Patients with a head injury, and their families and care providers, should be provided with verbal and printed discharge advice that is age appropriate and includes:
Details of the nature and severity of the injury
Red flags for seeking medical advice, including when to return to the emergency room,
A specification that a responsible adult should stay with the patient for the first 24 hours after their injury
Details about the recovery process, including the fact that some people may appear to make a quick recovery but later have difficulties or complications,
Contact details of community and hospital services in case of delayed complications
Information about return to everyday activities, including school, work, sports and driving
Details of support organizations.
Relative rest for the first 24-48 hours after a mild traumatic brain injury (TBI) is recommended.[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
[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
[100]Schneider KJ, Leddy JJ, Guskiewicz KM, et al. Rest and treatment/rehabilitation following sport-related concussion: a systematic review. Br J Sports Med. 2017 Jun;51(12):930-34.
https://bjsm.bmj.com/content/51/12/930
http://www.ncbi.nlm.nih.gov/pubmed/28341726?tool=bestpractice.com
Complete rest, such as lying in a dark room and avoiding all sensory stimuli (e.g., reading, interaction with others, etc.) does not accelerate recovery and is therefore not advisable.[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
[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
[100]Schneider KJ, Leddy JJ, Guskiewicz KM, et al. Rest and treatment/rehabilitation following sport-related concussion: a systematic review. Br J Sports Med. 2017 Jun;51(12):930-34.
https://bjsm.bmj.com/content/51/12/930
http://www.ncbi.nlm.nih.gov/pubmed/28341726?tool=bestpractice.com
[101]Silverberg ND, Iverson GL. Is rest after concussion "the best medicine?": recommendations for activity resumption following concussion in athletes, civilians, and military service members. J Head Trauma Rehabil. 2013 Jul-Aug;28(4):250-9.
http://www.ncbi.nlm.nih.gov/pubmed/22688215?tool=bestpractice.com
After an initial period of relative rest and symptom stabilization, patients should be encouraged to gradually resume normal daily activities (including screen time) as tolerated.[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
[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
Specific guidelines should be consulted for detailed guidance regarding return to school, sports, and military service.[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
[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
[102]McCulloch KL, Goldman S, Lowe L, et al. Development of clinical recommendations for progressive return to activity after military mild traumatic brain injury: guidance for rehabilitation providers. J Head Trauma Rehabil. 2015 Jan-Feb;30(1):56-67.
https://journals.lww.com/headtraumarehab/fulltext/2015/01000/development_of_clinical_recommendations_for.7.aspx
http://www.ncbi.nlm.nih.gov/pubmed/25563414?tool=bestpractice.com
To mitigate the risk of repeated mild TBI, patients should be counseled to not return to activities that involve a relatively high risk head impact exposure (e.g., collision sports) until they are clinically recovered.[94]Giza CC, Kutcher JS, Ashwal S, et al. Summary of evidence-based guideline update: evaluation and management of concussion in sports: report of the guideline development subcommittee of the American Academy of Neurology. Neurology. 2013 Jun 11;80(24):2250-57.
https://n.neurology.org/content/80/24/2250.long
http://www.ncbi.nlm.nih.gov/pubmed/23508730?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
[99]McCrory P, Meeuwisse W, Dvořák J, et al. Consensus statement on concussion in sport - the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017 Jun;51(11):838-47.
http://bjsm.bmj.com/content/51/11/838.long
Centers for Disease Control and Prevention: HEADSUP
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