minimal traumatic brain injury (mTBI)

Keep Your Head when Dealing with Concussion


Dr. Aly Abdulla1
Adil Abdulla2
Neelam Charania3

1 is a family doctor with specialties in sports medicine, palliative care, and cosmetic medicine. He can be found on Twitter, LinkedIn and
2 is a law student at the University of Toronto that has suffered 13 concussions.
3 is a Masters in Occupational Therapy from Boston University and involved in managing and rehabilitating patients with chronic concussion syndrome.


Abstract: Concussion or minimal traumatic brain injury is a confusing medical condition that is more common than previously appreciated. At the Berlin congress in 2016, 3 key tools and 11 key processes have been developed to clarify this condition and ensure good outcomes. This article summarizes those recommendations in an easy to use format.
Key Words: Concussion, minimal traumatic brain injury (mTBI), symptoms, protocol.
Do the SCAT5 or cSCAT5 on everyone with a mTBI.
When thinking of concussion also consider cervical spine or neck injury and vestibular injury. Learn to differentiate them. Treat accordingly.
The patient should rest for 24–48 hours after the injury, then can be encouraged to become gradually and progressively more active while staying below their cognitive and physical symptom-ex-acerbation thresholds
Any patients having persistent concussive symptoms (> 14 days for an adult or > 30 days in a child) should be referred to a specialist in mTBI and prescribed active rehabilitation.
Have a high rate of suspicion for mTBI
Most mTBI are managed well with Remove from play, Re-evaluate in office using SCAT5, and Rest
Repeat clinical testing is de rigeur for Return to Play
Learn to manage symptoms like poor sleep, mood changes, and deconditioning while patients recover.
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