concussion identification […] Traditional neuroimaging techniques, such as standard computed tomography (CT) and magnetic resonance imaging (MRI) […] are used to rule out more severe head and brain injuries, such as skull fractures and intracranial hemorrhages, as well as cerebral swelling that would require surgical intervention. […] The American Academy of Neurology has recently recommended that CT not be used to evaluate suspected sports-related concussion in the absence of signs or symptoms of more serious traumatic brain injury. […] Neuropsychological testing has become commonplace in the evaluation of concussed athletes.

• #2 Concussion: Practice Essentials, Background, Epidemiology

  https://emedicine.medscape.com/article/92095-overview

  MRI is the imaging study of choice for patients who have prolonged symptoms (7 days) or when a late change occurs in an individual’s neurologic signs or symptoms. […] Computer-based neuropsychological testing can be used to aid in the individualized workup and treatment for concussion; however, it is not essential. Baseline testing can be used, although it is not required or accepted as the standard of care. […] The purpose of this article is to review the epidemiology and diagnosis (but not necessarily the classification) of mTBI, as well as the role of imaging studies, issues regarding return to play, and complications surrounding mTBI.

• #2 Concussion | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/concussion

  A CT and an MRI will not detect any signs of a concussion. […] Each of those individual pieces is a piece of the puzzle. We have to put all the pieces of the puzzle together to make the clinical diagnosis of a concussion. […] It’s important for the physician to pull the entire story together with the injury, the symptoms that developed after the injury, and then their physical exam and how your child looks right now.

• #2 Finally, A Blood Test for Traumatic Brain Injury | Abbott Newsroom

  https://www.abbott.com/corpnewsroom/products-and-innovation/finally-a-blood-test-for-traumatic-brain-injury.html

  Our i-STAT TBI plasma test is the first rapid handheld traumatic brain injury (TBI) blood test, which will help clinicians assess individuals with suspected mild TBIs, including concussions. Tests results are available within 15 minutes after plasma is placed in the test cartridge. […] TBIs, including concussions, refer to an alteration in brain function, caused by an external force. This test measures specific proteins present in the blood after a TBI. A negative result on this test can be used to rule out the need for a head CT scan, a common tool used to evaluate concussion. For those who test positive, this test result complements CT scans to help clinicians evaluate whether someone has a TBI. […] Avoiding the hospital altogether, or getting in and out as quickly as possible, is top of mind for most people during the COVID-19 era. […] When hospital stay time is of the essence, having a TBI blood test available could help eliminate wait time in the emergency room and could reduce the number of unnecessary CT scans by up to 40%. Rapid diagnostic devices like i-STAT TBI allow healthcare workers to triage patients with traumatic brain injuries faster.

• #2 Head Injury Treatment: Diagnosis, Symptoms, and Recovery

  https://www.cognitivefxusa.com/blog/head-injury-treatment

  Treatment for Persistent Head Injury Symptoms at Cognitive FX […] At Cognitive FX, we specialize in treating patients with post-concussion syndrome. […] Treatment begins with an fNCI scan to determine where and to what extent the brain injury caused neurovascular coupling dysfunction. […] Most patients undergo treatment with us for one or more weeks. […] 90% of our patients experience symptom improvement in the first week, with an average symptom improvement of 60%. […] Traumatic head injuries are classified as mild, moderate, or severe traumatic brain injuries. […] Commonly called concussions, mild traumatic brain injuries (mTBI) are the most common type of brain injury. […] Moderate traumatic brain injuries are typically associated with loss of consciousness between 15 minutes and six hours, or a period of post-traumatic amnesia (memory loss) of up to 24 hours. […] Severe traumatic brain injuries involve loss of consciousness for six hours or more or a post-traumatic amnesia of 24 hours or more. […] If you’re experiencing symptoms that won’t resolve after a concussion, you’re not alone.

• #2

  https://www.beaumont.org/conditions/concussion/diagnostic-exams

  Your doctor may do some eye exams to check for signs of concussion or neurological damage. […] You should always see your doctor or another medical professional trained to identify concussion symptoms after any type of head injury to assess whether you have a concussion. […] Anytime a child has a potential head injury or concussion, you should seek an evaluation by a healthcare professional who has expertise in diagnosing concussions. […] A concussion protocol isnt a care plan, but rather, its a general guideline about what to do after a head injury to diagnose and care for a concussion. […] Any organization that involves people at risk for a concussion should have a concussion protocol. […] The people involved in concussion protocols will depend on the setting. […] There may be laws in your state that guide concussion protocols, but generally, they should include: a definition of a concussion, education about what a concussion is and how to recognize it, pre-season baseline testing for athletes, information about removal from activity after an injury, clinical evaluation process. […] If you have had a head injury or have been diagnosed with a concussion (or multiple concussions), Beaumont neurologists can help.

