Christina L. Master, MD; Andrew R. Mayer, PhD; Davin Quinn, MD; Matthew F. Grady, MD
CME Objective: To review current evidence for prevention, diagnosis, treatment, and prognosis of concussion.
Acknowledgment: The authors thank Laura Balcer, MD, and Michael Collins, PhD, who, along with Dr. Master, wrote the previous version of this In the Clinic.
Funding Source: American College of Physicians.
Disclosures: Dr. Master reports grant support from the Centers for Disease Control and Prevention, Department of Defense, the National Collegiate Athletic Association, and the National Institutes of Health/National Institute of Neurologic Diseases and Stroke. Dr. Mayer reports that he is 100% funded by grants from the National Institutes of Health, the Department of Defense, and the National Science Foundation. Dr. Quinn reports grants from the Department of Defense, the National Institutes of Health/National Institute of General Medical Sciences, and the National Institute of Mental Health outside the submitted work. Authors not named here have nothing to disclose. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-0544.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer and Johnson & Johnson.
With the assistance of additional physician writers, the editors of Annals of Internal Medicine develop In the Clinic using MKSAP and other resources of the American College of Physicians.
In the Clinic does not necessarily represent official ACP clinical policy. For ACP clinical guidelines, please go to https://www.acponline.org/clinical_information/guidelines/.
Concussions are a common injury for which patients often present first to primary care physicians. They can affect the day-to-day function of patients in school and work, as well as in sports and recreational activities. Recognizing common physical signs and symptoms after injury facilitates timely diagnosis and treatment, permitting initiation of an active management approach to recovery while preventing secondary injury. For persons with persistent symptoms, active rehabilitation may be utilized, with the goal of returning patients to full function.
Master CL, Mayer AR, Quinn D, Grady MF. Concussion. Ann Intern Med. 2018;169:ITC1–ITC16. doi: 10.7326/AITC201807030
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Published: Ann Intern Med. 2018;169(1):ITC1-ITC16.
Emergency Medicine, Neurology.
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