STEP 2: Concussion Live Course - November 5-6, 2024, in San Diego, CA-Initial Office Assessment for Acute Concussion

Pdf Summary

The document provides an overview of the evaluation and management of concussions in an office setting, as presented by Steven Flanagan, MD, from NYU Grossman School of Medicine. Dr. Flanagan discusses key factors impacting the assessment, diagnosis, and management of concussions, underlining the importance of considering both physical and psychosocial elements. He notes that concussions are generally caused by a blow to the head or body and result in altered function, encompassing cognitive, physical, autonomic, and emotional domains.<br /><br />The diagnosis process is emphasized as clinical rather than reliant on a single test, requiring a multi-modal assessment approach, which includes a detailed history of present illness (HPI), physical examination, and additional assessments. Important considerations include potential cervical injuries, prior concussions, psychiatric or neurological conditions, and psychosocial factors such as work, school, and family life.<br /><br />Key symptomatic areas discussed include cognitive challenges, physical symptoms like dizziness and headaches, autonomic dysfunction, and affective symptoms such as depression and anxiety. The examination process should be comprehensive, considering cranial nerves, cognitive functions, balance, vestibular assessments, vision, strength, and sensation. Mood and sleep are also screened for anxiety and depression, which can influence concussion recovery.<br /><br />The evaluation should enhance understanding of the patient's condition through history support and by distinguishing concussion symptoms from other possible etiologies. Dr. Flanagan stresses the importance of patient education, clarifying what concussions are, expected recovery outcomes, and treatment rationale, while addressing common misconceptions, such as the rarity of Chronic Traumatic Encephalopathy (CTE) following a concussion.<br /><br />In summary, effective concussion management requires a structured yet flexible approach, encompassing physical and psychosocial assessments to guide treatment decisions and patient education.

Asset Subtitle

Steven R. Flanagan, MD

Keywords

concussion management

Steven Flanagan

NYU Grossman School of Medicine

cognitive symptoms

psychosocial factors

multi-modal assessment

patient education

Chronic Traumatic Encephalopathy

autonomic dysfunction

clinical diagnosis