What is a mild traumatic brain injury? An expert explains

Dr Colette Griffin is a renowned consultant neurologist based in London. In her latest article, Dr Griffin offers her expert insight into mild traumatic brain injuries.

What are the most common symptoms of a mild traumatic brain injury (concussion)?

Traumatic brain injury specialists do not use the term “concussion.” We use the term mild traumatic brain injury (TBI). These injuries are classified according to the Mayo Classification system. The most common symptoms of mild TBI are headache, dizziness, fatigue, disrupted sleep patterns, slowed thinking and feeling “dazed.”

Are there any lesser-known or atypical symptoms that should be taken into consideration?

Most people present with the symptoms outlined above. More atypical symptoms might be double vision, changes in emotion/mood and an inability to perform daily activities.

Could you explain the typical timeline for recovery from a concussion?

Peer-reviewed scientific data shows us that by 12 weeks post-injury, 80% of people will be symptom-free. The remaining 20% can take longer to recover. Pre-existing conditions such as migraine and psychological/psychiatric conditions may mean that the symptoms take longer to settle.

What factors can influence the duration and progression of recovery?

If people can rest (both cognitively and physically) then this will help recovery in the initial couple of weeks. If people rush back to both exercise and work, the symptoms may not settle as quickly. A paced gradual return to activities is very important.

What are the recommended initial assessments and diagnostic tests to confirm a concussion diagnosis?

Being reviewed by a Traumatic Brain Injury Specialist is important. The specialist will then take a detailed history, perform a clinical examination, and imaging of the brain as required.

Are there any specific red flags or indicators that may warrant further investigation or specialized imaging?

Red flags would be headache with nausea and vomiting, new symptoms of weakness of the face or limbs, drowsiness, speech problems, or any sign of the patient having new neurological symptoms. All these patients should undergo immediate imaging of the brain.

What treatment strategies do you typically employ for managing concussions?

A bespoke interdisciplinary team rehabilitation process is critical. Cognitive and physical rest followed by a gradual re-introduction of exercise and day-to-day activities is important.

Are there any new or emerging therapies or interventions that have shown promising results?

There are multiple therapies in development, but none that have been scientifically evaluated as yet.

When should a patient be referred to a specialist for further evaluation and management?

If a person has had two or more mild TBIs then they should be reviewed by a specialist. People often benefit from being reviewed by a specialist after the first mild TBI if their symptoms are not settling, if their symptoms are worsening, or if they wish to discuss ways to prevent further mild TBIs.

What are the key considerations for determining the need for specialized care?

If symptoms are not beginning to settle in the first three months, if a person has had two or more mild TBIs, or if there are any unusual new neurological symptoms, review by a specialist is crucial.

After the first mild TBI, people can often find it reassuring to be reviewed by a specialist at an early stage. Reassurance and guidance in a case-by-case bespoke manner are important components of the role of a TBI specialist.

Dr Colette Griffin is a leading consultant neurologist based in London. If you would like to book a consultation with Dr Griffin, you can do so today via her Top Doctors profile.