Semin Neurol 2015; 35(01): 029-041
DOI: 10.1055/s-0035-1544243
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Diagnosis and Management of Acute Concussion

Meeryo C. Choe
1   Division of Pediatric Neurology, David Geffen School of Medicine at UCLA, Mattel Children's Hospital UCLA, Los Angeles, California
Christopher C. Giza
2   Division of Pediatric Neurology and Department of Neurosurgery, UCLA Brain Injury Research Center, David Geffen School of Medicine at UCLA, Los Angeles, California
› Author Affiliations
Further Information

Publication History

Publication Date:
25 February 2015 (online)


Mild traumatic brain injury (mTBI), or concussion, constitutes a significant percentage of the millions of TBIs sustained in the United States each year. Symptoms are typically short-lived, and may correlate to physiologic changes in the acute period after injury. There are many available tools that can be utilized on the sideline as well as in the clinical setting for assessment and diagnosis of concussion. It is important to use validated tests in conjunction with a thorough history and physical examination. Neurocognitive testing may be helpful in the subacute period. Management should begin with removal from risk if a concussion is suspected, and once diagnosis is made, education and reassurance should be provided. Once symptoms have resolved, a graded return-to-play protocol can be implemented with close supervision and observation for return of symptoms. Management should be tailored to the individual, and if symptoms are prolonged, further diagnostic evaluation may be necessary.