Management of specific post-concussion problems

Below are the Centre for Disease Control (CDC)  recommendations for the management of several common symptoms following mTBI. See our helpful Expert Tips and Patient Information Leaflets sections for advice on how to manage these common symptoms.

• Healthcare professionals in the Emergency Department should clinically observe and consider obtaining a head CT in children seen with severe headache, especially when associated with other risk factors and worsening headache after mTBI, to evaluate for intracranial injury.
• Healthcare professionals and caregivers should offer nonopioid analgesia (ie, ibuprofen or acetaminophen) to children with painful headache but also provide counselling to the family regarding the risks of analgesic overuse, including rebound headache.  
• Chronic headache after mTBI is likely to be multifactorial; therefore, health care professionals should refer children with chronic headache after mTBI for multidisciplinary evaluation and treatment, with consideration of analgesic overuse as a contributory factor.  

• Healthcare professionals may refer children with subjective or objective evidence of persistent vestibular-oculomotor dysfunction after mTBI to a program of vestibular rehabilitation. This is ideally done by a physiotherapist with additional training in this area.

• Healthcare professionals should provide guidance on proper sleep hygiene methods to facilitate recovery from paediatric mTBI  
• If sleep problems emerge or continue despite appropriate sleep hygiene measures, health care professionals may refer children with mTBI to a sleep disorder specialist

• Health care professionals should attempt to determine the etiology of cognitive dysfunction within the context of other mTBI symptoms
• Health care professionals should recommend treatment for cognitive dysfunction that reflects its presumed etiology
• Health care professionals may refer children with persisting problems related to cognitive function for a formal neuropsychological evaluation to assist in determining the etiology and recommending targeted treatment through the Queensland Paediatric Rehabilitation Service.