Postconcussive Syndrome Psychiatric Care Questions & Answers

1. Azouvi P, Arnould A, Dromer E, Vallat-Azouvi C. Neuropsychology of traumatic brain injury: An expert overview. Revue Neurologique. 2017. 173:461-472. [QxMD MEDLINE Link].

2. Robert A Laskowski, Jennifer A Creed, and Ramesh Raghupathi. Pathophysiology of Mild TBI. Kobeissy FH. Brain Neurotrauma: Molecular, Neuropsychological, and Rehabilitation Aspects. Taylor and Francis; 2015.

3. Traumatic Brain Injury and PTSD. PTSD: National Center for PTSD. Available at https://www.ptsd.va.gov/understand/related/tbi_ptsd.asp. Accessed: July 7, 2019.

4. Caroline van Heugten, Irene Renaud, and Christine Resch. The role of early intervention in improving the level of activities and participation in youths after mild traumatic brain injury: a scoping review. Concussion. 2017. 2:[QxMD MEDLINE Link]. [Full Text].

5. Barry J. Hoffer, Chaim G. Pick, Michael E. Hoffer, Robert E. Becker, Yung-Hsiao Chiang and Nigel H. Greig. Repositioning drugs for traumatic brain injury - N-acetyl cysteine and Phenserine. Journal of Biomedical Science. 2017. 24:

6. Tarun Sahni, Madhur Jain, Rajendra Prasad, Shanti K. Sogani & Varindera. P. Singh. Use of hyperbaric oxygen in traumatic brain injury: Retrospective analysis of data of 20 patients treated at a tertiary care centre. British Journal of Neurosurgery. 2012. 26:

7. Amir Hadanny & Shai Efrati. Treatment of persistent post-concussion syndrome due to mild traumatic brain injury: current status and future directions. Expert Review of Neurotherapeutics. 2016. 16:

8. Talavage TM, Nauman E, Breedlove EL, Yoruk U, Dye AE, Morigaki K. Functionally-Detected Cognitive Impairment in High School Football Players Without Clinically-Diagnosed Concussion. J Neurotrauma. 2010 Oct 1. [QxMD MEDLINE Link].

9. Lincoln AE, Caswell SV, Almquist JL, Dunn RE, Norris JB, Hinton RY. Trends in concussion incidence in high school sports: a prospective 11-year study. Am J Sports Med. 2011 May. 39(5):958-63. [QxMD MEDLINE Link].

10. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Washington, DC: American Psychiatric Association; 2013.

11. Bigler ED. Neuropsychology and clinical neuroscience of persistent post-concussive syndrome. J Int Neuropsychol Soc. 2008 Jan. 14(1):1-22. [QxMD MEDLINE Link].

12. Govindaraju V, Gauger GE, Manley GT, Ebel A, Meeker M, Maudsley AA. Volumetric proton spectroscopic imaging of mild traumatic brain injury. AJNR Am J Neuroradiol. 2004 May. 25(5):730-7. [QxMD MEDLINE Link].

13. Hurley RA, McGowan JC, Arfanakis K, Taber KH. Traumatic axonal injury: novel insights into evolution and identification. J Neuropsychiatry Clin Neurosci. 2004 Winter. 16(1):1-7. [QxMD MEDLINE Link].

14. Gaetz M. The neurophysiology of brain injury. Clin Neurophysiol. 2004 Jan. 115(1):4-18. [QxMD MEDLINE Link].

15. Konrad C, Geburek AJ, Rist F, Blumenroth H, Fischer B, Husstedt I, et al. Long-term cognitive and emotional consequences of mild traumatic brain injury. Psychol Med. 2010 Sep 22. 1-15. [QxMD MEDLINE Link].

16. Hessen E, Nestvold K, Anderson V. Neuropsychological function 23 years after mild traumatic brain injury: a comparison of outcome after paediatric and adult head injuries. Brain Inj. 2007 Aug. 21(9):963-79. [QxMD MEDLINE Link].

17. Butler IJ. Postconcussion Syndrome After Mild Traumatic Brain Injury in Children and Adolescents Requires Further Detailed Study. JAMA Neurol. 2013 Mar 25. 1-2. [QxMD MEDLINE Link].

18. Auxéméry Y. [Mild traumatic brain injury and postconcussive syndrome: a re-emergent questioning]. Encephale. 2012 Sep. 38(4):329-35. [QxMD MEDLINE Link].

