If symptoms return, activity should be reduced to a level that does not aggravate symptoms. Psychiatric symptoms, if they appear, should be treated immediately, referring to a neurologist, psychiatrist, or psychologist when necessary. Referral to individual medical specialists or to a specialized multidisciplinary mild traumatic brain injury (TBI) clinic is appropriate for patients with persistent symptoms (lasting more than 4-6 weeks) who do not respond to treatment in a primary care setting.[69]US Department of Veterans Affairs. VA/DoD clinical practice guidelines: management and rehabilitation of post-acute mild traumatic brain Injury (mTBI). 2021 [internet publication].
https://www.healthquality.va.gov/guidelines/rehab/mtbi/index.asp
[93]Lumba-Brown A, Yeates KO, Sarmiento K, et al. Centers for Disease Control and Prevention guideline on the diagnosis and management of mild traumatic brain injury among children. JAMA Pediatr. 2018 Nov 1;172(11):e182853.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006878
http://www.ncbi.nlm.nih.gov/pubmed/30193284?tool=bestpractice.com
[98]Silverberg ND, Iaccarino MA, Panenka WJ, et al. Management of concussion and mild traumatic brain injury: a synthesis of practice guidelines. Arch Phys Med Rehabil. 2020 Feb;101(2):382-93.
https://www.archives-pmr.org/article/S0003-9993(19)31305-X/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/31654620?tool=bestpractice.com
Earlier referral may be helpful if:[98]Silverberg ND, Iaccarino MA, Panenka WJ, et al. Management of concussion and mild traumatic brain injury: a synthesis of practice guidelines. Arch Phys Med Rehabil. 2020 Feb;101(2):382-93.
https://www.archives-pmr.org/article/S0003-9993(19)31305-X/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/31654620?tool=bestpractice.com
[123]Silverberg ND, Gardner AJ, Brubacher JR, et al. Systematic review of multivariable prognostic models for mild traumatic brain injury. J Neurotrauma. 2015 Apr 15;32(8):517-26.
http://www.ncbi.nlm.nih.gov/pubmed/25222514?tool=bestpractice.com
[124]Iverson GL, Gardner AJ, Terry DP, et al. Predictors of clinical recovery from concussion: a systematic review. Br J Sports Med. 2017 Jun;51(12):941-48.
https://bjsm.bmj.com/content/51/12/941
http://www.ncbi.nlm.nih.gov/pubmed/28566342?tool=bestpractice.com
The patient has a high symptom burden or known risk factors for prolonged recovery, such as a pre-existing mental health disorder
The patient is unable to progress with their return to activity or they are attempting to return to high-stakes roles soon after injury (e.g., those partaking in competitive sport or university examinations)
Access to care is limited (e.g., long waitlist times).
Patients with one to two specific symptoms may only require individual disciplines rather than referral to a multidisciplinary clinic. For example, those with primarily vestibular symptoms should be referred to physical therapy or otolaryngology.[69]US Department of Veterans Affairs. VA/DoD clinical practice guidelines: management and rehabilitation of post-acute mild traumatic brain Injury (mTBI). 2021 [internet publication].
https://www.healthquality.va.gov/guidelines/rehab/mtbi/index.asp
[98]Silverberg ND, Iaccarino MA, Panenka WJ, et al. Management of concussion and mild traumatic brain injury: a synthesis of practice guidelines. Arch Phys Med Rehabil. 2020 Feb;101(2):382-93.
https://www.archives-pmr.org/article/S0003-9993(19)31305-X/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/31654620?tool=bestpractice.com
Cognitive symptoms usually resolve quickly after mild TBI; a minority of patients have memory and concentration problems within 3 months of injury.[55]van Gils A, Stone J, Welch K, et al. Management of mild traumatic brain injury. Pract Neurol. 2020 May;20(3):213-21.
http://www.ncbi.nlm.nih.gov/pubmed/32273394?tool=bestpractice.com
Routine referral for cognitive (psychometric) assessment is not recommended after mild TBI; careful assessment of the nature of the injury and symptoms, including bedside cognitive tests is more appropriate in the first instance.[55]van Gils A, Stone J, Welch K, et al. Management of mild traumatic brain injury. Pract Neurol. 2020 May;20(3):213-21.
http://www.ncbi.nlm.nih.gov/pubmed/32273394?tool=bestpractice.com
[68]Healthcare Improvement Scotland. Brain injury rehabilitation in adults: a national clinical guideline. Mar 2013 [internet publication].
https://www.sign.ac.uk/media/1068/sign130.pdf
[69]US Department of Veterans Affairs. VA/DoD clinical practice guidelines: management and rehabilitation of post-acute mild traumatic brain Injury (mTBI). 2021 [internet publication].
https://www.healthquality.va.gov/guidelines/rehab/mtbi/index.asp
Most guidelines support the use of formal sidelines or office-based cognitive testing for sports-related concussion.[3]Harmon KG, Clugston JR, Dec K, et al. American Medical Society for Sports Medicine position statement on concussion in sport. Br J Sports Med. 2019 Feb;53(4):213-25.
https://bjsm.bmj.com/content/53/4/213.long
http://www.ncbi.nlm.nih.gov/pubmed/30705232?tool=bestpractice.com
[5]Patricios JS, Schneider KJ, Dvorak J, et al. Consensus statement on concussion in sport: the 6th International Conference on concussion in sport-Amsterdam, October 2022. Br J Sports Med. 2023 Jun;57(11):695-711.
https://bjsm.bmj.com/content/57/11/695
http://www.ncbi.nlm.nih.gov/pubmed/37316210?tool=bestpractice.com
Neuropsychological testing involves paper-and-pencil or computerized tests assessing attention, memory, and executive functions, as well as reaction times. Cognitive performance can be affected by stress, fatigue, effort, and medications. Therefore, if testing is required, neuropsychological evaluations should be carried out by trained neuropsychologists who can disentangle the effects of these factors from the consequences of mild TBI. Neuropsychological testing can be used to delineate the effects of concussion as well as to monitor recovery. It is important to ensure that an appropriate amount of time has passed between testing sessions to guard against practice effects and uphold test validity. Although neuropsychological tests are an important component of mild TBI assessment, they should not be the only benchmark in making decisions about recovery from a mild TBI.