• #2 Diagnosis | Living Concussion Guidelines

  http://concussionsontario.org/concussion/guideline-section/diagnosis

  Routine repeat CT scans are not recommended for patients presenting with concussion who are currently on anticoagulant or antiplatelet medication, based on current evidence. […] Patients presenting to hospital/clinic acutely with concussion can be safely discharged for home observation if they meet the following clinical criteria: Normal mental status (alertness/behavior/cognition) with clinically improving post-concussive symptoms. […] Once an appropriate evaluation of the patient has been completed, upon discharge, provide the patient (and support person) with written and verbal information regarding concussion management including: Symptoms and signs of acute deterioration and when to seek urgent follow-up (e.g., worsening or new symptoms).

• #2 Concussion | Mayfield Brain & Spine, Cincinnati, Ohio

  https://mayfieldclinic.com/pe-concussion.htm

  It is important not to resume sports until you are symptom free or cleared by a healthcare provider. A second concussion that happens before the first one is healed can have dangerous long-term effects. […] Prevention of a second injury during recovery is important because having a concussion increases the risk of a second concussion by 5 times, and a second concussion soon after the first increases the risk of dangerous brain swelling.

• #2 Current Concepts in Concussion: Initial Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0401/p426.html

  The hospital or clinic evaluation is similar to the sideline evaluation but encompasses a detailed history and neurologic examination. […] Imaging is not indicated for the evaluation of uncomplicated concussion. […] Management of concussion is summarized in a table. […] Education regarding basic facts of concussion, in written form and reinforced verbally, and reassurance that complete recovery is expected are among the most important aspects of concussion care. […] A multidisciplinary approach should be considered for those with prolonged symptoms, including referral to a physician experienced in concussion management and for formal neuropsychiatric testing. […] Recommendations for return to activity or return to play are similar to those for adults; however, guidelines recommend waiting until the child or adolescent has successfully tolerated returning to school before resuming full activity or play.

• #2 What Happens In A Concussion Diagnosis | Franciscan Health

  https://www.franciscanhealth.org/community/blog/concussion-diagnosis

  Dr. Scheidler explains that commonly utilized forms include: Standardized Assessment of Concussion (SAC), Acute Concussion Evaluation (ACE), Sport Concussion Assessment Tool 5th Edition (SCAT5). […] „Finally, the physician will want to rule out other conditions that would cause such symptoms, including alcohol or drug intoxication, post-traumatic stress disorder, or other injuries,” Dr. Scheidler said. […] „Concussion symptoms are usually immediate, but some can progress or worsen over time,” Dr. Scheidler said. […] „A concussion is a clinical diagnosis, meaning a clinician must diagnose the condition based on a history and physical exam,” Dr. Scheidler said. […] „While there is active and promising research into diagnostic tests for concussion, including blood laboratory studies, currently none are validated for everyday use,” Dr. Scheidler said. […] „Typical testing for a simple concussion may take only five to 10 minutes but can take longer if more testing is needed,” Dr. Scheidler said. […] Follow-up concussion tests are done to check for symptom improvements or persistence. […] „The most important element of recovery is mental and physical relative rest for one to three days after the injury followed by a gradual return to activity,” Dr. Scheidler said.

• #2

  https://bpac.org.nz/2022/concussion.aspx

  Imaging is not required to diagnose concussion, and should only be requested if a more severe TBI is suspected. […] Assessments such as BIST should be applied as support tools; they are not a replacement for clinical judgement, and should ideally be used together with other relevant questions and neurocognitive or physical assessments (as required). […] After more serious structural or brain injuries have been ruled out, a diagnosis of concussion can be made clinically, supported by evidence of a plausible mechanism of injury and symptoms/signs relating to altered brain functioning. […] The phrase persistent concussion symptoms is preferred to describe symptoms that are present beyond three months of a patient sustaining a concussion, e.g. fatigue, headache, concentration/memory impairment.

• #3 Concussion Causes, Symptoms, and Treatments

  https://www.upmc.com/services/orthopaedics/conditions/concussion

  How Do You Diagnose Concussion? […] The provider will review your health history, ask about your symptoms, and do a physical exam. […] To confirm if you have a concussion and which type you have, your concussion specialist will: […] Ask about your symptoms. […] […] Perform several tests. […] […] Review your health history. […] Your concussion specialist will do an exam and may ask you questions to test your memory and ability to pay attention. […] Your provider might also: […] Check your strength, balance, eye motion, coordination, reflexes, and sensation. […] […] See how quickly you can solve problems. […] […] Show you objects and then hide them and ask you to recall what they are. […] Tests to diagnose concussion […] Imaging does not diagnose a concussion.

