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Persistent post-concussion symptoms — MRCEM SBA MCQ

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HardConcussionPersistent post-concussion symptomsMRCEM SBA

A 23-year-old is reviewed 10 days after concussion with poor sleep, irritability and slowed concentration. Neurological examination is normal and there are no red flags. What is the most appropriate management?

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Correct answer: B — Use active symptom-targeted rehabilitation and graded return to activity

The best answer is “Use active symptom-targeted rehabilitation and graded return to activity”. Early concussion management favours relative rest followed by symptom-limited activity and targeted rehabilitation rather than prolonged complete rest. Sleep, mood, vestibular, cervical and cognitive symptoms should be assessed and treated as appropriate. Normal examination does not clear contact sport, while routine CT is not indicated without red flags or concern for structural injury.

Reference: British Journal of Sports Medicine: Amsterdam 2022 concussion consensus statement: https://bjsm.bmj.com/content/57/11/695