STEP 2: Concussion Live Course - October 21-22, 2025, in Salt Lake City, UT-Case Discussion: Risk Factors of Special Populations (Injured Worker)

Pdf Summary

The 2025 Annual Assembly features a case study on mild traumatic brain injury (TBI) in an injured worker, presented by Dr. Stuart J. Glassman, a specialist in physical medicine and rehabilitation with extensive clinical and academic experience. The presentation focuses on work-related mild TBI/concussion, highlighting unique risk factors, proper evaluation and management, and the role of pre-existing conditions and medications in recovery.<br /><br />The case study involves a 53-year-old ski instructor and college professor who sustained a concussion after a fall during training, with brief loss of consciousness and helmet impact. Initial ER findings included a negative head CT and cervical spine X-ray indicative of degenerative joint disease (DJD). Symptoms included headache, nausea, and neck pain, with a history of depression managed by Lamictal, Depakote, and Paxil.<br /><br />Follow-up evaluation by a concussion specialist at 10 days showed persistent symptoms (headache, dizziness, concentration issues, nausea, balance problems) with abnormal balance and vision exams. Neurocognitive testing (ImPACT) revealed deficits across multiple domains. Treatment included physical, occupational, and vestibular therapy, symptom-targeted medication, and modified work restrictions prohibiting skiing.<br /><br />Subsequent visits documented gradual symptom improvement and neurocognitive recovery, though some balance issues and dizziness persisted, possibly linked to pre-existing medications. After nine weeks, the patient was cleared for full duty with no impairment, although the ski season ended. He now works as an online college professor.<br /><br />Key takeaways include the importance of assessing patients’ multiple work roles, considering pre-existing conditions and medications when planning treatment and prognosis, reliance on symptom tracking and neurocognitive testing given the lack of baseline data, and recognizing that most injured workers aim to recover and return to normal functioning. Dr. Glassman emphasizes individualized care and careful monitoring throughout recovery.

Asset Subtitle

Stuart J. Glassman, MD, MBA

Keywords

mild traumatic brain injury

concussion

work-related injury

physical medicine and rehabilitation

neurocognitive testing

vestibular therapy

pre-existing conditions

medication impact

injured worker recovery

case study