• #3 Use of Cognitive Assessments to Support Concussion Diagnosis

  https://creyos.com/blog/diagnosing-concussion

  One of the more common screeners is the acute concussion evaluation (ACE) tool, which is often used to assess concussion symptoms and risk factors, providing a checklist of 22 signs that can affect recovery. […] Digital cognitive tests are a much more immediate option than neuropsychological evaluation that can measure aspects of cognitive performance and support physicians in making their diagnosis. […] By measuring aspects of memory, concentration, and coordination, the physician can capture a clearer picture of the patients condition and make an accurate diagnosis supported by both objective and subjective measurements. […] In the event of a head injury or suspected concussion, patients should seek medical attention immediately. A healthcare provider can perform the necessary assessments and determine if a concussion is present, as well as guide the patient through the appropriate recovery process.

• #3 Concussion Diagnostics: How We Evaluate Concussion in Children and Teens | Children’s Hospital of Philadelphia

  https://www.chop.edu/treatments/concussion-diagnostics-how-we-evaluate-concussion-children-and-teens

  Our research showed the complex tandem gait evaluation possessed the greatest sensitivity in diagnosing and ruling out concussion. […] One of the most promising new concussion diagnostic tools is the automated dynamic infrared pupillometry hand-held device commonly called the pupillometer which measures the pupils automated response to light. […] In a recent study, CHOP researchers explored whether pupillary light reflex (PLR) measured by the pupillometer could distinguish between youth with concussion and those without. Researchers assessed nine specific PLR metrics and found significant differences between the concussed and non-concussed adolescents for eight of those studied.

• #3 Concussion – Diagnosis : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/concussion-diagnosis/

  Confusion […] Emotional lability […] Behaviour or personality changes. […] Diagnostic Process […] MRI is generally not indicated […] Head CT based on the Canadian CT Head Rule […] High-Risk Injury (may require neurosurgical intervention) […] GCS score < 15 at 2 hr after injury [...] Suspected open or depressed skull fracture [...] Signs of basal skull fracture (hemotympanum, periorbital bruising (Raccoon eyes), CSF otorrhea or rhinorrhea, retroauricular bruising (Battle’s sign)) [...] Vomiting ≥ two episodes [...] Age ≥ 65 years. [...] Medium-Risk Injury (may have important brain injury on CT) [...] Amnesia before impact ≥ 30 min [...] Dangerous mechanism (pedestrian struck by vehicle, occupant ejected from vehicle, fall from elevation >3 feet [five stairs]).

• #3 Concussion tests and diagnosis – Queensland Brain Institute – University of Queensland

  https://qbi.uq.edu.au/brain/brain-injury/concussion/concussion-tests-and-diagnosis

  Research has shown that amateur boxers have higher levels of tau in the blood stream the week or so after a bout, even if they’re not knocked out. […] Similarly, a study by Zetterberg and his colleagues, conducted among Swedish ice-hockey players, showed that tau levels were elevated in the blood after a concussion when compared to measurements taken at the start of the hockey season. […] Research has also found a correlation between blood tau levels and the severity of a TBI, where levels were higher in patients with a poorer outcome following injury. These studies suggest the potential for tau to be used as a diagnostic indicator for concussion. […] The challenge now for researchers is to refine the tests for these biomarkers and use them in combination with imaging techniques in order to better diagnose concussion and assess when it is safe to return to play.

• #3 Post-Concussion Syndrome Tests: Know If You Have PCS

  https://www.cognitivefxusa.com/blog/post-concussion-syndrome-tests-diagnosis

  You might need more than one doctor to contribute to the diagnosis. […] In this section, we cover five common diagnostic methods: the SCAT5, CT scans, MRI scans, qEEGs, and baseline testing. […] A common way to do this is to use the SCAT5, short for Sport Concussion Assessment Tool 5. […] The SCAT5 is primarily used to diagnose the initial injury but may be used to help with a post-concussion syndrome diagnosis as well. […] For the majority of concussion patients, these symptoms go away in six weeks or less. But for those with post-concussion syndrome, persistent symptoms become the norm. […] CT scans by themselves cannot diagnose a concussion, but they can rule out other causes of your symptoms. […] Most of the time, a regular, structural MRI cannot detect post-concussion syndrome. But functional neurocognitive imaging (fNCI), which is a special type of MRI, can detect brain damage sustained from a mild TBI.

