Clinical considerations for the assessment, management, and treatment of concussion in females

Abstract

: This review paper describes an individualized, targeted clinical care approach for the assessment, management, and treatment of sport-related concussions (SRC), and also highlights important clinical considerations for providing care to females with a SRC. Ideally, SRCs should be managed by an interdisciplinary medical team including but not limited to neuropsychologists, primary care sports medicine physicians, and physical therapists. The clinician that coordinates care should employ a multi-modal assessment approach (e.g., neurocognitive, vestibular/ocular motor, symptoms, balance, clinical exam/interview) to capture the heterogeneity of symptoms and impairments that are associated with SRC. Clinicians must also be aware of certain factors, specific to females that may complicate SRC recovery such as female preferences for clinical care, their greater risk for established risk factors (e.g., concussion history and migraine) and female sex hormone cycles that may influence multiple concussion outcomes (e.g., symptom reports and neurocognitive scores). Concussion management has moved away from a one-size-fits-all approach and clinicians must be willing to provide a comprehensive assessment that caters to the needs of females in order to individualize the treatment recommendations and avoid a prolonged recovery.