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Evaluation and treatment of postconcussive symptoms

Issue title: Evaluation and Management of Neurobehavioral Syndromes of Traumatic Brain Injury

Guest editors: Thomas W. McAllister

Article type: Research Article

Authors: McAllister, Thomas W.a; * | Arciniegas, Davidb

Affiliations: [a] Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, USA | [b] Denver Veterans Affairs Medical Center and University of Colorado Health Sciences Center, Denver, CO, USA | Dartmouth Medical School, Department of Psychiatry, Dartmouth Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA. Tel.: +1 603 650 5824; Fax: +1 603 650 5842; E-mail: Thomas.W.McAllister@Dartmouth.edu

Correspondence: [*] Address for correspondence: Thomas W. McAllister, M.D., Professor of Psychiatry, Dartmouth Medical School, Dept of Psychiatry, Dartmouth Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA. E-mail: Thomas.W.McAllister@Dartmouth.edu

Keywords: postconcussion syndrome, mild traumatic brain injury, postconcussive symptoms

DOI: 10.3233/NRE-2002-17402

Journal: NeuroRehabilitation, vol. 17, no. 4, pp. 265-283, 2002

Published: 17 December 2002
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Abstract

Postconcussive symptoms such as headache, dizziness, irritability, and difficulties with memory and attention are reported frequently after traumatic brain injuries (TBI) of all severities. The etiology of these symptoms in individuals with mild TBI has been a subject of some controversy with theories ranging from neural damage to malingering. Furthermore, although the term postconcussive syndrome is commonly used clinically and in the scientific literature, it is not clear that postconcussive symptoms constitute a syndrome per se. Instead, it may be the case that the various symptoms that commonly co-occur after TBI are relatively independent consequences of a single neurological event. In other words, because the locations and severity of injury vary between individuals despite ostensibly similar injuries, it follows that there should be variations in symptom type and severity between individuals as well. This article reviews the sequelae and natural course of recovery from mild TBI, the evidence regarding both persistent postconcussive symptoms and the postconcussive syndrome, and outlines an approach to the assessment and treatment of individuals with these symptoms after TBI.

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