19. Smouha E. Inner ear disorders. NeuroRehabilitation. 2013 Jan 1. 32(3):455-62. [QxMD MEDLINE Link].

20. Currie S, Saleem N, Straiton JA, Macmullen-Price J, Warren DJ, Craven IJ. Imaging assessment of traumatic brain injury. Postgraduate Medicine Journal. 2016. 92:41-50. [QxMD MEDLINE Link]. [Full Text].

21. Jéssica Natuline Lanof and Renato Anghinah. Traumatic brain injury: An EEG point of view. Dementia and Neuropsychologia. 2017. 11:3-5. [QxMD MEDLINE Link]. [Full Text].

22. Buckley T, Munkasy B, Clouse B. Acute Cognitive and Physical Rest May Not Improve Concussion Recovery Time. J Head Trauma Rehabil. 2015. 31:233-241.

23. Scrimgeour AG, Condlin ML. Nutritional treatment for traumatic brain injury. J Neurotrauma. 2014. 31:989-999. [QxMD MEDLINE Link]. [Full Text].

24. Leddy JJ, Sandhu H, Sodhi V, Baker JG, Willer B. Rehabilitation of Concussion and Post-concussion Syndrome. Sports Health. 2012 Mar. 4(2):147-54. [QxMD MEDLINE Link]. [Full Text].

25. Bhatti Junaid, Nascimento Barto, Akhtar Umbreen, Rhind Shawn G., Tien Homer, Nathens Avery, et al. Systematic Review of Human and Animal Studies Examining the Efficacy and Safety of N-Acetylcysteine (NAC) and N-Acetylcysteine Amide (NACA) in Traumatic Brain Injury: Impact on Neurofunctional Outcome and Biomarkers of Oxidative Stress and Inflammation. Frontiers in Neurology. 2018. 8:744.

26. Bryant RA, O'Donnell ML, Creamer M, McFarlane AC, Clark CR, Silove D. The psychiatric sequelae of traumatic injury. Am J Psychiatry. 2010 Mar. 167(3):312-20. [QxMD MEDLINE Link].

27. Zatzick DF, Rivara FP, Jurkovich GJ, Hoge CW, Wang J, Fan MY, et al. Multisite Investigation of Traumatic Brain Injuries, Posttraumatic Stress Disorder, and Self-reported Health and Cognitive Impairments. Arch Gen Psychiatry. 2010 Dec. 67(12):1291-300. [QxMD MEDLINE Link].

28. Ashman TA, Gordon WA, Cantor JB, Hibbard MR. Neurobehavioral consequences of traumatic brain injury. Mt Sinai J Med. 2006 Nov. 73(7):999-1005. [QxMD MEDLINE Link].

29. Ashman TA, Spielman LA, Hibbard MR, et al. Psychiatric challenges in the first 6 years after traumatic brain injury: cross-sequential analyses of Axis I disorders. Arch Phys Med Rehabil. 2004 Apr. 85(4 Suppl 2):S36-42. [QxMD MEDLINE Link].

30. Bey T, Ostick B. Second impact syndrome. West J Emerg Med. 2009 Feb. 10(1):6-10. [QxMD MEDLINE Link].

31. Bigler ED, Brooks M. Traumatic brain injury and forensic neuropsychology. J Head Trauma Rehabil. 2009 Mar-Apr. 24(2):76-87. [QxMD MEDLINE Link].

32. Boake C, McCauley SR, Levin HS, Pedroza C, Contant CF, Song JX. Diagnostic criteria for postconcussional syndrome after mild to moderate traumatic brain injury. J Neuropsychiatry Clin Neurosci. 2005. 17(3):350-6. [QxMD MEDLINE Link].

33. Bruns JJ Jr, Jagoda AS. Mild traumatic brain injury. Mt Sinai J Med. 2009 Apr. 76(2):129-37. [QxMD MEDLINE Link].

34. Bryant RA. Disentangling mild traumatic brain injury and stress reactions. N Engl J Med. 2008 Jan 31. 358(5):525-7. [QxMD MEDLINE Link].

35. Donders J, Hanks R, Morgan J, Ricker J, Sweet J. Best practice guidelines for forensic neuropsychological examinations of patients with traumatic brain injury. J Head Trauma Rehabil. 2009 Sep-Oct. 24(5):413-4; discussion 414-8, author reply 418-9. [QxMD MEDLINE Link].

36. Eyres S, Carey A, Gilworth G, Neumann V, Tennant A. Construct validity and reliability of the Rivermead Post-Concussion Symptoms Questionnaire. Clin Rehabil. 2005 Dec. 19(8):878-87. [QxMD MEDLINE Link].

