Background: Concussions have been increasingly reported over the past decade, but the reported incidence likely minimizes the actual numbers of people affected. Associated symptoms include emotional, somatic, and cognitive complaints, which may be prolonged in patients with certain risk factors. Neurologic examination is necessary to exclude upper motor neuron lesions and thus the need for brain imaging. Cervical conditions are often found concurrently with head injury and displays a similar presentation to concussions. Therefore, determining symptom origin can be problematic. Neuropsychological, oculomotor, and balance evaluations expose specific deficits that can be successfully managed with rehabilitation. Osteopathic assessment of the cranium, spine, sacrum, and thorax for somatic dysfunctions allows for prudent interventions. Patients involved in sports may begin an established graduated return-to-play protocol once cleared by their physician. Concurrently, a parallel return-to-learn program, with applicable academic accommodations, is recommended.
- Saccadic dysfunction is prevalent in patients with concussion and correlates with a poorer recovery.
- King-Devick testing offers a validated and objective 1- to 2-minute assessment of saccades, attention, and language.
- Persistent symptoms may include visual disturbances. Rehabilitation including visual, vestibular and cognitive therapy has demonstrated effectiveness in several postconcussion conditions.