• #3 Concussions (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/concussions.html

  A concussion is a brain injury that affects the way the brain works and can lead to symptoms such as headache, dizziness, and confusion. […] To diagnose a concussion, the health care provider will: ask about how and when the head injury happened, ask about symptoms, test memory and concentration, do an exam and test balance, coordination, and reflexes. […] Concussions do not show up on a CAT scan or MRI. Those tests might be done to look for other problems if someone: was knocked out, keeps vomiting, has a severe headache or a headache that gets worse, was injured in a serious accident, such as from a car crash or very high fall. […] Call your health care provider if your child: is not back in school by 5 days after the concussion, isn’t doing their usual level of schoolwork after being back to school for 2 weeks, still needs medicine for headache a week or more after the injury, has symptoms (such as headache, vomiting, confusion, or dizziness) that aren’t getting better or get worse, still has symptoms 4 weeks after the concussion, passes out.

• #3 Concussion Basics | HEADS UP | CDC

  https://www.cdc.gov/heads-up/about/index.html

  A concussion is a type of traumatic brain injury. […] A child with a concussion needs to be seen by a health care provider. […] Concussions should be taken seriously because they can produce changes in your child’s brain, body, and behavior. […] You can play an active role in your child’s recovery by getting them checked by a health care provider. Health care providers have treatments to help. And getting care from a health care provider can help speed your child’s recovery. […] Getting more than one concussion may lead to more challenges with symptoms, longer recovery, and even chronic health problems. […] Exposure to repeated head impacts increases the chance for concussions and other TBIs, as well as the potential for changes in the brain and brain diseases. […] A child with a history of multiple concussions also may have ongoing problems with concentration, memory, headache. […] A greater risk for mental health problems and other chronic health conditions.

• #3 Current Concepts in Concussion: Initial Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0401/p426.html

  Early patient education and reassurance are a cornerstone of concussion management. […] Initial management of concussion includes brief cognitive and physical rest. […] An individualized approach to the gradual return to activity after concussion is favored over rigid guidelines, and most algorithms allow for patients to progress at various rates. […] Assessment tools for diagnosis and management of concussion are not exclusively effective. […] Combining tools increases sensitivity and specificity. […] Neuropsychological tests identify cognitive deficits, but they are not well validated for concussion. […] Balance testing is recommended as part of postconcussion evaluation; however, the evidence regarding its utility is insufficient. […] If concussion is suspected, an athlete should be removed from play and immediately evaluated by a qualified clinician.

• #3

  https://bpac.org.nz/2022/concussion.aspx

  The symptoms are not specific to concussion, and are also reported in more severe TBIs, other non-brain injured patients and in otherwise healthy people. […] The Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association (APA) and International Classification of Diseases 11th Revision (ICD-11) no longer recognise post-concussion syndrome as a diagnostic entity. […] If a Read Code is required for patients with persistent concussion symptoms, use either the concussion (S60..) or head injury codes (S646.).

• #4 Are Blood Tests Helpful in the Diagnosis or Management of a Mild Traumatic Brain Injury? | Complete Concussions

  https://completeconcussions.com/concussion-management/are-blood-tests-helpful-in-the-diagnosis-or-management-of-a-mild-traumatic-brain-injury/

  During the management of concussions, we are always looking for more objective tests that can help diagnose mild traumatic brain injuries (mTBI) and help guide the treatment of these patients. […] Currently, there is no accurate concussion laboratory test because there are no reliable blood markers that are both specific and sensitive to mild traumatic brain injury. […] Therefore, S100B has some promise as an immediate post-concussion assessment tool in its ability to rule out more severe injury. Still, it is not specific enough for generalized use in clinical care. […] In the aforementioned study by Geyer et al. (2009), NSE levels were also unable to distinguish between children who had a mild head injury with no symptoms and those who had a head injury and concussion symptoms. […] GFAP has also shown promise in its ability to rule out more serious intracranial injury after mTBI, showing 71% sensitivity and 71% specificity in detecting more severe brain injury after a head impact.

• #4 Current Concepts in Concussion: Initial Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0401/p426.html

  The hospital or clinic evaluation is similar to the sideline evaluation but encompasses a detailed history and neurologic examination. […] Imaging is not indicated for the evaluation of uncomplicated concussion. […] Management of concussion is summarized in a table. […] Education regarding basic facts of concussion, in written form and reinforced verbally, and reassurance that complete recovery is expected are among the most important aspects of concussion care. […] A multidisciplinary approach should be considered for those with prolonged symptoms, including referral to a physician experienced in concussion management and for formal neuropsychiatric testing. […] Recommendations for return to activity or return to play are similar to those for adults; however, guidelines recommend waiting until the child or adolescent has successfully tolerated returning to school before resuming full activity or play.

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