37. Foy K, Murphy KC. Post-concussion syndrome. Br J Hosp Med (Lond). 2009 Aug. 70(8):440-3. [QxMD MEDLINE Link].

38. Granacher RP Jr. Traumatic Brain Injury: Methods for Clinical and Forensic Neuropsychiatric Assessment, Second Edition. 2nd Edition. CRC; 2007.

39. Hall RC, Hall RC, Chapman MJ. Definition, diagnosis, and forensic implications of postconcussional syndrome. Psychosomatics. 2005 May-Jun. 46(3):195-202. [QxMD MEDLINE Link].

40. Harvey AG, Brewin CR, Jones C, Kopelman MD. Coexistence of posttraumatic stress disorder and traumatic brain injury: towards a resolution of the paradox. J Int Neuropsychol Soc. 2003 May. 9(4):663-76. [QxMD MEDLINE Link].

41. Helmick K. Cognitive rehabilitation for military personnel with mild traumatic brain injury and chronic post-concussional disorder: Results of April 2009 consensus conference. NeuroRehabilitation. 2010 Jan. 26(3):239-55. [QxMD MEDLINE Link].

42. Jorge RE, Robinson RG, Moser D, et al. Major depression following traumatic brain injury. Arch Gen Psychiatry. 2004 Jan. 61(1):42-50. [QxMD MEDLINE Link].

43. Kirkwood MW, Yeates KO, Wilson PE. Pediatric sport-related concussion: a review of the clinical management of an oft-neglected population. Pediatrics. 2006 Apr. 117(4):1359-71. [QxMD MEDLINE Link].

44. Landre N, Poppe CJ, Davis N, Schmaus B, Hobbs SE. Cognitive functioning and postconcussive symptoms in trauma patients with and without mild TBI. Arch Clin Neuropsychol. 2006 May. 21(4):255-73. [QxMD MEDLINE Link].

45. Larrabee G. Detection of symptom exaggeration with the MMPI-2 in litigants with malingered neurocognitive dysfunction. Clin Neuropsychol. 2003 Feb. 17(1):54-68. [QxMD MEDLINE Link].

46. McAllister TW, Arciniegas D. Evaluation and treatment of postconcussive symptoms. NeuroRehabilitation. 2002. 17(4):265-83. [QxMD MEDLINE Link].

47. McClincy MP, Lovell MR, Pardini J, Collins MW, Spore MK. Recovery from sports concussion in high school and collegiate athletes. Brain Inj. 2006 Jan. 20(1):33-9. [QxMD MEDLINE Link].

48. Mooney G, Speed J, Sheppard S. Factors related to recovery after mild traumatic brain injury. Brain Inj. 2005 Nov. 19(12):975-87. [QxMD MEDLINE Link].

49. Murrey G. The Forensic Evaluation of Traumatic Brain Injury: A Handbook for Clinicians and Attorneys, Second Edition. 2nd Edition. CRC; 2007. 2:

50. Neurobehavioral Guidelines Working Group, Warden DL, Gordon B, McAllister TW, Silver JM, Barth JT. Guidelines for the pharmacologic treatment of neurobehavioral sequelae of traumatic brain injury. J Neurotrauma. 2006 Oct. 23(10):1468-501. [QxMD MEDLINE Link].

51. Rao V, Lyketsos CG. Psychiatric aspects of traumatic brain injury. Psychiatr Clin North Am. 2002 Mar. 25(1):43-69. [QxMD MEDLINE Link].

52. Rapoport MJ, Herrmann N, Shammi P, Kiss A, Phillips A, Feinstein A. Outcome after traumatic brain injury sustained in older adulthood: a one-year longitudinal study. Am J Geriatr Psychiatry. 2007 May. 14(5):456-65.

53. Sahuquillo J, Vilalta A. Cooling the injured brain: how does moderate hypothermia influence the pathophysiology of traumatic brain injury. Curr Pharm Des. 2007. 13(22):2310-22. [QxMD MEDLINE Link].

54. Sheedy J, Geffen G, Donnelly J, Faux S. Emergency department assessment of mild traumatic brain injury and prediction of post-concussion symptoms at one month post injury. J Clin Exp Neuropsychol. 2006 Jul. 28(5):755-72. [QxMD MEDLINE Link].

