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Management of Concussion and Persistent Post-Concussive Symptoms for Neurologists

  • Neurotrauma (D Sandsmark, Section Editor)
  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Concussion is a complex injury that may present as a variety of clinical profiles, which can overlap and reinforce one another. This review summarizes the medical management of patients with concussion and persistent post-concussive symptoms (PPCS).

Recent Findings

Management of concussion and PPCS relies on identifying underlying symptom generators. Treatment options include sub-symptom threshold aerobic exercise, cervical physical therapy, vestibular therapy, vision therapy, cognitive rehabilitation, cognitive behavioral therapy, pharmacological management, or a combination of treatments.

Summary

Evidence-based treatments have emerged to treat post-concussion symptom generators for sport-related concussion and for patients with PPCS.

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Funding

Research reported in this publication was supported by the National Institute of Neurological Disorders and Stroke of the National Institutes of Health (NIH) under award number 1R01NS094444 and the National Center for Advancing Translational Sciences of the NIH under award number UL1TR001412 to the University at Buffalo, SUNY. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Author information

Authors and Affiliations

  1. UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA

    John J. Leddy & Mohammad Nadir Haider

  2. Department of Neuroscience, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA

    Mohammad Nadir Haider

  3. Department of Neurology, Taub Institute for Research On Alzheimer’s Disease and the Aging Brain, and G.H. Sergievsky Center, Columbia University, New York, NY, USA

    James M. Noble

  4. Department of Physical Medicine and Rehabilitation, State University of New York Upstate Medical University, Syracuse, NY, USA

    Brian Rieger

  5. Department of Rehabilitation Medicine, Rusk Institute of Rehabilitation Medicine, New York University School of Medicine, New York, NY, USA

    Steven Flanagan

  6. Department of Rehabilitation Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, USA

    Jacob I. McPherson & Ghazala T. Saleem

  7. Department of Neurology, Zucker School of Medicine, New York, NY, USA

    Kenneth Shubin-Stein

  8. Northern Westchester and Southern Putnam County School Districts, New York, NY, USA

    Louis Corsaro

  9. Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA

    Barry Willer

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  1. John J. Leddy
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  10. Barry Willer
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Contributions

John J Leddy, MD: University at Buffalo, SUNY: Conception, design, and writing of the manuscript.

M Nadir Haider, MD: University at Buffalo, SUNY: Conception, design, and writing of the manuscript.

James M Noble, MD: Columbia University: Conception, design, and writing of the manuscript.

Brian Rieger, PhD: SUNY Upstate: Conception, design, and writing of the manuscript.

Steven Flanagan, MD: New York University: Conception, design, and writing of the manuscript.

Jacob I McPherson, DPT: University at Buffalo, SUNY: Design and writing of the manuscript.

Kenneth Shubin Stein, MD: Department of Neurology, Zucker School of Medicine: Design and writing of the manuscript.

Ghazala T Saleem, EdD, MS: University at Buffalo, SUNY: Design and writing of the manuscript.

Lou Corsaro, MD: Northern Westchester and Southern Putnam County School Districts.: Design and writing of the manuscript.

Barry S Willer, PhD: University at Buffalo, SUNY: Conception, design, and writing of the manuscript.

Corresponding author

Correspondence to John J. Leddy.

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Conflict of Interest

John J Leddy, Flanagan Steven, Jacob I McPherson, Kenneth Shubin-Stein, Ghazala T. Saleem, Louis Corsaro, and Barry Willer each declare no potential conflicts of interest.

James M. Noble is the co-founder and chief medical officer of NoMo Diagnostics, which aims to develop an EEG-based concussion diagnostic tool; he has stock options in the company. Dr. Noble is co-inventor of a device with patent under review (Columbia University). Its use is not discussed or advised in the manuscript. In addition, Dr. Noble has a patent US20190298262A1 pending. The patent's use is licensed to NoMo Diagnostics.

Mohammad Nadir Haider has received personal fees from BlinkCNS and Oculogica Inc.

Brian Rieger reports equity interest in Quadrant Biosciences (Motion Intelligence), and is Co-Chair, Brain Injury Association of New York State—Concussion Initiative.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Leddy, J.J., Haider, M.N., Noble, J.M. et al. Management of Concussion and Persistent Post-Concussive Symptoms for Neurologists. Curr Neurol Neurosci Rep 21, 72 (2021). https://doi.org/10.1007/s11910-021-01160-9

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