Long-Term Assessment of Concussion

  • Jonathan E. Romain


Postconcussion syndrome (PCS) refers to the presence of symptoms persisting typically days to a few weeks beyond the initial injury, whereas persistent postconcussion syndrome (PPCS) represents symptoms lasting greater than 3 months. The aim of this chapter is to review the history of and current research on persistent symptoms of concussion, while concurrently helping the reader to judiciously select and effectively utilize assessment tools in the identification and management of PCS. Research trends in developing assessment and management tools for PCS are reviewed. A discussion of the controversies in the literature regarding definitions and diagnostic criteria is inevitable, but is kept to a minimum except as it relates to the need for further research.


Traumatic Brain Injury Somatic Symptom Persistent Symptom Mild Traumatic Brain Injury Cognitive Complaint 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Achenbach, T. M. (1978). The classification of child psychopathology: A review and analysis of empirical efforts. Psychological Bulletin, 85, 1275–1301.PubMedCrossRefGoogle Scholar
  2. Alexander, M. P. (1995). Mild traumatic brain injury: the Pathophysiology, natural history, and clinical management. Neurology, 45, 1253–1260.PubMedGoogle Scholar
  3. Ayr, L. K., Yeates, K. O., Taylor, H. G., & Browne, M. (2009). Dimensions of postconcussive symptoms in children with mild traumatic brain injuries. Journal of the International Neuropsychological Society, 15, 19–30.PubMedCrossRefGoogle Scholar
  4. Bigler, E. D. (2008). Neuropsychology and clinical neuroscience of persistent post-concussive syndrome. Journal of the International Neuropsychological Society, 14, 1–22.PubMedCrossRefGoogle Scholar
  5. Boake, C., McCauley, S. R., Levin, H. S., et al. (2005). Diagnostic criteria for postconcussional syndrome after mild to moderate traumatic brain injury. The Journal of Neuropsychiatry and Clinical Neurosciences, 17, 350–356.PubMedCrossRefGoogle Scholar
  6. Carroll, L. J., Cassidy, J. D., Peloso, P. M., et al. (2004). WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Journal of Rehabilitation Medicine, 43, 84–105.PubMedCrossRefGoogle Scholar
  7. Casey, R., Ludwig, S., & McCormick, M. C. (1986). Morbidity following minor head trauma in children. Pediatrics, 78, 497–502.PubMedGoogle Scholar
  8. Fann, J., Uomoto, J. M., & Katon, W. J. (2001). Cognitive improvement with treatment of depression following mild traumatic brain injury. Psychosomatics, 42, 48–54.PubMedCrossRefGoogle Scholar
  9. Field, M., Collins, M. W., Lovell, M. R., & Maroon, J. (2003). Does age play a role in recovery from sports-related concussion? A comparison of high school in collegiate athletes. Journal of Pediatrics, 142, 546–553.PubMedCrossRefGoogle Scholar
  10. Ganesalingam, K., Yeates, K. O., Ginn, M. S., et al. (2008). Family burden and parental distress following mild traumatic brain injury in children and its relationship to post-concussive symptoms. Journal of Pediatric Psychology, 33(6), 621–629.PubMedCrossRefGoogle Scholar
  11. Gioia, G. A., Schneider, J. C., Vaughan, C. G., et al. (2009). Which symptom assessments and approaches are uniquely appropriate for paediatric concussion? British Journal of Sports Medicine, 43, i13–i22.PubMedCrossRefGoogle Scholar
  12. Guskiewicz, K. M., Bruce, S. L., Cantu, R. C., Ferrara, M. S., et al. (2004). National Athletic Trainers’ Association Position Statement: management of sport-related concussion. Journal of Athletic Training, 39, 280–297.PubMedGoogle Scholar
  13. Hall, R. C., Hall, R. C., & Chapman, M. J. (2005). Definition, diagnosis, and forensic implications of postconcussional syndrome. Psychosomatics, 46(3), 195–202.PubMedCrossRefGoogle Scholar
  14. Iverson, G. L. (2005). Outcome from mild traumatic brain injury. Current Opinions in Psychiatry, 18, 301–317.CrossRefGoogle Scholar
  15. Iverson, G. L., Brooks, B. L., Collins, M. W., & Lovell, M. R. (2006). Tracking neuropsychological recovery following concussion in sport. Brain Injury, 20, 245–252.PubMedCrossRefGoogle Scholar
  16. McCrea, M. A. (2008). Mild traumtic brain injury and postconcussion syndrome: the new evidence base for diagnosis and treatment. New York: Oxford Univeristy Press.Google Scholar
  17. McCrory, P. (2001). Does second impact syndrome exists? Clinical Journal of Sport Medicine, 11, 144–149.PubMedCrossRefGoogle Scholar
  18. Miller, L. J., & Mittenberg, W. (1998). Brief cognitive behavioral interventions in mild traumatic brain injury. Applied Neuropsychology, 5(4), 172–183.PubMedCrossRefGoogle Scholar
  19. Mittenberg, W., Wittner, M. S., & Miller, L. J. (1997). Postconcussion syndrome occurs in children. Neuropsychology, 11(3), 447–452.PubMedCrossRefGoogle Scholar
  20. Ommaya, A. K., & Gennarelli, T. A. (1974). Cerebral concussion and traumatic unconsciousness. Brain, 97, 633–654.PubMedCrossRefGoogle Scholar
  21. Ponsford, J. (2005). Rehabilitation interventions after mild head injury. Current Opinions in Neurology, 18, 692–697.CrossRefGoogle Scholar
  22. Randolph, C., Millis, S., Barr, W. B., McCrea, M., Guskiewicz, K. M., Hammeke, T. A., et al. (2009). Concussion symptom inventory: an empirically derived scale for monitoring resolution of symptoms following sport-related concussion. Archives of Clinical Neuropsychology, 24(3), 219–229.PubMedCrossRefGoogle Scholar
  23. Stovner, L. J., Schrader, H., Mickeviciene, D., Surkiene, D., & Sand, T. (2009). Headache after concussion. European Journal of Neurology, 16(1), 112–120.PubMedCrossRefGoogle Scholar
  24. Yarnell, P. R. (1970). Retrograde memory immediately after concussion. Lancet, 1, 863–864.PubMedCrossRefGoogle Scholar
  25. Yeates, K. O., Luria, J., Bartkowski, H., Rusin, J., Martin, L., & Bigler, E. D. (1999). Postconcussive symptoms in children with mild closed head injuries. The Journal of Head Trauma Rehabilitation, 14(4), 337–350.PubMedCrossRefGoogle Scholar
  26. Yeates, K. O., & Taylor, H. G. (2005). Neurobehavioural outcomes of mild head injury in children and adolescents. Pediatric Rehabilitation, 8(1), 5–16.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Psychiatry and Behavioral MedicineChildren’s Hospital of WisconsinMilwaukeeUSA

Personalised recommendations