Assessment Procedures

• Medical history:
  • Important to determine possible injury context (sports, fall, etc.).
• SCAT (Sport Concussion Assessment Tool):
  • A standardized checklist used in athletics.
  • Includes questions on symptoms such as:
    • Headache, dizziness, nausea.
    • Confusion, irritability, anxiety.
    • Fatigue, amnesia.
  • Helps evaluate the severity of symptoms.

Neurologic Exam

• Includes assessment of:
  • Vision, hearing.
  • Strength and sensation.
  • Balance and coordination.
  • Reflexes.
  • Memory and concentration (cognitive testing).

When to Hospitalize

• Signs indicating serious injury:
  • Severe headache, seizures, repeated vomiting.
  • These require immediate imaging and hospitalization.
• Monitoring:
  • Keep the patient overnight if symptoms are severe.
  • Watch for increasing intracranial pressure.
  • Treatment is directed at preventing secondary injury from swelling or pressure.

Mild Concussion

• No loss of consciousness or altered awareness.
• Symptoms last 2–3 days.
• Full recovery expected.
• Return-to-play protocol:
  • Gradual return after symptoms resolve.
  • Re-emergence of symptoms leads to sidelining and further rest.
  • Baseline testing in athletes helps monitor injury severity.

Post-Concussion Protocol

• Rest initially.
• Gradual reintegration into activity.
• Continued symptom monitoring.
• If symptoms recur, pause activity again.

Severe or Prolonged Concussion

• Classic concussion often involves temporary loss of consciousness (minutes to hours).
• Longer symptoms:
  • Weeks to months or longer.
  • Called post-concussion syndrome.
• Symptoms include:
  • Insomnia, depression, sensitivity to noise and light.
  • Forgetfulness, concentration issues.
  • Avoidance of screens and stress.

Management

• Full rest of the brain.
• Avoiding alcohol, screens, and stressful stimuli.
• Usually improves over time; some cases take months or over a year.

Summary

• Concussion diagnosis is supported by symptom assessment and baseline tests.
• Proper management involves initial rest and a gradual return to activity.
• Post-concussion syndrome can be long-lasting, requiring patience and supportive care.