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Polinder S, Cnossen MC, Real RGL, et al. A Multidimensional Approach to Post-concussion Symptoms in Mild Traumatic Brain Injury. Front Neurol. 2018;9:1113doi: 10.3389/fneur.2018.01113.
Polinder, S., Cnossen, M. C., Real, R. G. L., Covic, A., Gorbunova, A., Voormolen, D. C., Master, C. L., Haagsma, J. A., Diaz-Arrastia, R., & von Steinbuechel, N. (2018). A Multidimensional Approach to Post-concussion Symptoms in Mild Traumatic Brain Injury. Frontiers in neurology, 91113. https://doi.org/10.3389/fneur.2018.01113
Polinder, Suzanne, et al. "A Multidimensional Approach to Post-concussion Symptoms in Mild Traumatic Brain Injury." Frontiers in neurology vol. 9 (2018): 1113. doi: https://doi.org/10.3389/fneur.2018.01113
Polinder S, Cnossen MC, Real RGL, Covic A, Gorbunova A, Voormolen DC, Master CL, Haagsma JA, Diaz-Arrastia R, von Steinbuechel N. A Multidimensional Approach to Post-concussion Symptoms in Mild Traumatic Brain Injury. Front Neurol. 2018 Dec 19;9:1113. doi: 10.3389/fneur.2018.01113. eCollection 2018. PMID: 30619066; PMCID: PMC6306025.
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Front Neurol. 2018 Dec 19;9:1113. doi: 10.3389/fneur.2018.01113. eCollection 2018.

A Multidimensional Approach to Post-concussion Symptoms in Mild Traumatic Brain Injury.

Frontiers in neurology

Suzanne Polinder, Maryse C Cnossen, Ruben G L Real, Amra Covic, Anastasia Gorbunova, Daphne C Voormolen, Christina L Master, Juanita A Haagsma, Ramon Diaz-Arrastia, Nicole von Steinbuechel

Affiliations

  1. Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.
  2. Institute of Medical Psychology and Medical Sociology, Georg-August-University, Göttingen, Germany.
  3. Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.
  4. Department of Emergency Medicine, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands.
  5. Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.

PMID: 30619066 PMCID: PMC6306025 DOI: 10.3389/fneur.2018.01113

Abstract

Mild traumatic brain injury (mTBI) presents a substantial burden to patients, families, and health care systems. Whereas, recovery can be expected in the majority of patients, a subset continues to report persisting somatic, cognitive, emotional, and/or behavioral problems, generally referred to as post-concussion syndrome (PCS). However, this term has been the subject of debate since the mechanisms underlying post-concussion symptoms and the role of pre- and post-injury-related factors are still poorly understood. We review current evidence and controversies concerning the use of the terms post-concussion symptoms vs. syndrome, its diagnosis, etiology, prevalence, assessment, and treatment in both adults and children. Prevalence rates of post-concussion symptoms vary between 11 and 82%, depending on diagnostic criteria, population and timing of assessment. Post-concussion symptoms are dependent on complex interactions between somatic, psychological, and social factors. Progress in understanding has been hampered by inconsistent classification and variable assessment procedures. There are substantial limitations in research to date, resulting in gaps in our understanding, leading to uncertainty regarding epidemiology, etiology, prognosis, and treatment. Future directions including the identification of potential mechanisms, new imaging techniques, comprehensive, multidisciplinary assessment and treatment options are discussed. Treatment of post-concussion symptoms is highly variable, and primarily directed at symptom relief, rather than at modifying the underlying pathology. Longitudinal studies applying standardized assessment strategies, diagnoses, and evidence-based interventions are required in adult and pediatric mTBI populations to optimize recovery and reduce the substantial socio-economic burden of post-concussion symptoms.

Keywords: diagnosis; etiology; mild traumatic brain injury; outcome; post-concussion symptoms; prevalence; treatment

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