STEP 2: Concussion Live Course - November 5-6, 2024, in San Diego, CA-Assessment: Persisting Symptoms After Concussion

Pdf Summary

The document titled "Assessment of Persisting Symptoms after Concussion" by Priyanca Shah, DO, provides an overview of the consequences of concussions, distinguishing between acute and persistent symptoms. Most individuals recover from concussion symptoms in a few weeks, but 15-20% may experience prolonged symptoms. The term "Post Concussion Syndrome" (PCS) is distinguished from "Persisting Symptoms after Concussion" (PSaC), emphasizing a nuanced understanding of post-concussion effects with a focus on individualized treatment and potential for recovery through active rehabilitation.<br /><br />Definitions of persistent symptoms are complex due to the subjective and non-specific nature of symptoms and the influence of pre-existing conditions. Diagnosis often involves comparing pre- and post-injury symptoms, with tools like the ICD-10 offering criteria based on symptom persistence across several domains.<br /><br />Assessment involves detailed patient history, including mechanism of injury, symptom progression, pre-existing conditions, and lifestyle, as well as a comprehensive physical exam focusing on neurological and neck health, visual concerns, and balance.<br /><br />The document includes a detailed case study of an 18-year-old female rugby player with ADHD and mental health conditions, who experienced recurrent concussions resulting in chronic symptoms like headaches, cognitive difficulties, and sleep disruptions. Her symptoms were managed through education about concussions, physical therapy for cervicogenic headaches, sub-symptom aerobic exercise, neuropsychological evaluation, and academic accommodations.<br /><br />Her management plan adapted over time to address headaches with medication, sleep issues with melatonin and potential sleep agents, and emotional stress by changing her academic path. This personalized approach emphasizes the dynamic nature of managing persistent concussion symptoms with a blend of medical, psychological, and lifestyle modifications aimed at gradual recovery.<br /><br />The document underscores the need for a paradigm shift in addressing persistent symptoms post-concussion, advocating for comprehensive and adaptive management strategies that are sensitive to individual patient needs and circumstances.

Asset Subtitle

Priyanca B. Shah, DO MBA

Keywords

concussion

persistent symptoms

Post Concussion Syndrome

active rehabilitation

ICD-10

neurological assessment

cervicogenic headaches

sub-symptom aerobic exercise

personalized treatment

paradigm shift