Abstract
In this clinical practice review, the controversies and difficulties managing post concussion symptoms following mild traumatic brain injury are discussed. Based on considerable clinical experience in a designated Concussion Clinic, the authors (a neuropsychologist, a psychiatrist, and a neurologist) review relevant literature and issues for clinical practice, particularly with respect to understanding risk factors for and vulnerability to, development of chronic post-concussion symptoms. We contend it is not just the kind of head that matters but also the kind of complications, the kind of outcomes and the kind of management that can influence injury recovery. Given these complexities, a bio-psychosocial conceptualization of chronic post-concussion syndrome is appropriate. Though understanding is still elusive, management should not be biased by physiogenic or psychogenic aetiological theories for management needs to address patient reported outcomes regardless of underpinning aetiology.
Highlights
Post-concussion symptoms and the potentially enduring sequelae of mild traumatic brain injury (MTBI), such as Psychiatrists’ involvement in cases of MTBI generally concerns those who have not recovered and the constellation of symptoms has become chronic and complicated by a host of psychosocial and medico legal issues
The general public expects that symptoms will occur after a Traumatic brain injuries (TBIs) [4] [5]
The forensic implications of chronic post concussion symptoms further enhance the complexity of the syndrome and distract from treatment
Summary
Post-concussion symptoms and the potentially enduring sequelae of mild traumatic brain injury (MTBI), such as. Traumatic brain injuries (TBIs) often occur in an “accident” setting and anger, fault, grief and distress may rapidly affect clinical status. The profound physical and mental exhaustion experienced in many traumatic, infective and oncological disorders of the brain, is debilitating and potentially demoralizing The symptom constellation and complications resultant upon the head injury, and it is not possible to correlate type or location of trauma with potential clinical sequelae, significantly influences the induction of psychosocial complications. As for severe TBIs the prognosis is difficult to predict and clinical surprises are not infrequent It is an appealing prospect in a disorder of uncertain pathogenesis, accompanied by psychological influences, and with medicolegal implications, to “blame” the sufferer and their pre-injury past for the condition. The forensic implications of chronic post concussion symptoms further enhance the complexity of the syndrome and distract from treatment
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