Family Med

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Concussion care: Simple strategies, big payoffs
APCToday, 08/19/09

McConnell A et al. – Whenever a patient tells you about a head injury, however minor, assess for concussion. Repeated head trauma increases the risk of second impact syndrome, a rapid cascade of symptoms that can lead to brain herniation and death.

Practice recommendations:

• Consider any alteration of mental status that follows a trauma to be a concussion, whether or not there is also a loss of consciousness (Strength of recommendation (SOR) A – Good–quality patient–oriented evidence).
• Don’t order neuroimaging routinely; it is not necessary for diagnosing concussion. Neuroimaging is important, however, for patients who exhibit prolonged unconsciousness, focal neurologic deficits, or worsening symptoms (SOR A).
• Treat post–concussive headache, a common complaint, with acetaminophen or ibuprofen (SOR A).

Teach parents, teachers, coaches, and players the signs and symptoms of concussion and the importance of avoiding premature return to play.

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