STEP 2: Concussion Live Course - October 21-22, 2025, in Salt Lake City, UT-Initial Office Assessment for Acute Concussion

Pdf Summary

This document, authored by Dr. Steven Flanagan, provides guidance on evaluating and managing concussions in an office setting. It emphasizes that concussion diagnosis is clinical, relying on a multimodal approach including history, physical examination, and other assessments, as no single test can definitively establish the condition.<br /><br />Concussion involves a blow to the head or body causing altered function across cognitive, physical, autonomic, and emotional domains. Evaluation requires careful history-taking to understand the trauma event, symptom details, prior concussions, and comorbid conditions such as cervical injury, psychiatric, neurological, or psychosocial factors. Symptoms are varied and not specific, covering cognitive, physical (e.g., dizziness, headache), autonomic, and affective aspects (e.g., anxiety, depression).<br /><br />Examination incorporates cranial nerve assessment, cognitive, balance, vestibular, vision, strength, sensation testing, and orthostatic vital signs, paying attention to mood and consistency in patient responses. Particularly important are psychosocial factors and their influence on symptoms and recovery.<br /><br />Management involves educating patients about concussion basics, expected recovery, treatment rationale, and dispelling myths, such as the inevitability of chronic traumatic encephalopathy (CTE). The document stresses flexibility in assessment and treatment plans based on individual presentations.<br /><br />In summary, concussion assessment must be comprehensive, addressing physical, cognitive, autonomic, and emotional components while recognizing overlapping conditions. Structured history and examination guide diagnosis and management, with patient education playing a key role in outcomes.

Asset Subtitle

Steven R. Flanagan, MD

Keywords

concussion evaluation

clinical diagnosis

multimodal assessment

history taking

physical examination

cognitive symptoms

autonomic symptoms

psychosocial factors

patient education

management guidelines