55. Sheedy J, Harvey E, Faux S, Geffen G, Shores EA. Emergency department assessment of mild traumatic brain injury and the prediction of postconcussive symptoms: a 3-month prospective study. J Head Trauma Rehabil. 2009 Sep-Oct. 24(5):333-43. [QxMD MEDLINE Link].

56. Signorini DF, Alderson P. Therapeutic hypothermia for head injury. Cochrane Database Syst Rev. 2000. CD001048. [QxMD MEDLINE Link].

57. Smits M, Dippel DW, Houston GC, Wielopolski PA, Koudstaal PJ, Hunink MG, et al. Postconcussion syndrome after minor head injury: brain activation of working memory and attention. Hum Brain Mapp. 2009 Sep. 30(9):2789-803. [QxMD MEDLINE Link].

58. Stalnacke BM, Elgh E, Sojka P. One-year follow-up of mild traumatic brain injury: cognition, disability and life satisfaction of patients seeking consultation. J Rehabil Med. 2007 May. 39(5):405-11. [QxMD MEDLINE Link].

59. Taylor HG, Dietrich A, Nuss K, Wright M, Rusin J, Bangert B, et al. Post-concussive symptoms in children with mild traumatic brain injury. Neuropsychology. 2010 Mar. 24(2):148-59. [QxMD MEDLINE Link]. [Full Text].

60. Warriner EM, Rourke BP, Velikonja D, Metham L. Subtypes of emotional and behavioural sequelae in patients with traumatic brain injury. J Clin Exp Neuropsychol. 2003 Oct. 25(7):904-17. [QxMD MEDLINE Link].

61. Yudofsky SC. Textbook of Traumatic Brain Injury. 2nd Edition. American Psychiatric Publishing; 2004.

62. David B. Arciniegas MD (Author, Editor), Nathan D. Zasler MD (Author, Editor), Rodney D. Vanderploeg PhD (Author, Editor), Michael S. Jaffee MD (Author, Editor). Management of Adults With Traumatic Brain Injury. 1. Washington DC: American Psychiatric Publishing; 2013.

63. Traumatic Brain Injury: Methods for Clinical and Forensic Neuropsychiatric Assessment,Third Edition. 3. CRC; 2015.

64. Huber BR, Alosco ML, Stein TD, McKee AC. Potential Long-Term Consequences of Concussive and Subconcussive Injury. Phys Med Rehabil Clin N Am. 2016. 27(2):503-11.

65. Scott R. Laker. Concussion in Sports. Physical Medicine and Rehabilitation Clinics; 27: 373-538.

66. Renaud MI, Lambregts SA, de Kloet AJ, Catsman-Berrevoets CE, van de Port IG, van Heugten CM. Activities and participation of children and adolescents after mild traumatic brain injury and the effectiveness of an early intervention (Brains Ahead!): study protocol for a cohort study with a nested randomised controlled trial. Trials. 2016. 17(1):236.

67. Kerr ZY, Zuckerman SL, Wasserman EB, Covassin T, Djoko A, Dompier TP. Concussion Symptoms and Return to Play Time in Youth, High School, and College American Football Athletes. JAMA Pediatric. 2016.

68. into PS1, Poretti A, Meoded A, Tekes A, Huisman TA. The unique features of traumatic brain injury in children. Review of the characteristics of the pediatric skull and brain, mechanisms of trauma, patterns of injury, complications and their imaging findings--part 1. J Neuroimaging. 2012. 22(2):

69. Wang K, Cui D, Gao L. Traumatic brain injury: a review of characteristics, molecular basis and management. Frontiers of Bioscience. 2016. 21:890-9.

70. Main KL, Soman S, Pestilli F, et al. DTI measures identify mild and moderate TBI cases among patients with complex health problems: A receiver operating characteristic analysis of U.S. veterans. Neuroimage Clin. 2017. 16:1–16.

Roy H Lubit, MD, PhD Private Practice

Roy H Lubit, MD, PhD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

David Bienenfeld, MD Professor, Departments of Psychiatry and Geriatric Medicine, Wright State University, Boonshoft School of Medicine

David Bienenfeld, MD is a member of the following medical societies: American Medical Association, American Psychiatric Association, Association for Academic Psychiatry

Disclosure: Nothing to disclose.

Jennifer S Morse, MD Associate Medical Director, Optum Health

Jennifer S Morse, MD is a member of the following medical societies: Academy of Psychosomatic Medicine, Aerospace Medical Association, American Psychiatric Association

Disclosure: Nothing to disclose.

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author Julia Frank, MD to the development and writing of this article.

• Print this section
• Print the entire contents of
• Print the entire contents of article